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Objective To study the clinic characters of patients with latent autoimmune diabetes in adults (LADA). Methods We evaluated the prevalence of acute and chronic complications in the LADA patients with serum antibodies to glutamic acid decarboxylase (GADA) or to islet cell cytoplasmic antigens (ICA). The prevalence of acute and chronic complications were further compared with that in patients with acute onset type 1 or type 2 diabetes. Results The mean age, BMI, fasting and postprandial C peptide levels of the LADA patients were higher than those of type 1 diabetes and lower than those of type 2 diabetes. Of the LADA patients, 29.3% had ketosis. Although the frequency of repeated attack of ketosis in the LADA patients was similar to that in type 1 diabetes, the duration from diabetic onset to first ketosis in the LADA patients was much longer. The prevalence of retinopathy in the LADA patients was 19.5%, which was similar to that in type 1 diabetes. The prevalence of cataract in the LADA patients was 48.8%, which was similar to that in type 2 diabetes. Less LADA patients had microalbuminuria, compared with the other groups. There was no difference in the prevalence of overt nephropathy, neuropathy and hyperlipidemia among the three groups. The prevalence of coronary heart disease in the LADA patients was similar to that in type 2 diabetes. The prevalence of hypertension in the LADA patients was higher than that in type 1 but lower than that in type 2 diabetes. Conclusion The clinic characters as well as acute and chronic complications in LADA patients are different from those in type 1 and type 2 diabetes.
RESUMO
To exclude the interfering factors in islet cell antibodies(ICA) determination some pretreatments on both pancreatic sections and serum samples were made. The results revealed that the islet structures of pretreated pancreatic frozen section appeared clearly. The positive rate of ICA by ABC enzyme-labelled method was higher than that by indirect immunofluorescence method. Comparing the ICA results of exchange sera provided by Immunology and Diabetes Workshop with the reference results,the validity、consistency、sensitivity and specificity was 81%、63%、75%and 88%, respectively. These results suggest that ABC method with the pretreated pancreatic frozen section is a stable method of ICA determination.
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A study on the ideal method for cryopreserving human fetal islet tissues was carried out. The viability and the secretory function of fetal islets cryopreserved with 1.0,1.5,and 2.0 mol/L DMSO and with balancing for 30 and 60 minutes under room temperature and 4℃ as well as the influence of different cooling rates were compared. The results of the study showed that the viability of islets cryopreserved with slow cooling rate at 0.3℃/min, was the best and the insulin content of the media and the amount of insulin secretion of the insulin releasing test were significantly higher than those of the control group.In addition,morphologic examination with HE and immunocytochemical staining showed that the morphology of the islets cryopreserved with 1.5 mol/L DMSO,balancing under 4℃ for 60 minutes and slow cooling rate was much better,i.e.the acinar cells appeared to be degenerated and necrosed,clusters of islets with insulin-positive cells and the ductule-like cells were clearly visible.
RESUMO
The positive rate of autoantibodies was 29.7% in 1617 diabetic patients. The positive rate of monoautoantibody was lower than that of combined assay with 3 autoantibodies. Combined assay of multiple autoantibodies may enhance the positivity of early diagnosis of type 1 diabetes mellitus. Glutamic acid decarboxylase antibody (GADA) may be a better screening test for predicting insulin dependency, the prediction of GADA combined with protein tyrosine phosphatase antibody may approximate to 100%, whereas islet cell antibody assay may be needed in the adolescent patients.