title: Clinical characteristics, GAD antibody (GADA) and change of C-peptide in Korean young age of onset diabetic patients.
abstract: OBJECTIVE
  To investigate the association of clinical and immunological markers with diabetes classification in newly diagnosed young diabetic patients at disease onset.
  
  
  METHODS
  Eighty-two diabetic patients recruited within 1 year of onset (mean age 23.0 +/- 7.1, M:F = 46:36) were divided into three groups, namely: a low fasting C-peptide (FC) level at baseline group (the low FC group (n = 14, FC < 0.18 nmol/l)), an intermediate FC group (n = 29, 0.18 nmol/l < or = FC < 0.37 nmol/l), and a high FC group (n = 39, 0.37 nmol/l < or = FC). Patients were reclassified at follow-up (mean follow-up period 3.7 +/- 1.4 years) in the same manner as described above into low FC group (n = 31), intermediate FC group (n = 20), and high FC group (n = 31). The clinical characteristics and prevalence of GADA were compared.
  
  
  RESULTS
  Patients in the high FC group at baseline had a higher body mass index (BMI), a higher frequency of a family history of diabetes, a higher meal-stimulated C-peptide increment, a lower frequency of ketonuria, a lower frequency of history of diabetic ketoacidosis, and a lower frequency of insulin therapy at diagnosis than those in the low and intermediate FC groups at baseline. Insulin secretory capacity, which was represented by fasting C-peptide, was affected by BMI at diagnosis and the presence of GADA. All the patients of the low FC group on follow-up were finally classified as having Type 1 diabetes; moreover, the factors that determined the type of diabetes were lower BMI at onset, GADA positivity, insulin therapy, lower fasting C-peptide level and lower meal-stimulated C-peptide increment at initial admission.
  
  
  CONCLUSIONS
  Our study suggests that follow-up involving C-peptide and GADA measurements in combination with clinical characteristics is useful for discriminating between the types of diabetes in these groups.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. kenardy@psy.uq.edu.au
authors.forename: C W
authors.initials: CW
authors.lastname: Ahn
authors.forename: H S
authors.initials: HS
authors.lastname: Kim
authors.forename: J H
authors.initials: JH
authors.lastname: Nam
authors.forename: Y D
authors.initials: YD
authors.lastname: Song
authors.forename: S K
authors.initials: SK
authors.lastname: Lim
authors.forename: K R
authors.initials: KR
authors.lastname: Kim
authors.forename: H C
authors.initials: HC
authors.lastname: Lee
authors.forename: K B
authors.initials: KB
authors.lastname: Huh
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D044466:Asian People; D001323:Autoantibodies / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy / Q000276:immunology*; D005215:Fasting; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D007723:Korea; D008297:Male
chemical_list: D001323:Autoantibodies; D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D005968:Glutamate Decarboxylase