Latent autoimmune diabetes in adults (LADA) has clinical and metabolic features of type 1 and type 2 diabetes. LADA does not have specific features for its diagnosis apart from autoantibody detection; however, these tests are not affordable in clinical settings. In this cross-sectional study, we analyzed clinical criteria, metabolic control, pharmacological treatment, and diabetic complications in two groups of patients with diabetes -LADA and T2D- in order to identify specific characteristic of these clinical entities. Finally, we evaluated if the estimated glucose disposal rate (eGDR) and age at diagnosis of diabetes could be used as a diagnostic criterion for LADA. Demographic, biochemical, clinical and treatment were measured in 377 individuals with diabetes. The diagnostics of LADA were determined using Glutamic acid decarboxylase autoantibodies levels. Chi-square test or t-Student test were used to establish differences between groups. To identify factors associated with LADA, a logistic regression analysis was used. Finally, a ROC curve was plotted to assess the possible variables as diagnostic criteria for LADA. The 377 patients with diabetes were separated into 59 patients with LADA and 318 patients with T2D. Patients with LADA showed lower fasting glucose values, fewer diabetic complications, younger age at diagnosis of diabetes, higher insulin use, and higher eGDR in comparison to patients with T2D. Both groups had a mean BMI classified as overweight. The ROC evaluated the sensitivity and specificity, this analysis indicated that an age younger than 40.5 years and an eGDR value higher than 9.75 mg/kg/min correlated better with LADA. These parameters could be useful to identify patients suspected to have LADA at the first level of medical care in the population of southeastern Mexico and refer them to a second level of care.
Latent autoimmune diabetes in adults (LADA) is characterized by the presence of autoantibodies, indicating an autoimmune pathogenesis. As LADA has clinical and metabolic features from type 1 and type 2 diabetes, it has no categorically defined features; additionally, the autoantibody detection is not affordable in clinical settings. We analyzed the LADA diagnosis in relation to clinical criteria, metabolic control, drug treatment and diabetes complications in individuals from southeast Mexico. Finally, we evaluated the diagnostic value of the most significant features of our patients. A sample of 377 individuals with type 2 diabetes were evaluated through their GADA levels. They were divided into 59 patients with LADA and 318 patients with T2D. We used the Chi-squared test for categorical variables and the t-Student test for numerical data; we also performed a logistic regression analysis. The receiver operating curve evaluated the sensitivity and specificity of significant numerical variables in the logistic regression. Age at diagnosis of diabetes was lower in individuals with LADA than in individuals with type 2 diabetes. For diabetes complications, we found lower frequencies in patients with LADA. Both groups had a BMI close to obesity. Individuals with type 2 diabetes showed higher levels of fasting glucose. Individuals with LADA used insulin more frequently. The receiver operating curves analysis indicated that age at diagnosis of diabetes was under 41 years; an eGDR value higher than 9.75 correlated better with LADA. Patients with LADA showed lower values of fasting glucose levels, fewer diabetic complications, younger age at diagnosis of diabetes, higher use of insulin, and higher eGDR. An age at diagnosis of diabetes <41 years and an eGFR value >9.75 could be indicators to identify patients with LADA in a population of southeast Mexico.
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