Using the information from Rachel's medical record, identify the factors that would allow the physician to distinguish between T1DM and T2DM
What will be an ideal response?
Diabetes-related antibodies are often measured to distinguish between type 1 and type 2 DM. It is these antibodies that cause self-destruction of the β-cells of the pancreas and lead to inability of the β-cells to synthesize and secrete adequate insulin. The antibodies that are tested for include: islet cell cytoplasmic autoantibodies (ICA), insulin autoantibodies (IAA), insulinoma-associated-2 autoantibodies (IA-2A), and glutamic acid decarboxylase autoantibodies (GADA). The presence of antibodies can be used to distinguish between type 1 and type to diabetes because it is only type 1 that is auto-immune in origin. Type 2 is not auto-immune in origin, and therefore will not demonstrate antibodies in antibody testing.
C-peptide is also used as a marker for determining if the individual is producing insulin. If C-peptide is present, insulin is being produced and the patient most likely has T2DM. Due to the presence of the autoantibodies and the lower levels of C-peptide, the self-destruction of Rachel's beta cells is currently taking place. This allows the physician to clearly diagnose her with T1DM over T2DM.
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