Prevalence of ICA and GAD antibodies at initial presentation of type 1 diabetes mellitus in Singapore children

Objective: To determine the prevalence of islet cell antibodies (ICA) and a ntibodies to glutamic acid decarboxylase (GAD) in Asian children with diabe tes mellitus (DM) at the time of diagnosis, Patients and methods: 41 children were studied at their initial presentatio n from 1993 to 2000. Results: Mean age of onset (+/- SD) of DM was 7.6 (+/- 4.2) years. One or b oth of the two autoantibodies, ICA and anti-CAD, were present in 17 of the 41 children (41.5%) at the time of diagnosis, Comparing the group of childr en with autoantibodies and the group without detectable autoantibodies, the re were no significant differences in body mass index (15.4 vs 16.3 kg/m(2) ), age of onset (7.4 vs 7.8 years), random C-peptide levels (203 vs 311 pmo l/l), HbA(1c) levels (13.2 vs 12.7%), and frequency of diabetic ketoacidosi s at presentation (53.3 vs 55%). Conclusion: Prevalence of antibodies at presentation of DM in Singapore (41 .5%) is lower than in Caucasian populations (60-90%). Other autoantibodies yet to be identified may be contributory. Alternatively, non-immune mediate d mechanisms may be responsible for a significant proportion of type 1 DM i n Singapore children.