January 19, 2001
Question from Northport, New York, USA:
My eight and one-half year old was diagnosed with type�1 diabetes three years ago. For the past year or more, she has complained of her stomach hurting every once in a while, and she started complaining more frequently over the past few months. I asked about this at our latest meeting, and her doctor ordered an antibody test. She was negative for IgA, but positive for IgG. She has no other symptoms such as diarrhea. I have been told that some children with diabetes have antibodies to this IgG. Can you tell me more about this? What does this means in terms of her diabetes or overall health concerns?
I think that perhaps there has been some misunderstanding over the antibody tests done on your daughter with diabetes. You need to talk this over again with her doctor.
IgA and IgG are immunoglobulins that are normally present in everyone’s blood. They are not reported as positive and negative, but quantitatively, and they have no special relevance to diabetes. The antibody tests that were done might have included the ICA [Islet Cell Antibody] test often taken when diabetes is first diagnosed to see if it is the type�1A or autoimmune form or another type�1B or idiopathic form. However, in most cases, these tests could be negative after three years, but the doctor might have hoped nonetheless that they would confirm the autoimmune form and thus indicate further tests to explain the abdominal pain.
Abdominal pain can have many causes in a six year old girl with diabetes, but two especially come to mind. First, it might be occurring with hypoglycemia. The second is that it might be associated with celiac syndrome which is another autoimmune condition which is associated with this form of diabetes in about 8% of cases. In the latter instance, there is an appropriate antibody test called an anti-transglutaminase test.