The autoimmune destruction of the insulin-producing pancreatic beta cells generally occurs over a period of time leading to the eventual onset of overt diabetes mellitus. During this extended pre-clinical phase, the characteristic circulation of autoantibodies against a variety of islet cell antigens including glutamic acid decarboxylase (GAD65), IA-2 (a tyrosine phosphatase-like protein), and insulin provides early markers of autoimmune disease activity.
Measurement of these immunologic markers has been shown to be of considerable value in assisting the attending clinician with the diagnosis and management of patients with diabetes and in predicting the development of diabetes in first-degree relatives of diabetic patients.
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