Category: Diabetes/Prediabetes/Hypoglycemia

Monitor: 19

19 - PREVALENCE OF ISLET CELL ANTIBODIES IN SUDANESE DIABETIC PATIENTS

Thursday, Apr 25
11:30 AM – 12:00 PM

Objective :

Diabetes autoantibodies are directed against (specific proteins), cytoplasmic components of  the islet cells; The autoantibodies that are currently measured bind to Glutamic acid decarboxylase65 (GAD), Protein tyrosine phosphates islet antigen-2 (IA-2)/ insulinoma antigen, Zinc transporter 8 (ZnT8) and Insulin(IAA).


Prevalence of any autoantibody in patients with type I diabetes is 85 – 90 %, type II diabetes 11.6 % and in healthy persons 1 to 2 %. No clear order of type, appearance, combination or quantity of autoantibody has been detected.  

To study the presence of islet cell autoantibodies among Sudanese patients with type 1 and type 2 DM in Khartoum State and to evaluate the relationship with patient demographics, family history and treatment used.


Methods :

A prospective, hospital-based, cross-sectional study involving diabetic patients in Khartoum State. Seventy diagnosed diabetics IDDM and NIDDM who attended  different diabetic refer clinics in  Khartoum during the period from February to May 2014 were enrolled. Twenty healthy (non diabetic) individuals were included for control purposes. 

Five milliliters of peripheral blood were collected to determine islet cell surface antibodies.  


Results : There was high prevalence of islet cell antibodies among Sudanese diabetic patients as is the experience elsewhere.Gender, age and duration of DM appeared not to have a major effect on autoantibody frequency, but, family history of diabetes was a recognized risk factor. Patients with autoantibodies required more insulin for diabetes control.


Discussion :

Ninety-five percent of children diagnosed with type 1 diabetes have high levels of islet cell antibodies. Up to 25% of people with type 2 diabetes have elevated levels. Some of the individuals with type 2 diabetes can have antibodies  higher than those who have type 1 diabetes. Bingley (2010) found that only 2% to 4% of patients with type 1 diabetes were antibody negative; 90% have more than 1 antibody marker, and 70% have 3 markers. Another study conducted in Sudan showed that twenty-nine patients (63%) were found to have with ICA in their sera. (2) These figures are significantly higher than those reported for African populations, and higher than our study report of  46.%  type I, 53.7%  type II. These might point an association between diabetes and islet cell antibodies in the studied patients.


Conclusion :

Because autoantibodies appear successively, the time period required to account for all autoantibodies may be counteractive in the aim of prevention and the suppression of insulinitis as early as possible is a key for success. A prediction system based on one autoantibody alone would therefore be beneficial.


 

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Sulaf I. Abdelaziz

Consultant Internal Medicine and Endocrine,
University of Khartoum, SUDAN
Khartoum, Khartoum, Sudan

• Graduate of University of Khartoum, 1987.
• Currently, Senior Consultant, DM and Endocrinology
• Assistant Professor of Medicine, University of Khartoum.
• Head Department of Medicine, Soba University Hospital 2009-2017.
• Over 25 years experience in Internal Medicine, 19 years experience in DM and Endocrinology, with special interest in DM and the pillars of Islam, Medical Education and Basic Clinical Skills.
• Interested in clinical research in DM and Endocrinology.
MEMBERSHIPS
• Member of Sudan Medical Council
• Member of Saudi Council For Health Specialties 2002 to date
• Former Academic Secretary (2011-2015) and currently Vice-President of Sudan Diabetes Association (SUDA).
• Academic Secretary (2014-2017) of the Sudan Association of Physicians (SAP).
• Founding Member and General Secretary of Sudan Endocrine Society (SUDES) 2010 to date.
• Member of the Arab Diabetes Forum. (ADF) 9/2011 to date.
• Vice-president of the 5th Insulin Therapy Summit, Arab Diabetes Forum (ADF), 2018
• Member of the International Diabetes Federation- Diabetes and Ramadan (IDF-DAR) International Alliance. (2013 to date)
• Member of the Arab Association for the Study of Diabetes. (AASD) 9/2013 to date.
• Member of the American Association of Clinical Endocrinology. (AACE) 7/2015 to date.
ACTIVITIES
• Special interest in DM and Ramadan, and co-author in the 2016 IDF DAR International Guidelines.
• Co-author in the Diabetes and Hajj 2018 International Guidelines.
• Attended many National, Regional and International Workshops and Conferences in DM and Endocrinology.
• Speaker and Chairperson in a number of National, Regional and International conferences in DM and Endocrinology.
• Organized a number of Workshops, Symposia and Conferences on DM and Endocrinology.
• Working on research on DAR and other local DM and Endocrine-related issues.

Zenab G. Osman

Specialist Clinical Immionology
UNIVERSITY OF KHARTOUM
Khartoum, Sudan

currently working in Saudi Arabia as a Specialist in Clinical Immunology