Low prevalence of latent autoimmune diabetes in adults in northern India

Sachan, Abhishek; Zaidi, Ghazala; Sahu, Ravi P.; Agrawal, Suraksha; Colman, Peter G; Bhatia, Eesh

doi:10.1111/dme.12644

Cited by 21 publications

(19 citation statements)

References 22 publications

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“…Frequency of GADA positivity in our cohort was considerably higher than 1.5% and 1.6% reported in two large studies involving adult north Indian subjects The participants of these two studies had higher mean age and longer duration of diabetes than in our study [33,37]. This can be the possible explanation for the discrepancy in results as diabetes autoantibodies in the sera tend to disappear with increasing age and duration of diabetes [3,15].…”

Section: Discussioncontrasting

confidence: 80%

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Latent Autoimmune Diabetes in Adults (LADA): The Prevalent Form of Adult-Onset Autoimmune Diabetes in a Region of India

Kumar¹,

Leiva²

2017

JED

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Aims: We undertook a study to investigate the prevalence and general characteristics of patients with Latent autoimmune diabetes in adults (LADA).Methods: This was a cross-sectional investigation conducted in the National Capital Region of India. Total of 139 subjects were recruited in the study. All subjects were screened for Glutamic acid decarboxylase autoantibody (GADA). GADA was analysed using ELISA kits with 98% specificity and 92% sensitivity. Results:The prevalence of LADA was 6.5% (6.3% in men and 6.8% in women); 95% Confidence interval (CI): 3.29 -12.0% among adult-onset diabetic patients. Prevalence of LADA seemed to gradually decline with increasing age. LADA (n=9) and DM2 (n=130) patients were compared. LADA patients were younger (p = 0.045), had lower age at onset of diabetes (p = 0.025), waist circumference (p = 0.021). LADA patients had also longer duration of diabetes (p = 0.045). There was no significant difference in BMI between two groups. Conclusions:Our results indicate that LADA represents 6.5 % of cases among adult-onset diabetes in a region of north India. LADA is a prevalent form of adult-onset autoimmune diabetes and not rare. This study shows different phenotypic features of LADA patients compared to DM2 patients. In the developing world, sometimes routine antibody testing may be considered not to be cost-effective. Thus, clinical and phenotypic features of LADA may help clinicians recognize patients for potential antibody screening.

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Section: Discussioncontrasting

confidence: 80%

“…This can be the possible explanation for the discrepancy in results as diabetes autoantibodies in the sera tend to disappear with increasing age and duration of diabetes [3,15]. Moreover, sensitivity of the assay used for GADA measurement in one of these studies was lower than used in our analyses [37].…”

Section: Discussionmentioning

confidence: 70%

Latent Autoimmune Diabetes in Adults (LADA): The Prevalent Form of Adult-Onset Autoimmune Diabetes in a Region of India

Kumar¹,

Leiva²

2017

JED

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“…Compared to Caucasians, results of large studies have shown lower prevalence of LADA in Asian population ranging from 2.6 % in the United Arab Emirates to 5.7% in China. Two large studies on Indian subjects also revealed low prevalence of LADA 2.6% and 3.2%. There seems to be a clear difference between the prevalence of LADA in Northern Europe and Asia.…”

Section: Comparision Of Lada Between Asian and Western Populationmentioning

confidence: 99%

“…With reference to the prevalence of LADA in India, studies have revealed controversial results [36][37][38][39]44,45 Such variation in results may be attributed to the differential aspects such as age at onset, demographics of the studied subjects, and methods used to measure GAD/Protein tyrosine phosphatase-like protein (IA-2) antibodies. Considerably, high prevalence of LADA was reported in few studies.…”

Section: Epidemiologymentioning

confidence: 99%

Latent autoimmune diabetes in adults (LADA) in Asian and European populations

Kumar

Leiva

2017

Diabetes Metabolism Res

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Diabetes mellitus is a chronic disorder caused by relative or absolute insulin deficiency and characterized by chronic hyperglycaemia. It is expected that by year 2025, 80% of all type 2 diabetic patients will be living in developing or low- and middle-income countries. Among Asians, there has been an overall increase in abdominal obesity; however, the risk of diabetes in these populations starts at much lower body mass index as compared to Caucasians. A significant proportion of diabetic patients with adult-onset, initially nonrequiring insulin treatment, have diabetes-associated autoantibodies in their sera. A new subclass of diabetes with the designation of latent autoimmune diabetes of adult-onset (LADA) has been proposed for this category of subjects. Studies have demonstrated that patients with autoimmune diabetes, characterized by the presence of glutamic decarboxylase autoantibodies display a different clinical phenotype from classical type 2 diabetes without glutamic decarboxylase autoantibodies. This subset of phenotypic type 2 diabetes subjects with islet autoantibodies tend to have sulphonylurea failure and need insulin treatment earlier in the disease process. Diagnosing LADA at an initial stage will be important so that insulin can be initiated earlier, facilitating improved glycemic control sooner as well as the preservation of residual beta-cell function in adult-onset autoimmune diabetes. Because of differences in dietary habits, environmental factors, and phenotypic characteristics between European and Asian populations, there may be heterogeneity in the prevalence and other characteristics of LADA in these two populations.

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“…Despite the high prevalence of T2D in populations of Asian ancestry, LADA prevalence when compared to populations of European ancestry has been reported to be generally lower in China, Japan, Korea and India (2.5-9.2%) ( Table 1)[48, [96][97][98][99][100][101][102]. In a study comparing a European ancestry cohort with three ethnic groups from Singapore (Indian, Malay and Chinese) [103], glutamic acid decarboxylase (GAD) autoantibodies were more frequent in the European cohort, while islet antigen 2 (IA-2) antibody positivity was higher in the Asian ethnic groups.…”

Section: Asian Ancestrymentioning

confidence: 99%

A Global Perspective of Latent Autoimmune Diabetes in Adults

Mishra

Hodge

Cousminer

et al. 2018

Trends in Endocrinology & Metabolism

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Latent autoimmune diabetes in adults (LADA) is characterized by the presence of islet autoantibodies and initial insulin independence, which can lead to misdiagnosis of type 2 diabetes (T2D). As such, understanding the genetic etiology of LADA could aid in more accurate diagnosis. However, there is ongoing debate regarding the exact definition of LADA, so understanding its impact in different populations when contrasted with type 1 diabetes (T1D) and T2D is one potential strategy to gain insight into its etiology. Unfortunately, the lack of consistent and thorough autoantibody screening around the world has hampered well-powered genetic studies of LADA. This review highlights recent genetic and epidemiological studies of LADA in diverse populations as well as the importance of autoantibody screening in facilitating future research.

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Low prevalence of latent autoimmune diabetes in adults in northern India

Abstract: In the present north-Indian population with Type 2 diabetes, the overall prevalence of GAD antibodies and the prevalence of either GAD or IA2 antibodies were considerably lower than those reported in white European populations.

Cited by 21 publications

References 22 publications

Latent Autoimmune Diabetes in Adults (LADA): The Prevalent Form of Adult-Onset Autoimmune Diabetes in a Region of India

Latent Autoimmune Diabetes in Adults (LADA): The Prevalent Form of Adult-Onset Autoimmune Diabetes in a Region of India

Latent autoimmune diabetes in adults (LADA) in Asian and European populations

A Global Perspective of Latent Autoimmune Diabetes in Adults

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