Impact of islet autoimmunity on the progressive β-cell functional decline in type 2 diabetes
BM Brooks-Worrell, EJ Boyko, JP Palmer - Diabetes Care, 2014 - Am Diabetes Assoc
BM Brooks-Worrell, EJ Boyko, JP Palmer
Diabetes Care, 2014•Am Diabetes AssocOBJECTIVE Cross-sectional studies have suggested that islet autoimmunity may be more
prevalent in type 2 diabetes (T2D) than previously appreciated and may contribute to the
progressive decline in β-cell function. In this study, we longitudinally evaluated the effect of
islet autoimmune development on the progressive β-cell dysfunction in T2D patients.
RESEARCH DESIGN AND METHODS Twenty-three T2D patients negative for islet
autoantibodies (GAD antibody and insulinoma-associated protein 2) and islet-specific T …
prevalent in type 2 diabetes (T2D) than previously appreciated and may contribute to the
progressive decline in β-cell function. In this study, we longitudinally evaluated the effect of
islet autoimmune development on the progressive β-cell dysfunction in T2D patients.
RESEARCH DESIGN AND METHODS Twenty-three T2D patients negative for islet
autoantibodies (GAD antibody and insulinoma-associated protein 2) and islet-specific T …
OBJECTIVE
Cross-sectional studies have suggested that islet autoimmunity may be more prevalent in type 2 diabetes (T2D) than previously appreciated and may contribute to the progressive decline in β-cell function. In this study, we longitudinally evaluated the effect of islet autoimmune development on the progressive β-cell dysfunction in T2D patients.
RESEARCH DESIGN AND METHODS
Twenty-three T2D patients negative for islet autoantibodies (GAD antibody and insulinoma-associated protein 2) and islet-specific T cells were evaluated prospectively for up to 36 months. We investigated the percentage of patients who developed islet autoantibodies (Ab+) and/or islet-reactive T cells (T+) and the effect of the islet autoimmunity on fasting and glucagon-stimulated C-peptide responses. We defined positive islet autoimmunity as Ab+ and/or T+ for at least two study visits.
RESULTS
Of the 23 patients, 6 (26%) remained negative for islet autoimmunity (Ab−T−), 14 (61%) developed Ab+ and/or T+, and 3 (13%) were unclassifiable because they developed islet autoimmunity at only one study visit. Islet Ab+ was observed to be less stable than islet-specific T-cell responses. Development of islet autoimmunity was significantly associated with a more rapid decline in fasting (P < 0.0001) and glucagon-stimulated (P < 0.05) C-peptide responses.
CONCLUSIONS
These pilot data suggest that the development of islet autoimmunity in T2D is associated with a significantly more rapid β-cell functional decline.
Am Diabetes Assoc