What are the characteristics of phenotypic type 2 diabetic patients with low-titer GAD65 antibodies?

Mahadeb , Yovan Parikshat;Gruson, Damien;Buysschaert, Martin;Hermans, Michel
(2014) Acta Diabetologica : an international journal devoted to the study of clinical and experimental diabetes and metabolism — Vol. 51, n° 1, p. 103-111 (2014)

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Abstract
Type 2 diabetes results from combined insulin resistance and β-cell deficiency. Type 1 diabetes results from β-cell destruction associated with islet autoantibodies, including those directed against glutamate decarboxylase (GAD65 antibodies [GADA]). Clinical impact of low GADA positivity (<60 U/ml) in type 2 diabetes is debated, being rarely performed in routine care. The aim of our study was to determine the prevalence and cardiometabolic/autoimmune phenotype of GADA[+] patients. 524 type 2 diabetes consecutive outpatients were assessed for glucose homeostasis using homeostasis model assessment (HOMA): insulin sensitivity (HOMA S); β-cell function (HOMA B) and annualized loss in [BXS]. GADA prevalence was 6% (n = 30). There were no differences between groups for age, diabetes duration and family history of diabetes. There were proportionately more women (33 vs. 53%) in GADA[+]. There were no differences in body mass index, waist circumference or visceral fat. HOMA S was lower than normal, with no difference between groups, as was HOMA B. Annualized rate of [BXS] loss was 1.26%/year (GADA[+]) versus 1.34%/year (GADA[-]; NS). HbA1c was 7.8% (GADA[+]) versus 7.6% (GADA[-]; NS). Among all patients, prevalence of autoimmune thyroid disease was 10%. In GADA[+], this prevalence was significantly increased and equally affected both sexes: 29% (men) versus 25% (women), while for GADA[-] the prevalence was 5% (men) versus 18% (women; p < 0.0001). Low-titer GADA autoimmunity among type 2 diabetes patients was not associated with accelerated β-cell function, nor with any distinctive cardiometabolic phenotype, but for a markedly increased prevalence of autoimmune thyroid disease, especially among men.
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Mahadeb, Y. P., Gruson, D., Buysschaert, M., & Hermans, M. (2014). What are the characteristics of phenotypic type 2 diabetic patients with low-titer GAD65 antibodies? Acta Diabetologica : an international journal devoted to the study of clinical and experimental diabetes and metabolism, 51(1), 103-111. https://doi.org/10.1007/s00592-013-0513-7 (Original work published 2014)