The potential of anti-glutamic acid decarboxylase antibodies to support a diagnosis of autoimmune diabetes mellitus.

Autor: Liepert M; Division of General Internal Medicine, Department of Medicine, The Ottawa Hospital, University of Ottawa, 501 Smyth Rd, Ottawa, Ontario, K1H 8L6, Canada. Electronic address: mliepert@toh.ca., Alhaqqan S; Division of General Internal Medicine, Department of Medicine, The Ottawa Hospital, University of Ottawa, 501 Smyth Rd, Ottawa, Ontario, K1H 8L6, Canada. Electronic address: salhaqqan@toh.ca., Husain A; Division of Endocrinology and Metabolism, Department of Medicine, The Ottawa Hospital, University of Ottawa, 1967 Riverside Drive, Ottawa, Ontario, K1H 7W9, Canada. Electronic address: alhusain@toh.ca., Lochnan H; Division of Endocrinology and Metabolism, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa Hospital Research Institute, 1967 Riverside Drive 4th Floor Endocrinology, Ottawa, Ontario, K1H 7W9, Canada. Electronic address: hlochnan@toh.ca., Booth RA; Division of Biochemistry, Department of Pathology and Laboratory Medicine, The Ottawa Hospital, 501 Smyth Rd, Ottawa, Ontario, K1H 8L6, Canada. Electronic address: rbooth@uottawa.ca., Shaw J; Division of Biochemistry, Department of Pathology and Laboratory Medicine, The Ottawa Hospital, 501 Smyth Rd, Ottawa, Ontario, K1H 8L6, Canada. Electronic address: julshaw@eorla.ca., Sun CJ; Division of Endocrinology and Metabolism, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa Hospital Research Institute, 1967 Riverside Drive 4th Floor Endocrinology, Ottawa, Ontario, K1H 7W9, Canada. Electronic address: csun@toh.ca.
Jazyk: angličtina
Zdroj: Clinical biochemistry [Clin Biochem] 2024 Nov 15, pp. 110842. Date of Electronic Publication: 2024 Nov 15.
DOI: 10.1016/j.clinbiochem.2024.110842
Abstrakt: Objective: Anti-glutamic acid decarboxylase (anti-GAD) antibodies are a frequently used diagnostic marker for autoimmune forms of diabetes mellitus (DM), namely, type 1 diabetes mellitus (T1DM) and latent autoimmune diabetes in adults (LADA). We sought to provide insight into a unique diagnostic application of anti-GAD antibodies in patients potentially misdiagnosed with type 2 diabetes mellitus (T2DM).
Methods: We present a case series of patients who had a change in diagnosis from T2DM to autoimmune DM that was supported by positive anti-GAD antibodies. Patients were identified via a retrospective chart review of all anti-GAD antibodies tests ordered between 1 January 2020 and 31 December 2021 at a tertiary care academic hospital.
Results: Of the 23 patients with previous diagnosis of T2DM, positive anti-GAD antibodies supported the clinician's decision to change the diagnosis to autoimmune DM. The prominent clinical reasons for ordering anti-GAD antibodies in patients previously diagnosed as T2DM were patient presentation with diabetic ketoacidosis, features of insulin insufficiency, inadequate effect of oral diabetes mellitus medications, young age at diagnosis, and a family history of autoimmune conditions.
Conclusion: Anti-GAD antibodies' positivity can support a change in diagnosis from T2DM to autoimmune DM, which has substantial impact on patient care. Timely and reliable clinical laboratory reporting of anti-GAD antibodies is highly recommended.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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