Islet Cell Antibody

Diabetes

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No Fasting Required

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Autoantibody test.

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Islet Cell Antibody Test Guide

Why is it done?
- Detects antibodies against insulin-producing islet cells in the pancreas, which are markers of autoimmune destruction of pancreatic beta cells
- Screen for Type 1 Diabetes Mellitus, particularly in newly diagnosed patients or those at risk
- Differentiate Type 1 Diabetes from Type 2 Diabetes and other forms of diabetes
- Identify at-risk individuals in families with history of autoimmune diabetes
- Predict progression to Type 1 Diabetes in asymptomatic individuals
- Evaluate for autoimmune polyendocrine syndromes
Normal Range
- Negative Result: < 1.0 Units or Undetectable
  - Indicates absence of islet cell antibodies, normal pancreatic function
- Positive Result: ≥ 1.0 Units
  - Indicates presence of islet cell antibodies, suggesting autoimmune attack on beta cells
- Borderline Result: 0.75-1.0 Units
  - May require repeat testing or additional autoimmune markers
- Units of Measurement: Islet Cell Units (ICU) or percentage
Interpretation
- Single Positive ICA: Approximately 5-10% risk of developing Type 1 Diabetes within 5 years
- Multiple Positive Antibodies (ICA + GAD + IA2 + ZnT8): Greater than 90% risk of developing Type 1 Diabetes within 5 years, especially in children
- High Titer Levels: Associated with more rapid progression to clinical diabetes
- Negative Result in Symptomatic Patient: Strongly suggests non-autoimmune form of diabetes (Type 2 or other)
- Clinical Context Matters: Results should be interpreted with clinical presentation, glucose levels, and other antibody testing
- Factors Affecting Results: Age at testing, duration of symptoms, concurrent infections, and genetic predisposition (HLA genotype) can influence antibody presence and levels
Associated Organs
- Primary Organ: Pancreas (specifically the islets of Langerhans containing beta cells)
- Type 1 Diabetes Mellitus: Autoimmune destruction of insulin-producing beta cells leading to insulin deficiency
- Latent Autoimmune Diabetes in Adults (LADA): Slow-progressing autoimmune diabetes initially misdiagnosed as Type 2
- Autoimmune Polyendocrine Syndrome (APS): Multiple endocrine gland involvement including pancreas, thyroid, and adrenal glands
- Associated Complications: Diabetic ketoacidosis, hyperglycemia, microvascular complications (neuropathy, nephropathy, retinopathy), macrovascular disease
Follow-up Tests
- Other Diabetes Autoantibodies: GAD-65 (Glutamic Acid Decarboxylase), IA2 (Tyrosine Phosphatase-like protein), ZnT8 (Zinc Transporter 8)
- Fasting Plasma Glucose and HbA1c: Assess current glucose control and diabetes status
- Oral Glucose Tolerance Test (OGTT): Evaluate glucose metabolism and predict diabetes development
- C-Peptide Level: Assess remaining beta cell function and insulin secretion capacity
- Thyroid Peroxidase (TPO) Antibodies and TSH: Screen for concurrent autoimmune thyroid disease
- Tissue Transglutaminase (tTG-IgA): Screen for celiac disease, commonly associated with Type 1 Diabetes
- Adrenal Antibodies and Cortisol: Evaluate for autoimmune adrenal involvement in polyendocrine syndromes
- Monitoring: Repeat testing annually for at-risk asymptomatic individuals or more frequently if positive
Fasting Required?
- Fasting Required: No
  - Islet Cell Antibody testing can be performed on non-fasting (random) blood samples
- Sample Collection: Standard blood draw into serum separator or plasma tube, typically 3-5 mL
- Medications: No specific medications need to be avoided for ICA testing
- Patient Preparation: No special preparation needed; routine blood draw can be performed at any time of day
- Important Note: If simultaneous glucose testing (fasting glucose, OGTT) is planned, fasting may be required for those components only, not for ICA

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