[03.10.2024] Content error, AnKing Overhaul for Step 1 & 2/AnKingMed, ID 1175148

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@AnKing-Maintainers Think this is a good catch but might be beyond scope of step 1/2, it’s not fully addressed by Amboss or FAS1. Agree with changes to text, but not the comment in extra that anti-GAD is diagnostic for T1DM. T1DM and T2DM are both diagnosed the same with glucose tolerance testing, but anti-GAD antibodies can help distinguish T1DM from T2DM

Amboss: “Genetics / environmental triggers → autoimmune response with the production of autoantibodies, e.g., anti-glutamic acid decarboxylase antibody (anti-GAD), anti-islet cell cytoplasmic antibody (anti-ICA) → progressive destruction of β cells

FAS1 just says primary defect is “Autoimmune T-cell–mediated destruction of β cells”

Research articles / science direct says " antibodies appear to be markers for, rather than the cause of, β-cell injury"

https://www.sciencedirect.com/topics/immunology-and-microbiology/pancreas-islet-cell-antibody

Yeah, not sure about the extra but support the text.

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You’re right I got that part from same Amboss under Diagnostic > Additional studies
I missed the part “These tests are not routinely indicated or required to establish a diagnosis.”
that first part in extra should be removed then because it is not diagnostic for T1DM just an indicator.

Maybe change extra to “Anti-GAD antibodies are seen in ~60-80% of patients T1DM”?

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See note history from max023, rejected by me. This removes a classic HY association, don’t think much is gained by changing unless there is a q-bank question on it.

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my suggestion is different than the rejected suggestion my max023. His suggestion was to remove anti-GAD and replace with CD8+ T cells (there is already a card that states this exactly so would be a duplicate)
The way the card is currently written is just wrong because auto-antibodies do not lead to T1DM or cause it. That would suggest its a type 2 HSR when it’s type 4. The antibodies are just a by product of the autoimmune destruction similar to chronic autoimmune gastritis

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See the difference now, changed my vote!

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