ESPE Abstracts (2018) 89 P-P1-089

Endocrinology Research Center, Moscow, Russian Federation

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.

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