Mintage Journal of Pharmaceutical and Medical Sciences (ISSN: 2320-3315)

Author(s): AIF A. MAKALAF*1, ORUBA K. ABBAS2, MEDIAN A. HUSSEIN

Background:Latent  autoimmune  diabetes  in  adults  (LADA)  accounts  for  2%-12%  of  all  cases  of  diabetes.  Patients  are  typically  diagnosed  after  35  years  of  age  and  are often misdiagnosed as type IIDiabetes Mellitus (DM). Glycemic control is initially achieved with sulfonylureas but patients eventually become insulin dependent more rapidly than  with  type IIDM  patients.  Although  they  have  a  type IIDM  phenotype,  patients  have  circulating  beta  (β)  cell  autoantibodies,  a  hallmark  of  type IDM.  Alternative terms  that  have  been  used  to  describe  this condition  include  type  1.5  diabetes,  latent  type Idiabetes,  slowly  progressive  Insulin  Dependent  Diabetes  Mellitus,  or  youth onset diabetes of maturity. With regards to its autoimmune basis and rapid requirement for insulin, it has been suggested that LADA is a slowly progressive form of type IDM.Objective:Theobjective of the present study was to evaluate the ratio of Latent Autoimmune Diabetes of Adults (LADA) patients among Iraqi type II DM, To quantify the association between H. pylori infection and(LADA) patients and To detection of H. Pylori IgG and detection of its virulence factors (anti-CagA and anti-VacA) and which of them is more prevalence with H. pylori positive samples.Methods:A total of 350 patients with type II DM admitted to National Diabetes center of AL-Mustansiriyah University/ Al-Yarmouk/  Baghdad.  Blood  sample  where  collected  from  350  patients  and  serum  sample  collected  from  these  patients  and  40  healthy  persons.  Radioimmunoassay technique using  to  identify  the  C-peptide serum  levels of  these patients,  ELISA  technique  for detection  of anti-GAD65,  anti-H.pylori IgG,  anti-CagA and anti-VacA, also  the Blood HbA1c  concentration were  measured.Results:Thediagnosis  of LADA patients  was  based  on  clinical findings,  immunological and  chemical analysis  of  blood.  Fifty-seven  of  patients  were  have  low  C-peptide  serum  level,  from  which,  40  patients  were  have  autoantibody  to  Glutamic  Acid  Decarboxylase  (Anti-GAD65  Ab)  diagnosed  as LADA patients and the other seventeen patients as classical type II (positive control).The mean C-peptide level in patients with LADA was 0.30 ng/ml, 1.94 ng/ml in control and 3.15 ng/ml in classical type II. It is clear from the range of serum C-peptide level that there are no overlapping values seen for serum C-peptide in groups. Conclusion:SerumC-peptide levels can be used in the early diagnosis of LADA patients; Also Anti-GAD65 is more valuable marker than the other predictive marker. Similarly, they may be may be useful in differential diagnosis among types of diabetes to assess treatment efficacy.