Serum C-peptide levels in young ketosis-resistant diabetics.
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Biomedical subjects
Publications and source records attributed to M M Ahuja.
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In a multinational study, fasting plasma glucose values in 3583 diabetic patients, aged 34-56 years, were related to the characteristics of these subjects and to the presence and severity of microangiopathy as ascertained by standardised methods. The patients were from nine different populations and ranged in number from 193 to 686 per population (London, Warsaw, Berlin (FRG), New Delhi, Tokyo, Havana, Oklahoma Indians, Arizona Pima Indians, and a national sample in Switzerland). In the total group, mean fasting plasma glucose was 8.1 mmol/l for those on diet alone, 9.7 mmol/l for those on oral agents, and 12.7 mmol/l for insulin-treated patients, of whom 25% had values exceeding 16.5 mmol/l. Since many variables were measured in each patient, it was possible to take into account many confounding factors in evaluating the relationship of plasma glucose levels to retinopathy and nephropathy.
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Pancreatic islet cell, thyroid, gastric parietal cell, and adrenal autoantibodies were studied in 110 young insulin-dependent diabetics (type I; IDDM), 12 non-insulin-dependent diabetics (NIDDM), 26 patients with pancreatic diabetes, and 123 age- and sex-matched healthy controls. All the patients were aged 30 years or under at the onset of diabetes. Islet cell antibody was found in 31% of the patients with IDDM, but in only one patient with NIDDM, one patient with pancreatic diabetes, and one healthy control subject. Thyroid, parietal cell, and/or adrenal antibodies were present in 26% of the IDDM patients, 17% of the NIDDM patients, 12% of the patients with pancreatic diabetes, and 19% of the control subjects. There was no association between the presence of islet cell antibody and other organ-specific autoantibodies and any particular HLA phenotype. Data from the North Indian study have been compared with those from other populations of the world, similarities and differences have been brought out, and their significance has been discussed. The relative contribution of the autoimmune component in the etiopathogenesis of different forms of diabetes mellitus varies among the different populations of the world, accounting to some extent for the observed differences in incidence and clinical profiles.
Fifty-four North Indian patients with Type I (Insulin-Dependent) diabetes mellitus who were aged 30 yr or under at onset were HLA-typed. The frequencies of HLA-BW21, BW35, and A28 were significantly increased and that of HLA-B7 was significantly reduced. On correction for the number of antigens tested, only the difference observed with HLA-BW21 for positive association and B7 for negative association remained statistically significant. HLA-B8, B15 and B18 did not demonstrate any significant association with IDDM in this series of patients. The results of the study further emphasize the well recognized race specificity in HLA antigen distribution in normal population as well as disease states. This association of HLA-BW21 with IDDM is the first report from North India.
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