International Journal of Clinical Endocrinology and Metabolism Citation: Mansour AA, Saead Almomin AM, Ali Alhamza AH (2015) Glutamic Acid Decarboxylase Autoantibodies Role in Reclassifying Diabetes of Adulthood in Basrah. Int J Clin Endocrinol Metab 1(1): 013-016. 013 Abstract Aim: To determine the prevalence and phenotypic characteristics of diabetes subtypes based on glutamic acid decarboxylase autoantibodies (GADA) status in those newly presented diabetic to the Al-Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC) in Basrah, Southern Iraq. Methods : The study design is cross-sectional and includes adult diabetic patients if they are free of insulin treatment for at least 6 months from diagnosis and to be 30 years of age and over from the period of January 2013 to March 2013. Results: Of our diabetics with age 30 years and more, 26.4% were GADA-positive. The only signiicantly higher variables seen more among GADA-positive diabetes groups were normal weight and current insulin uses. GADA-positivity was not associated with gender, age, BMI, family history, smoking, hypertension, duration of diabetes, or speciic HbA1c in the current study. Conclusion: A quarter of adults diabetic in Basrah were GADA positive. GADA positivity means more likely to be normal weight diabetics and currently on insulin use. Prospective Diabetes Study (UKPDS), who had detectable GADA, required insulin treatment within 6 years of diagnosis [5]. A suggestion for diagnostic criteria for LADA as the age of 30 years or more at clinical presentation and not requiring insulin for > 6 months post-diagnosis might help with the deinition of this disease [9], which represent a variable proportion (2–22%) [10]. In a large cohort of white European diabetics (n =3, 672) aged 25 –65 years in the UKPDS, the prevalence of LADA was 10% [5]. GADA persist in LADA for several years ater diagnosis, which is in contrary to what observed in classical Type 1 diabetic patients [11]. LADA patients have a similar risk of complications and death to patients with clinically diagnosed type 2 diabetes without GADA, except for a lower prevalence and incidence of nephropathy [12]. here are suggestions that LADA phenotype is diferent from that of patients with GADA negative type 2 diabetes [13], with some features (including younger age, relative leanness and greater glycemia) that could inluence the development of complications, at least theoretically. At diagnosis, patients with adult-onset autoimmune diabetes are usually non – insulin requiring and clinically indistinguishable from patients with type 2 diabetes though they tend to be younger and leaner. Only with screening for autoantibodies, especially GADA, can they be identified with certainty [7]. In the age limit, the Immunology of Diabetes Society had suggested an age limit of ≥30 to deine LADA [14]. However, this is not always universal, as islet antibody-positive and slowly progressive diabetes has also been described in patients less than 30 years of age [15]. he aim of this study was to determine the prevalence and phenotypic characteristics of diabetes subtypes based on GADA Introduction Glutamicacid decarboxylase autoantibodies (GADA), also called 65kDa antibodies, is the most frequent form of autoantibodies in type 1 diabetic children and also occurs in some patients who initially present with adult-onset non-insulin requiring diabetes, also called latent adult-onset autoimmune diabetes (LADA) [1]. GADA is no longer only used in theory but are beginning to be used in clinical practice to reclassify type 2 diabetes mellitus [2]. LADA was introduced in 1994 to separate a GADA positive subgroup of adult patients initially diagnosed with type 2 diabetes [3]. Using this deinition with the add-on criteria of no exogenous insulin during the irst 6–12 months, the prevalence of LADA among unselected “type 2 diabetic patients” is variable, ranging between 25% in subjects less than 35 years and between 4 and 13% in subjects older than 35 years at diagnosis in diabetics of European origin [4]. On follow up researches, a progressive defect in insulin secretion was observed in 50–60% of LADA patients within 6–10 years [5], which led the World Health Organization (WHO) to include those patients in a category called a slowly progressing form of type 1 diabetes in the classiication of diabetes [6]. LADA is clearly diferent from type 2 diabetes, in that LADA is associated with histocompatibility (HLA) genes, diabetes-associated autoantibodies, less insulin secretion, no need for insulin therapy initially ater diagnosis, and less prevalence of metabolic syndrome [7]. And it’s may be considered as a slowly progressive form of autoimmune β-cell destruction, given that people with LADA have evidence of islet autoimmunity, namely circulating islet antibodies and type 1 diabetes susceptibility HLA class II alleles DQ2 and/or DQ8 [8]. A majority of adults with diabetes in the United Kingdom Research Article Glutamic Acid Decarboxylase Autoantibodies Role in Reclassifying Diabetes of Adulthood in Basrah Abbas Ali Mansour 1 *, Ammar Mohamd Saead Almomin 2 and Ali Hussein Ali Alhamza 3 1 Professor of Medicine, Department of Medicine, Basrah College of Medicine, Basrah-61013, Iraq 2 Al-Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah-61013 Iraq 3 Al-Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah-61013 Iraq Dates: Received: 03 June, 2015; Accepted: 13 July, 2015; Published: 15 July, 2015 *Corresponding author: Abbas Ali Mansour, Director of Al-Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC)Chair Diabetes ,Endocrine and Metabolism Division, Basrah College of Medicine, Hattin post ofice .P.O Box: 142, Basrah 61013, Tel: 009647801403706; E-mail: www.peertechz.com Keywords: GADA; Autoantibodies; LADA; Type 2 diabetes; Basrah