RESUMO
The presence of multiple autoantibodies to different islet cell antigen including those to insulin autoantibodies [IAA] islet cell cytoplasm [ICA] and glutamic acid decarboxylase [GAD-Ab] were studied in 70 diabetic patients [30 cases of type I diabetes [IDDM], 30 cases of type II [NIDDM], 10 cases shifted from oral hypoglycemic therapy to insulin, in addition to 20 normal healthy controls]. All were subjected to fasting and postprandial plasma glucose, C-peptide level, glycosylated hemoglobin, insulin antibodies, islet cell cytoplasmic antibodies and glutamic acid decarboxylase antibodies. The obtained results showed that in IDDM group, 23.3% were positive for ICA, 40% were positive for GAD-Ab and 60% were positive for IAA. In NIDDM group, 23.7% were positive for ICA, 36.7% positive for GAD-Ab and 50% were positive for IAA. In the group of patients who shifted recently to insulin therapy, 30% were positive for ICA, 30% positive for GAD-Ab and 90% were positive for IAA. There was a positive correlation between glycosylated hemoglobin with the number of positive antibodies. Cases with no positive antibodies had a significant lower glycosylated hemoglobin level than those with one or more positive antibodies. It was concluded that the presence of both ICA and GAD-Ab was a stronger predictor of rapid B cell loss; hence, there was a more need for insulin therapy