Author/Authors :
Bassyouni, Atef Cairo University - Faculty of Medicine - Department of lnternal Medicine NIDE, Egypt , El Ebrashy, Ibrahim Cairo University - Faculty of Medicine, Egypt , Salam, Gamal Cairo University - Faculty of Medicine - Department of lnternal Medicine NIDE, Egypt , Amam, Sayed Cairo University - Faculty of Medicine - Department of lnternal Medicine NIDE, Egypt , Abdella, Aly Cairo University - Faculty of Medicine - Department of lnternal Medicine NIDE, Egypt , Mahfouz, Amr Cairo University - Faculty of Medicine - Department of lnternal Medicine NIDE, Egypt , Hussein, Ghada Cairo University - Faculty of Medicine - Department of Clinical and Chemical Pathology NIDE, Egypt
Abstract :
Introduction: Several studies have been performed in order to evaluate the prevalence of autoimmunity to β-cells in patients with adult onset diabetes and have been based on screening for ICA and/or GADA. In these studies, the prevalence of autoimmune diabetes ranged from 8 to 45%, according to different populations and selection criteria. The aim of our study was to evaluate the prevalence of anti GAD antibody and to characterize the phenotype of patients with adult-onset, clinically diagnosed type 2 diabetes attending the outpatient clinics at The National Institute of Diabetes Endocrinology (NIDE) Cairo Egypt. Design and methods: A total of 500 Egyptian patients clinically diagnosed as T2DM and treated with insidin were studied. Inclusion criteria included: diagnosis of T2DM at age of ≥35 years, the lack of a requirement for insulin at least 6 months after the diagnosis of T2DMand age at recruitment 20 years. Anthropometric and clinical data were collected and compared amongst patients with or without autoantibodies. Beside routine investigations, both C peptide level presence of glutamic acid decarboxylase antibodies were also assessed in these patients. Results: Out of a total of 500 patients, GADA were found in 159 (31.8%). Age at diagnosis of DM, FPG and LDL C peptide level were significantly higher among patients without GADA while among those with GADA the frequency offemale sex was significantly higher. The female sex low C peptide level were predictors of presence of GADA among this group ofpatients. Conclusion: The prevalence of GADA (as a marker of autoimmune diabetes) among the insulin treating patients with adult-onset, clinically diagnosed T2DM attending the outpatient clinics at The NIDE is high (31.8%). The clinical phenotype may not help to characterize these patients the determination of GADA particularly in females those with low C peptide level represents the best tool for a correct classification and a necessary prerequisite for a correct therapeutic appraisal.
