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J Diabetes Complications. 2004 Jan-Feb;18(1):10-7.

Immune-mediated disease and secondary failure to oral therapy in type 2 diabetes mellitus.

Author information

1
Department of Internal Medicine, The University of Texas Southwestern Medical Center at Dallas, Parkland Health and Hospital System 5323 Harry Hines Boulevard G5.238, Dallas, TX 75390-8858, USA. maines.aviles-santa@utsouthwestern.edu

Abstract

PURPOSE:

To determine the proportion of adults with type 2 diabetes, who developed secondary failure to oral medications that had immune-mediated diabetes (IMD).

SUBJECTS AND METHODS:

One hundred and eight subjects who failed to oral therapy were screened for autoantibodies (ICA, IAA, IA-2A, and GADA(65)) and HLA DR/DQ markers of IMD.

RESULTS:

Mean age was 49 years and mean body mass index (BMI) was 31.5 kg/m(2); 21.3% were non-Hispanic White (NHW), 32.3% Latin American (LA), and 43.2% African American (AA). Fourteen percent had one or more autoantibodies [Ab(+)]: five NHW, three LA, and seven AA. Ab(+) patients were younger (P=.03) and had lower body weight (P=.05) than Ab(-) patients. HLA markers of susceptibility for IMD were identified in 64% Ab(+) and in 43% Ab(-) (chi(2), P=.46).

CONCLUSIONS:

These results suggest that secondary failure to oral therapy can be due to continuing IMD in obese, type 2 diabetic individuals of varying ethnic backgrounds than those who have been traditionally associated with autoimmune type 1 diabetes. Screening for markers for IMD at diagnosis could be a useful way to predict those likely to develop secondary failure to oral therapy and may assist in the selection of medical therapy.

PMID:
15019594
DOI:
10.1016/S1056-8727(02)00253-2
[Indexed for MEDLINE]

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