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Diabetes autoinmune del adulto en diabéticos tipo 2: frecuencia y características

Keywords: diabetes mellitus, non-insulin-dependent [genetics], diabetes mellitus, non-insulin dependent [immunology], adult, islets of langerhans.

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this paper was aimed at knowing the frequency, clinico-biochemical, immunologic and genetic characteristics of autoimmune diabetes in adults (lada) in 1 000 type 2 diabetic patients aged 35 or over with different times of duration of diabetes. glycemia, anti-pancreatic islet cell antibodies (ica), anti-gad65 antibodies, anti-ica512bdc/ia2 antibodies, anti-microsomal thyroid antibodies (amt), anti-gastric parietal antibodies (agp), antinuclear antibodies (an), microalbuminuria and peptide c during fasting were determined. these patients were surveyed and some clinical characteristics were registered. they were divided into 2 groups according to the presence of ica. all the type 2 + diabetics for anti-islet cell autoantibodies (ica and/or antigad65) were identified as lada. 3.4 % of type 2 ica + were detected. 22.0 % of type 2 ica - diabetics had anti-gad65 antibodies. it was found that type 2 ica + diabetics were younger, that their diabetes was shorter, that they had lower bmi, reduced levels of fasting peptide c, less dm2 history family (parents), lower values of diastolic and systolic arterial pressure, higher presence of anti-gad65 antibodies, amt and agp in comparison with type 2 ica - diabetics. it was observed that type 2 ica+ diabetics (lada) have specific characteristics that make them similar to type 1 diabetics, which would lead to important variations in their treatment and evolution as regards type 2 ica - diabetics. among the cuban type 2 diabetics it was detected a low frequency of ica and a high frequency of gad, which were different to those found in the caucasian populations. the anti-gad65 antibodies were higher than ica to detect lada. the clinical and immunological characteristics of these patients show the slow progression of the autoimmune destruction of b-cells with therapeutic implications.


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