Type II diabetes mellitus with positive anti-glutamic acid decarboxylase antibodies

Abstract

            The differential diagnosis between the different types of diabetes in the age group between 25 and 45 years is complex. In addition to type 1 and type 2 diabetes, there are other, even less documented varieties in which genetic predisposition, immunological findings and unstable insulin secretion overlap. Since 1994, a series of patients affected by adult-onset diabetes has been described, most of whom require insulin for its control. These patients showed common phenotypic characteristics, and as in type 1 diabetes, a higher concentration of autoantibodies against structures of the pancreatic beta cell, more specifically, glutamic acid decarboxylase antibodies (GADA). Based on this premise, two interesting clinical cases are discussed showing the presence of autoimmunity against beta cells that warranted the start of insulin therapy, with unfavorable evolution and the appearance of hypoglycemic episodes, which warranted a delay in insulin therapy and the start of oral antidiabetics. achieving adequate metabolic control and improvement of hypoglycemic episodes. Migrating from the binary perception of an entity that has shown its syndromic behavior with growing is a task that must begin to be prioritized with the firm conviction of achieving precision diabetes that improves the diagnostic performance, quality of life and pharmacological treatment of patients living with diabetes.