Antibodies to pancreatic islet cell antigens in diabetes seen in Southern India with particular reference to fibrocalculous pancreatic diabetes

Abstract

Fibrocalculous pancreatic diabetes (FCPD) is a type of diabetes secondary to tropical chronic non-alcoholic pancreatitis. Little is known about the aetiopathogenesis of FCPD. We studied glutamic acid decarboxylase antibodies (GAD-Ab) and islet cell antibodies (ICA) in patients with FCPD and compared the results with Type 1 (insulin dependent) diabetes mellitus, Type 2 (non-insulin-dependent) diabetes mellitus and non-diabetic subjects in Southern India. The prevalence of GAD-Ab was 7.0 % (95 % Confidence Interval (CI) 1.9-17.2) in FCPD, 47.5 % (CI 31.4-64.0) in Type 1 (p < 0.001 compared to FCPD), 5.6 % (CI 1.5-13.9) in Type 2 (non-significant (NS) compared to FCPD) and 0 % in controls. The prevalence of ICA was 6.3 % (CI 1.2-17.4) in FCPD, 53.8 % (CI 37.1-70.0) in Type 1 (p < 0.001 compared to FCPD), 9.9 % (CI 4.0-19.4) in Type 2 (NS compared to FCPD) and 4.7 % (CI 0.4-16.1) in controls. The data suggest that in FCPD, the frequency of auto-antibodies is low and its aetiology is probably not linked to autoimmunity in the majority of the patients.