Pancreatic autoantibodies in individuals with a clinical diagnosis of type 2 diabetes mellitus

Abstract

Objectives: It can be challenging to accurately diagnose type 2 diabetes (T2D) in children based on clinical features alone. We aimed to describe pediatric patients with a clinical diagnosis of T2D who are positive for pancreatic autoantibodies and compare their clinical features to patients with T2D without autoantibodies. Material and Methods: This cross-sectional study and medical record review included patients aged 10–30 years with T2D seen at our pediatric diabetes clinic between January 01, 2013, and December 31, 2020. We compared the characteristics of autoantibody-positive patients with autoantibody-negative patients using Chi-square tests for binary variables and t-tests for continuous variables. Results: Eleven out of 87 (12.6%) patients with a clinical diagnosis of T2D had positive autoantibody results. The groups with and without antibodies were not significantly different in terms of age, sex, and body mass index (BMI) Z-score. However, the hemoglobin A1c (HbA1c) closest to the time of the first autoantibody test was significantly lower in the autoantibody-positive group. Two of the 11 antibody-positive patients had two positive autoantibodies and one had four positive autoantibodies. The other eight patients were positive for one autoantibody only. One of the 11 antibody-positive patients had an episode of diabetic ketoacidosis (DKA). Conclusion: While age, sex, and BMI were similar in both groups, patients with autoantibodies had significantly lower HbA1c at the time of antibody testing and one patient went into DKA. Autoantibodies should be measured in all patients diagnosed with diabetes to avoid the consequences of potential misclassification.