Insulin antibody determination is used to predict the future development of type 1 diabetes in asymptomatic children, adolescents, and young adults, in conjunction with family history and other laboratory tests (HLA typing, GAD65 antibodies, IA-2 antibodies), in the differential diagnosis of type 1 and type 2 diabetes, in the assessment of diabetic patients with insulin resistance and the investigation of hypoglycemia in non-diabetic individuals.
Type 1 diabetes, or insulin-dependent diabetes, is caused by the destruction of pancreatic beta-cells that results in complete insulin deficiency. Clinical onset of diabetes does not occur until 80 to 90% of these cells are destroyed. Prior to the clinical onset of the disease, type 1 diabetes is often characterized by certain autoantibodies against various islet cell antigens, including glutamic acid decarboxylase (GAD65), tyrosine phosphatase (IA2), and insulin. Autoimmune destruction of insulin-producing beta cells of the pancreas is believed to be the leading cause of type 1 diabetes. The presence of these autoantibodies provides an early indication of progressive autoimmunity and their measurement is useful for predicting, diagnosing, and managing diabetic patients.
Antibodies against insulin are mainly found, if not exclusively, in young children who develop type 1 diabetes. Insulin antibodies are found in almost 100% of children and are almost absent in adults with type 1 diabetes. As the risk of diabetes increases with the presence of each additional autoantibody marker, the positive predictive value of insulin antibody measurement is increased when measured in combination with antibodies against GAD65 and IA-2.
The inclusion of a newly described fourth autoantibody (against zinc carrier 8, ZnT8) further reinforces the prediction for type 1 diabetes and its distinction from type 2 diabetes.
Laboratory test results are the most important parameter for the diagnosis and monitoring of all pathological conditions. 70%-80% of diagnostic decisions are based on laboratory tests. The correct interpretation of laboratory results allows a doctor to distinguish "healthy" from "diseased".
Laboratory test results should not be interpreted from the numerical result of a single analysis. Test results should be interpreted in relation to each individual case and family history, clinical findings, and the results of other laboratory tests and information. Your personal physician should explain the importance of your test results.
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