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Review
. 2018 Dec 15;57(24):3581-3587.
doi: 10.2169/internalmedicine.1008-18. Epub 2018 Aug 10.

Glutamic Acid Decarboxylase Autoantibody-negative Slowly Progressive Type 1 Diabetes Mellitus: A Case Report and Literature Review

Michi Kobayashi  1 , Nobumasa Ohara  1 , Yohei Ikeda  2 , Ouki Nagano  3 , Toshinori Takada  4 , Makoto Kodama  5 , Hirohito Sone  6
Affiliations
Review

Glutamic Acid Decarboxylase Autoantibody-negative Slowly Progressive Type 1 Diabetes Mellitus: A Case Report and Literature Review

Michi Kobayashi et al. Intern Med. .

Abstract

A 59-year-old non-obese Japanese woman developed diabetes mellitus with a negative glutamic acid decarboxylase autoantibody (GADA) test result. Her hyperglycemia was initially well controlled by oral hypoglycemic agents; however, despite continued treatment the hyperglycemia gradually worsened. As she had endogenous insulin deficiency and tested positive for insulin autoantibody (IAA), insulin therapy was initiated. Few studies have investigated GADA-negative patients with slowly progressive type 1 diabetes mellitus (SPT1D). Our IAA-positive SPT1D patient progressed from the clinical onset of diabetes mellitus to starting insulin therapy relatively quickly (1.5 years), similarly to other previously reported non-obese patients with GADA-positive SPT1D.

Keywords: C-peptide immunoreactivity; human leukocyte antigen; insulin autoantibody; type 1 diabetes mellitus.

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Figures

Figure.
Figure.
Clinical course. The patient had not received insulin therapy before May 2017, when she was diagnosed with slowly progressive type 1 diabetes mellitus associated with decreased endogenous insulin secretion, tested positive for insulin autoantibodies, and started insulin therapy. BW: body weight, HbA1c: glycated hemoglobin
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