Low rate of latent autoimmune diabetes in adults (LADA) in patients followed for type 2 diabetes: A single center’s experience in Turkey

Abstract

Objective: In this study, we aimed to determine the frequency of and the clinical and metabolic features of patients with latent autoimmune diabetes in adults (LADA) at a single center in Turkey. Subjects and methods: Patients over 30 years of age diagnosed with type 2 diabetes who did not require insulin for a minimum of 6 months following diagnosis were included. Data from 324 patients (163 women; 161 men), with a mean age of 54.97 ± 7.53 years, were analyzed in the study. Levels of antibodies to glutamate decarboxylase (anti-GAD) were measured in all patients, and LADA was diagnosed in patients testing positive for anti-GAD antibodies. Results: Anti-GAD positivity was identified in 5 patients (1.5%). Family history of diabetes, body mass index (BMI), age, sex distribution, insulin resistance, serum triglycerides, high-density lipoprotein, and low-density lipoprotein were similar in the LADA and type 2 diabetes patients. Median HbA1c was significantly higher (10.8% vs. 7.38%, p = 0.002) and fasting C-peptide was lower (0.75 ng/mL vs. 2.82 ng/mL, p = 0.009) in patients with LADA compared to in those with type 2 diabetes. Among the 5 patients with LADA, 4 were positive for antithyroid peroxidase antibodies. The median disease duration was relatively shorter among patients with LADA (4 years vs. 7 years, p = 0.105). Conclusion: We observed a LADA frequency of 1.5% among Turkish patients followed for type 2 diabetes. The presence of obesity and metabolic syndrome did not exclude LADA, and patients with LADA had worse glycemic control than patients with type 2 diabetes did.

Latent Autoimmune Diabetes in Adults (LADA) and its Metabolic Characteristics among Yemeni Type 2 Diabetes Mellitus Patients

“…42 Therefore, the clinical phenotype of LADA patients varies considerably with GADA titre, whereby low-titre GADA patients are phenotypically more similar to those with Type 2 DM. 6,16 Fasting blood glucose and HbA1c in our LADA patients were significantly higher, which is in agreement with earlier studies, 36,50,59,67 and in line with other studies reporting higher FBG and HbA1c levels, though nonsignificant, in LADA compared to Type 2 DM. 33,51 Individuals with GADA-positive were also reported to have a tendency towards a higher proportion of individuals with HbA1c above the optimal target range when compared with GADA-negative subjects.…”

“…Moreover, LADA patients were reported to be at high risk for the progressive loss of muscle mass and function compared to Type 2 DM. 58 In our study, TG, cholesterol and HDL-c were nonsignificantly lower in LADA with respect to Type 2 DM, which is in agreement with several studies, 28,35,51,59 and in line with other studies reporting significant decrease in TG and cholesterol in LADA. 5,60 The slight decrease in TG might be attributed to the observed associated decrease in insulin resistance (HOMA-IR).…”

“…Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2021:14 4228 of insulin treatment compared with Type 2 DM patients. 5,14,17,59,77 Recently, the decline pattern of C-peptide in LADA patients was demonstrated to be biphasic with an initial rapid linear progression followed by a stable mode. 73 The lower HOMA-β in our LADA patients with respect to previous studies conducted in other LADA populations 36,68 might be explained in view of the fact that our Type 2 DM patients were diagnosed more than 2 months and less than 5 years and therefore their β-cell mass is much affected (12%); whereas those of other populations the participants were newly diagnosed Type 2 DM in which their β-cell mass was still preserved and not much affected (≈40%).…”

Prevalence of Islet Cell Autoantibodies in Adult Patients Followed for Type 2 Diabetes Mellitus: A Cross-sectional Study

“…2,20 Due to the importance of this issue, many studies have been conducted in the field of LADA epidemiology. [21][22][23][24] It seems that adult-onset autoimmune diabetes accounts for 4%-14% of all diabetic cases. 14 Because LADA occurs in adults, it is very difficult to differentiate it from T2DM, without measuring autoantibodies.…”

Antioxidant, Anti-Inflammatory, and Immunomodulatory Properties of Tea—The Positive Impact of Tea Consumption on Patients with Autoimmune Diabetes

“…LADA diabetes is a form of autoimmune diabetes that affects adult patients and is characterized by the presence of circulating β cell antibodies [25]. It entails a chronic autoimmune process that results in the destruction of pancreatic islets [11].…”