Adult-onset diabetes mellitus is one of the most common chronic diseases of modern times. In 1990 the Cremona Study evaluated the prevalence of diabetes mellitus, based on the oral glucose tolerance test (OGTT) in accordance with the World Health Organization (WHO) criteria, at 9.4 % in a sample representative of the general adult population of northern Italy [1]. Type II (non-insulin-dependent) diabetes mellitus is the predominant form of adult-onset diabetes mellitus. A proportion of adult patients with diabetes diagnosed as Type II develop insulin-requiring diabetes and many of these can be identified by the presence of circulating islet autoantibodies [2±4]. This form of diabetes is also known as latent autoimmune diabetes in adults (LADA) and, according to the new classification criteria, is now considered a Diabetologia (1999) Results. Increased concentrations of glutamic acid decarboxylase antibodies were found in 4 (2.8 %) of 143 participants with known diabetes and none of 50 with previously unknown diabetes, 1 (0.65 %) of 153 with impaired and 18 (1.0 %) of 1718 with normal glucose tolerance. The increased prevalence of these antibodies in subjects with known diabetes was not statistically significant. Protein tyrosine phosphatase IA-2-antibodies were found in only four subjects, two of whom also had glutamic acid decarboxylase antibodies, all with normal glucose tolerance. After 8 years of follow-up, none of 21 non-diabetic subjects with either glutamic acid decarboxylase or IA-2-antibodies had developed diabetes and only a slight deterioration from normal to impaired fasting glucose was observed in 3 of 15 subjects with previous normal glucose tolerance. Conclusion/interpretation. This study has shown that in northern Italy the prevalence of adult autoimmune diabetes in the general adult population is 0.19 % (95 % CI 0.05±0.5); that autoimmune diabetes represents only a minority of all cases of adult diabetes; and that islet autoantibodies are not a high-risk factor for diabetes development in adults with normal glucose tolerance over 8 years of follow-up. [Diabetologia (1999) 42: 840±844]
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