scholarly journals Peer Review #2 of "A convenient diagnostic tool for discriminating adult-onset glutamic acid decarboxylase antibody-positive autoimmune diabetes from type 2 diabetes: a retrospective study (v0.1)"

2020 ◽  
Author(s):  
C Juhl
Keyword(s):  
Type 2 Diabetes ◽  
Retrospective Study ◽  
Glutamic Acid ◽  
Diagnostic Tool ◽  
Glutamic Acid Decarboxylase ◽  
Autoimmune Diabetes ◽  
Acid Decarboxylase ◽  
Adult Onset ◽  
Glutamic Acid Decarboxylase Antibody

scholarly journals A convenient diagnostic tool for discriminating adult-onset glutamic acid decarboxylase antibody-positive autoimmune diabetes from type 2 diabetes: a retrospective study

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8610
Author(s):  
Hon-Ke Sia ◽  
Shih-Te Tu ◽  
Pei-Yung Liao ◽  
Kuan-Han Lin ◽  
Chew-Teng Kor ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glutamic Acid Decarboxylase ◽  
Autoimmune Diabetes ◽  
Age At Onset ◽  
Acid Decarboxylase ◽  
Adult Onset ◽  
Discriminant Functions ◽  
Glutamic Acid Decarboxylase Antibody ◽  
Linear Discriminant

Background The glutamic acid decarboxylase antibody (GADA) test, commonly used to diagnose autoimmune diabetes, is not cost-effective in areas of low prevalence. The aim of this study was to develop a convenient tool to discriminate adult-onset GADA-positive autoimmune diabetes from type 2 diabetes (T2DM) in patients with newly diagnosed diabetes. Methods This retrospective cross-sectional study, conducted at Changhua Christian Hospital in Taiwan, collected electronic medical record data from January 2009 to December 2018. Patients were divided into a case group (GADA+, n = 152) and a reference group (T2DM, n = 358). Variables that differed significantly between the groups were subjected to receiver operator characteristic analysis to establish cutoff values. Discriminant function analysis was then employed to discriminate the two groups. Results At the onset of diabetes, the GADA+ group was younger, with lower body mass index (BMI), higher hemoglobin A1c (HbA1c), higher high-density lipoprotein cholesterol (HDL-C), and lower total cholesterol and triglycerides (TG). Five major factors were identified to form the linear discriminant functions: BMI, age at onset, TG, HDL-C, and HbA1c. BMI < 23 kg/m2 was the most important factor, followed by TG < 98 mg/dL, HDL-C ≥ 46 mg/dL, age at onset < 30 years, and HbA1c ≥ 8.6%. The overall accuracy of the linear discriminant functions was 87.1%, with 84.2% sensitivity and 88.3% specificity. Conclusions Routine tests in diabetes care were used to establish a convenient, low-cost tool that may assist in the early identification of adult-onset GAD+ autoimmune diabetes in clinical practice.

scholarly journals Combined treatment with sitagliptin and vitamin D in a patient with latent autoimmune diabetes in adults

2016 ◽  
Vol 2016 ◽  
Author(s):  
E Rapti ◽  
S Karras ◽  
M Grammatiki ◽  
A Mousiolis ◽  
X Tsekmekidou ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Glutamic Acid ◽  
Glutamic Acid Decarboxylase ◽  
Autoimmune Diabetes ◽  
Combined Treatment ◽  
Acid Decarboxylase ◽  
Latent Autoimmune Diabetes ◽  
Glutamic Acid Decarboxylase Antibodies

Summary Latent autoimmune diabetes in adults (LADA) is a relatively new type of diabetes with a clinical phenotype of type 2 diabetes (T2D) and an immunological milieu characterized by high titers of islet autoantibodies, resembling the immunological profile of type 1 diabetes (T1D). Herein, we report a case of a young male, diagnosed with LADA based on both clinical presentation and positive anti-glutamic acid decarboxylase antibodies (GAD-abs), which were normalized after combined treatment with a dipeptidyl peptidase-4 inhibitor (DPP-4) (sitagliptin) and cholecalciferol. Learning points Anti-glutamic acid decarboxylase antibodies (GAD-abs) titers in young patients being previously diagnosed as type 2 diabetes (T2D) may help establish the diagnosis of latent autoimmune diabetes in adults (LADA). Sitagliptin administration in patients with LADA might prolong the insulin-free period. Vitamin D administration in patients with LADA might have a protective effect on the progression of the disease.

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