Glutamic acid decarboxylase autoantibodies (GAD-A) and tyrosine phosphatase IA-2 autoantibodies (IA2-A) were measured in sera of 50 recently diagnosed (10 yr, 57% with onset age below 15 yr). More specific GADA assays are therefore needed. It has recently been suggested that the predictive value of these humoral markers is associated with the number of the studied antibodies directed against different pancreatic antigens (ICA, GADA, IA-2,A IAA). In the present study, 3-week-old female NOD mice were vaccinated twice in tibialis muscles with plasmid-DNA encoding 65-kDa GAD or betagalactosidase. The GAD gene markers were analyzed in relation to the presence of specific HLA types and GAD autoantibodies. The overall prevalence of GAD antibody and ICA positivity at the time of diagnosis was 9.0 and 3.8% in diabetic patients and 1.6 and 0% in the control population, respectively. The detection of antibodies against glutamic acid decarboxylase may serve a role in the early detection and treatment of type 1 diabetes.
Since she tested positive for the GAD antibodies, does this mean my daughter has a greater risk of developing type 1? Does that mean there is already “activity taking place?” I am just more confused now than ever. There was no significant correlation between ICA index and FCP. what does this mean? There are three major pancreatic antibodies that are “typically” checked for when assessing for common autoimmune, type 1 diabetes. Different laboratories do these tests differently and not all laboratories have reliably sensitive assays. Tobin’s team included graduate student Daniel Kaufman, now a UCLAprofessor in the department of molecular and medical pharmacology, and graduatestudent Mark Erlander, now executive vice president and chief scientificofficer of AviaraDx, a biotechnology company in Carlsbad, Calif.
I don’t know (nor do you, probably) which laboratory may have done your daughter’s tests. IMPORTANTLY, the tests themselves ARE NOT 100% predictive of the development of type 1 diabetes! One of antibodies is the “ICA,” which means “islet cell antibody.” A more sensitive/specific version of this test is the ICA-512 antibody test. The islet cell is the actual pancreatic cell that produces insulin. This test has widely been replaced with a more specific “IA2” test, which is an antibody to one of the kinase enzymes within the islet cell. So, the ICA-512 and IA2 tests are essentially the same. Another test is the IAA test (not to be confused with the IA2 test).
This is the insulin auto-antibody test. It is the least sensitive or specific, but often is detectable (“positive”) in younger children (under two years) with type 1 diabetes. The third test is the GAD (sometimes referred to as the GAD-65) antibody test.”GAD” stands for glutamic acid decarboxylase, another islet cell enzyme important in the production of insulin. GAD antibodies may be the most sensitive and specific antibodies to suggest RISK of type 1 diabetes. So,your daughter has been found to be positive for GAD antibodies. This indeed is a little bit of a concern, but I would emphasize a LITTLE BIT. The patient’ speech was fluent, and her articulation and prosody were normal.
The protocol was approved by an External Evaluation Committee convened by NIDDK and by the institutional review board of each participating center. But still, there is a risk. You know that smoking cigarettes is a risk for the development of lung cancer, a fairly strong risk factor. And, you probably know people who have smoked tobacco and have developed lung cancer. Screening visits (n = 1,211) were conducted from May 2004 to September 2008. And, you may even know of people who developed lung cancer who never smoked at all. Having GAD antibodies (and IA2) antibodies is a risk for the development of type 1 diabetes, but it is only a risk.
Anti-IAA assay has intra- and interassay CVs between 3.0 and 5.8% and 4.2 and 6.7%, respectively. The cross-sectional and retrospective data in this study showed that fasting C-peptide was a more sensitive indicator of insulin requirement than GADA positivity. The study was approved by the ethics committee of the Japan Diabetes Society. At present, there is NO PREVENTATIVE method for the person at risk for the development of type 1 diabetes. Your frequent monitoring in the face of lack of symptoms may only cause you and your family, especially your daughter, more anxiety and pain! So, unless you would want to explore an experimental protocol in the prevention of type 1 diabetes for people at high, high risk, I’d suggest that you only monitor periodically but keep a special eye out for symptoms of increased thirst and urination. On the other hand, if you are willing to participate all the way with an experimental research protocol in the prevention of type 1 diabetes for those at especially high risk, talk to your pediatric endocrinologist or explore on the Internet about TrialNet.
Research protocols have very strict inclusion and exclusion criteria, so your daughter may not even qualify. Good luck. Let us know what you find out. And please, be an informed parent, but I would ask you to not be too, too worried. If, for instance, your daughter does have a first degree relative (sibling or parent) who has type 1 diabetes, then, in general terms, she only has a 5% (1 in 20) chance of developing diabetes. Does she have 19 other brothers and sisters? Certainly, if the first degree relative has antibodies themselves and with your daughter’s positive GAD antibodies, the odds increase.
If there were second/third degree relatives (cousins, half-siblings, grandparents), the risks would go down some. So, I guess I’m saying “don’t panic.” Get information, like you are trying to do.