2 research outputs found
Islet Autoimmunity is Highly Prevalent and Associated With Diminished 尾-Cell Function in Patients With Type 2 Diabetes in the Grade Study
Islet autoimmunity may contribute to 尾-cell dysfunction in type 2 diabetes (T2D). Its prevalence and clinical significance have not been rigorously determined. In this ancillary study to the Glycemia Reduction Approaches in Diabetes-A Comparative Effectiveness (GRADE) Study, we investigated the prevalence of cellular and humoral islet autoimmunity in patients with T2D duration 4路0卤3路0 y, HbA1c 7路5卤0路5% on metformin alone. We measured T cell autoreactivity against islet proteins, islet autoantibodies against GAD65, IA2, ZnT8, and 尾-cell function. Cellular islet autoimmunity was present in 41路3%, humoral islet autoimmunity in 13路5%, and both in 5路3%. 尾-cell function calculated as iAUC-CG and 螖C-peptide(0- 30)/螖glucose(0-30) from an oral glucose tolerance test was lower among T cell-positives (T+) than T cell-negatives (T-) using two different adjustments for insulin sensitivity (iAUC-CG: 13路2% [95% CI 0路3, 24路4%] or 11路4% [95% CI 0路4, 21路2%] lower; 螖C-peptide(0-30)/螖glucose(0-30)) 19% [95% CI 3路1, 32路3%] or 17路7% [95% CI 2路6, 30路5%] lower). T+ patients had 17% higher HbA1c (95% CI 0路07, 0路28) and 7路7 mg/dL higher fasting plasma glucose levels (95% CI 0路2,15路3) than T- patients. We conclude that islet autoimmunity is much more prevalent in T2D patients than previously reported. T cell-mediated autoimmunity is associated with diminished 尾-cell function and worse glycemic control
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Islet Autoimmunity is Highly Prevalent and Associated With Diminished 尾-Cell Function in Patients With Type 2 Diabetes in the Grade Study.
Islet autoimmunity may contribute to 尾-cell dysfunction in type 2 diabetes (T2D). Its prevalence and clinical significance have not been rigorously determined. In this ancillary study to the Glycemia Reduction Approaches in Diabetes-A Comparative Effectiveness (GRADE) Study, we investigated the prevalence of cellular and humoral islet autoimmunity in patients with T2D duration 4路0卤3路0 y, HbA1c 7路5卤0路5% on metformin alone. We measured T cell autoreactivity against islet proteins, islet autoantibodies against GAD65, IA2, ZnT8, and 尾-cell function. Cellular islet autoimmunity was present in 41路3%, humoral islet autoimmunity in 13路5%, and both in 5路3%. 尾-cell function calculated as iAUC-CG and 螖C-peptide(0- 30)/螖glucose(0-30) from an oral glucose tolerance test was lower among T cell-positives (T+) than T cell-negatives (T-) using two different adjustments for insulin sensitivity (iAUC-CG: 13路2% [95% CI 0路3, 24路4%] or 11路4% [95% CI 0路4, 21路2%] lower; 螖C-peptide(0-30)/螖glucose(0-30)) 19% [95% CI 3路1, 32路3%] or 17路7% [95% CI 2路6, 30路5%] lower). T+ patients had 17% higher HbA1c (95% CI 0路07, 0路28) and 7路7 mg/dL higher fasting plasma glucose levels (95% CI 0路2,15路3) than T- patients. We conclude that islet autoimmunity is much more prevalent in T2D patients than previously reported. T cell-mediated autoimmunity is associated with diminished 尾-cell function and worse glycemic control