Glutamic acid decarboxylase (GAD-65) antibody is useful to diagnose insulin dependent diabetes mellitus [Type I diabetes (autoimmune-mediated diabetes)] to assess risk for development of Type I diabetes, to predict onset of Type I diabetes, and risk of development of related endocrine disorders, e.g., thyroiditis.
Before clinical onset, Type I diabetes is characterized by lymphocytic infiltration of the islet cells, and by circulating autoantibodies against a variety of islet cell antigens, including GAD-65, IA-2 (a tyrosine phosphatase-like protein), and insulin (IAA).
Glutamic acid decarboxylase (GAD65) is an enzyme that is produced primarily by pancreatic islet cells. A number of recent studies indicate that patients with insulin-dependent diabetes mellitus (IDDM) often have antibodies to GAD65 and several other islet cell antigens. This is consistent with the hypothesis that IDDM is an autoimmune disease and that autoantibody production is an early step in the development of IDDM.
Measurement of GAD65 antibody can also be of use in distinguishing insulin-dependent from non−insulin-dependent diabetics when the clinical history is ambiguous. GAD65 autoantibodies are often markedly elevated in patients with the stiff-person syndrome (also referred to as stiff-man syndrome), a condition that is associated with fluctuating stiffness and paroxysmal spasms of the trunk and legs.
- The presence of GAD65 autoantibodies can be detected in many cases prior to the onset of glucose intolerance.
- The presence of GAD65 autoantibodies has been shown to be a strong predictive marker for the eventual onset of IDDM.
- GAD65 autoantibodies are often markedly elevated in patients with the stiff-person syndrome (also referred to as stiff-man syndrome), a condition that is associated with fluctuating stiffness and paroxysmal spasms of the trunk and legs.
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