Type 1 insulin-dependent diabetes mellitus (IDDM) is an organ specific autoimmune disease affecting the pancreas. The presence of antibodies in diabetes screening is important in assessing the type of diabetes. However, they cannot be used to make a diagnosis as the presence of antibodies does not guarantee the development of IDDM as well as the reverse with some diabetes patients never developing detectable amounts (this is rare with 95% of cases testing positive for at least one).
Antibodies are specialized proteins found in the blood and other places in the body. Part of the immune systems functions, antibodies respond to foreign substances. When antibodies malfunction and attack the body’s own systems they are called autoantibodies. With IDDM, autoantibodies attack islet beta cells in the pancreas that produce insulin, causing deficiency. Four of the most common antibodies related to type 1 diabetes are: glutamic acid decarboxylase 65 antibodies (GADA), insulin antibodies (IAA), and insulinoma-associated-2 antibodies (IA-2A), islet cell antibodies (ICA). ICA are detected in nearly 80% of all newly diagnosed cases of diabetes.
Genetic Link of Antibodies in Diabetes Patients
The tendency to have autoantibodies is thought to be genetic. Research showed that first-degree relatives of people with IDDM who have ICA and a low insulin response to an intravenous injection of glucose have more than a 50% risk of developing the disease in five years. Currently there are no therapies to prevent the onset of IDDM however knowing the probability of developing the disease by looking at the prevalence of antibodies can prevent organ damage. The first symptoms of diabetes emerge when 80-90% of beta cells in the pancreas have been destroyed, creating hyperglycemia. High blood glucose levels result in the initial symptoms of diabetes such as increased thirst and urination as well as indicate the onset of organ damage.
Antibodies in Diabetes Detection
Ten percent of all cases of diabetes diagnosed are type 1 with most diagnosed before the age of 20. The antibodies that are found in children are often different than those found in adults. IAA is the most common antibody found in young children with diabetes, with 50% of cases testing positive. As the disease progresses it is often replaced by ICA, GADA, and IA-2A. Additional statistics show 95% of children diagnosed with type 1 diabetes have high levels of GADA and ISA and 25% of adults with type 2 have elevated levels. The significance of antibodies for type 2 patients is their presence may indicate a need for insulin in the future. Latent autoimmune diabetes of adulthood (LADA) is adult-onset diabetes that first appears as type 2 before manifesting as insulin-dependent diabetes.
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