Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Feb 13:9:32.
doi: 10.3389/fendo.2018.00032. eCollection 2018.

Islet Cell Associated Autoantibodies and C-Peptide Levels in Patients with Diabetes and Symptoms of Gastroparesis

Elias S Siraj  1 , Carol Homko  2 , Laura A Wilson  3 , Patrick May  3 , Ajay D Rao  2 , Jorge Calles  4 , Gianrico Farrugia  5 , William L Hasler  6 , Kenneth L Koch  7 , Linda Nguyen  8 , William J Snape  9 , Thomas L Abell  10 , Irene Sarosiek  11 , Richard W McCallum  11 , Pankaj J Pasricha  3 , John Clarke  3 , James Tonascia  3 , Frank Hamilton  12 , Henry P Parkman  2
Affiliations

Islet Cell Associated Autoantibodies and C-Peptide Levels in Patients with Diabetes and Symptoms of Gastroparesis

Elias S Siraj et al. Front Endocrinol (Lausanne). .

Abstract

Introduction: Individuals with diabetes are at increased risk for complications, including gastroparesis. Type 1 diabetes mellitus (T1DM) is an autoimmune disorder resulting in decreased beta-cell function. Glutamic acid decarboxylase-65 antibody (GADA) is the most commonly used test to assess autoimmunity while C-peptide level is used to assess beta-cell function. Patients with type 2 diabetes mellitus (T2DM), who are GADA positive, are labeled latent autoimmune diabetes in adults (LADA).

Objective: To characterize patients with T1 and T2DM who have symptoms of gastroparesis using GADA and C-peptide levels and to look for association with the presence of gastroparesis and its symptom severity.

Design: 113 T1DM and 90 T2DM patients with symptoms suggestive of gastroparesis were studied. Symptom severity was assessed using Gastroparesis Cardinal Symptom Index (GCSI). Serum samples were analyzed for GADA and C-peptide.

Results: Delayed gastric emptying was present in 91 (81%) of T1DM and 60 (67%) of T2DM patients (p = 0.04). GADA was present in 13% of T2DM subjects [10% in delayed gastric emptying and 20% in normal gastric emptying (p = 0.2)]. Gastric retention and GCSI scores were mostly similar in GADA positive and negative T2DM patients. GADA was present in 45% of T1DM subjects [46% in delayed gastric emptying and 41% in normal gastric emptying (p = 0.81)]. Low C-peptide levels were seen in 79% T1DM patients and 8% T2DM. All seven T2DM patients with low C-peptide were taking insulin compared to 52% of T2DM with normal C-peptide.

Conclusion: GADA was present in 13% while low C-peptide was seen in 8% of our T2DM patients with symptoms of gastroparesis. Neither did correlate with degree of delayed gastric emptying or symptom severity.

Clinicaltrialsgov identifier: NCT01696747.

Keywords: C-peptide; GAD; GAD65; GAD65 antibodies; diabetic gastroparesis; gastric emptying; gastroparesis; islet cell antibodies.

PubMed Disclaimer

References

    1. Leslie RDG, Kolb H, Schollot NC, Buzzetti R, Mauricio D, De Leiva A, et al. Diabetes classification: grey zones, sound and smoke: action LADA. Diabetes Metab Res Rev (2008) 24:511–9.10.1002/dmrr.877 - DOI - PubMed
    1. Zinman B, Kahn SE, Haffner SM, O’Neill MC, Heise MA, Freed MI. Phenotypic characteristics of GAD antibody-positive recently diagnosed patients with type 2 diabetes in North America and Europe. Diabetes (2004) 53:3193–201.10.2337/diabetes.53.12.3193 - DOI - PubMed
    1. Hawa MI, Buchan AP, Ola T, Wun CC, DeMicco DA, Bao W, et al. LADA and CARDS: a prospective study of clinical outcome in established adult-onset autoimmune diabetes. Diabetes Care (2014) 37:1643–9.10.2337/dc13-2383 - DOI - PubMed
    1. Arikan E, Sabuncu T, Ozer EM, Hatemi H. The clinical characteristics of latent autoimmune diabetes in adults and is relation with chronic complications in metabolically poor controlled Turkish patients with Type 2 diabetes mellitus. J Diabetes Complication (2005) 19:254–8.10.1016/j.jdiacomp.2005.02.004 - DOI - PubMed
    1. Andersen CD, Bennet L, Nyström L, Lindblad U, Lindholm E, Groop L, et al. Worse glycaemic control in LADA patients than in those with type 2 diabetes, despite a longer time on insulin therapy. Diabetologia (2013) 56:252–8.10.1007/s00125-012-2759-y - DOI - PubMed

Associated data

LinkOut - more resources