الفهرس 
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Abstract
Diabetes mellitus is a complex, chronic illness requiring continuous medical care with multifactorial risk-reduction strategies beyond glycemic control. In the US, type 2 diabetes represents the majority of the diabetic population with a prevalence of 95%. About 86 million people are at high risk of developing type 2 diabetes.In type 2 diabetic patients, positivity for glutamic acid decarboxylase autoantibodies, as well as autoantibodies to other islet cell antigens, correlates with some of the phenotypic features consistent with those of type 1 diabetes, such as younger age at diagnosis, lower body mass index, and loss of B-cell function. This form of the disease with initial type 2-like diabetes presentation and with serological evidence of islet cell autoimmunity has been termed latent autoimmune diabetes, or type 1.5 diabetes, and has been associated with progressive decline in B-cell function and future insulin requirement in some population.
The current study included 100 patients with type 2 diabetes of more than 5 years duration aged above 40 years old. The patients were assigned to insulin or oral hypoglycaemic drugs. The study aimed to assess anti-glutamic acid decarboxylase level in type 2 Egyptian diabetic patients, and whether it could be used as a marker for progression of insulin deficiency and treatment with insulin. Comparison between the two studied groups regarding baseline characteristics revealed that there was no significant difference between them regarding age, family history of diabetes millets, number of previous operations, and vaccination. While body mass index was significantly larger in patients with insulin than patients with oral hypoglycaemicdrugs (P-value <0.001).
Our study showed that the mean of anti-glutamic acid decarboxylase antibodies was 43.52 (±23.6) in the oral hypoglycemic drugs group and 36.8 (±17.8) in the insulin group, with no significant difference between the two groups (P-value = 0.11). Our results showed that anti-glutamic acid decarboxylase antibodies positively correlated with age(r = 0.262, P value = 0.008). In contrast, our results showed that anti-glutamic acid decarboxylase negatively correlated with fasting C-peptide (r = -0.270, P value = 0.006). The results of the current study did not show a significant correlation between anti-glutamic acid decarboxylase and duration of treatment, HbA1c, fasting blood glucose, and 2 hourspostprandial blood sugar.In terms of diabetes mellitus characteristics, patients assigned to insulin were associated with longer duration of treatment of diabetes mellitus (P-value = 0.002) and a larger number normal of peripheral pulsation (P-value = 0.029) compared to patients with oral hypoglycemic drugs. While, there was no significant difference in terms of HbA1c, number of hypoglycaemic attacks, neuropathy, foot ulcers, and hydration status.