Patients with ketosis-prone diabetes (KPD) may show different patterns of beta cell function and autoimmunity. Balsubramanyam et al reviewed different classification schemes to standardize terminology. The authors are from Baylor University, Ben Taub General Hospital in Houston, and the University of Washington in Seattle.
Parameters:
(1) markers of islet cell autoimmunity (A)
(2) beta cell function (beta)
Autoimmunity (A)
Beta Cell Function (beta)
Designation
Type
present
absent
A(+) beta(-)
1A
absent
absent
A(-) beta(-)
1B
present
present
A(+) beta(+)
2A
absent
present
A(-) beta(+)
2B
where:
• Markers of autoimmunity: antibodies to GAD (glutamic acid decarboxylase), GAD65 (Mr 65), GAD67 (Mr G7), and/or islet cells.
variable course; some show progressive loss of beta cell function associated with need for insulin therapy, others have preserved beta cell function and can discontinue insulin therapy
2B
potentially can discontinue insulin therapy
Performance:
• The A-beta scheme has a sensitivity of 99% and specificity of 96%.
• The area under the ROC curve is 0.97.
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