Diabetes mellitus Related Antibodies
Background
Diabetes mellitus (DM), commonly referred to as diabetes, is a chronic metabolic disorder characterized by elevated blood glucose levels. DM represents a major health problem in the 21st century. Earlier detection and therapy of DM will result in significant long-term health benefits. At present, immunoassays are widely used to determine HbA1c, C-peptide, insulin, and autoantibodies to beta cell proteins, which are essential biomarkers for the diagnosis and classification of diabetes mellitus. Besides, many other biomarkers also have been used for diagnostic tests and monitoring for diabetes.
Classification of Diabetes
Fig. 1 Disorders of glycemia: etiologic types and stages. (American Diabetes Association. Diabetes Care. 2013)
Diabetes can be classified into four general categories:
- Type 1 diabetes: Due to the destruction of β-cell, this form of diabetes usually leads to absolute insulin deficiency. Markers of the immune destruction of the β-cell include islet cell autoantibodies, autoantibodies to insulin, autoantibodies to GAD (GAD65), and autoantibodies to the tyrosine phosphatases IA-2 and IA-2β.
- Type 2 diabetes: Accounts for 90% of diabetes cases. Two major pathophysiological mechanisms characterize type 2 diabetes, insulin resistance and defective insulin secretion from the pancreas.
- Gestational diabetes mellitus (GDM): Traditionally refers to abnormal glucose tolerance with onset or first recognition during pregnancy. It is now 1 of the most common complications of pregnancy.
- Specific types of diabetes: Monogenic diabetes syndromes, diseases of the exocrine pancreas, and drug- or chemical-induced diabetes, etc.
Diabetes-related Signaling Pathways
The pathogenesis of diabetes is related to various diabetes-related signaling pathways, such as insulin signaling pathway, glucagon signaling pathway, and omentin signaling pathways. These signaling pathways have thus become the major source of the promising novel drug targets to treat metabolic diseases and diabetes.
- Insulin Signaling Pathway: Insulin mediates the role of its signal transduction pathway through the insulin receptor (IR) on the cell membrane. IR-mediated signal transduction can be divided into IRS-mediated signal transduction pathways and non-IRS-mediated signal transduction pathways depending on whether IRS (insulin receptor substrate) is mediated.
- Glucagon Signaling Pathway: In contrast to the role of the insulin signaling pathway, the glucagon signaling pathway is a pathway that promotes catabolism. The glucagon signaling pathway has a strong role in promoting glycogenolysis and gluconeogenesis, resulting in a significant increase in blood glucose.
- Omentin Signaling Pathway: Omentin is widely involved in various pathophysiological processes such as obesity, insulin resistance, inflammatory response, atherogenesis, and is closely related to diabetes.
- Other metabolism signaling pathways: View more »
Diagnosis of Diabetes
The determination of biomarkers is essential for the laboratory diagnosis of diabetes. Immunoassays are biochemical test systems for determining the concentrations of proteins or small molecules by using antibodies. In diabetology, it is clinically important to detect the presence and quantification of endogenous antigen and antibodies. For quantification of biomarkers in clinical chemistry, two general formats are used: the competitive and the non-competitive immunoassay. Several immunoassays have been developed for many important biomarkers (e.g., HbA1c, C-peptide, insulin, etc.)
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