ESPE Abstracts

Purpose: To assess the prevalence of pancreatic autoantibodies (Ab) and their impact on the course of type 2 diabetes mellitus (DM2) in adolescents.

Materials and methods: ICA, GADA, IA-2 and IAA were measured in 66 patients with DM2. Depending on the presence of autoantibodies (Ab) patients were divided into 2 groups: Ab^- and Ab⁺. HLA-typing was carried out in 45 patients. The secretion of C-peptide in the standard carbohydrate breakfast test (50 g carbohydrates) in the debut of the disease and after 1 year was studied.

Results: Specific Ab were detected in 15.2% (ICA – 9.1% and IAA – 6.1% in low titer (up to 20 IU/ml); GADA and IA-2 were not detected). Patients of 2 groups (Ab⁻, n=56, and Ab⁺, n=10) did not differ significantly in age of diagnosis, sex ratio, obesity degree, frequency of ‘acanthosis nigricans’. The frequency of HLA-haplotypes of high risk DM1 in Ab⁺ was higher (77.8% against 36.1%, P<0.05), but the frequency of HLA-genotypes of high risk DM1 in the two groups did not differ significantly. The level of HbA1c in the debut of DM was higher in Ab⁺(7.4% (7.0; 10.6) against 6.75% (6.1; 7.9), P<0.05), after 1 year HbA1c did not differ (6.4% (5.9; 7.8) and 6.1% (5.7; 6.8)). Basal level of C-peptide in the disease debut did not differ significantly (2.3 ng/ml (1,8; 4,0) in Ab⁺ and 3.4 ng/ml (1.9; 4.4) in Ab^-), the stimulated C-peptide level was higher by 120 min in Ab^- (3.2 ng/ml (3.0; 8.4) vs 15.6 ng/ml (5.1; 17.2), P<0.05). After 1 year the secretion did not differ. Insulin therapy in the debut of the disease received 40% of Ab⁺ and 25% - of Ab^-, P=0.3. Insulin therapy was not needed in any patient minimum 1 year from the diagnosis.

Conclusions: The incidence of pancreatic Ab in adolescents diagnosed with DM2 was 15.2%. In Ab⁺ patients in the debut of the disease, there is a lower secretion of C-peptide at a higher level of HbA1c, but after 1 year, the secretion of C-peptide increases, and HbA1c decreases to the level in patients Ab⁻. The presence of low titre ICA and IAA is not associated with the emergence of the need for insulin for 1 year minimum.

Keywords: Type 1 diabetes mellitus, type 2 diabetes mellitus, adolescents, autoantibody.