Latent Autoimmune Diabetes in Adults in the United Arab Emirates: Clinical Features and Factors Related to Insulin-Requirement - PubMed (original) (raw)

Ernesto Maddaloni et al. PLoS One. 2015.

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Abstract

Aims: To describe and to characterize clinical features of latent autoimmune diabetes in adults (LADA) compared to type 1 and type 2 diabetes in the UAE.

Methods: In this cross-sectional study a dataset including 18,101 subjects with adult-onset (>30 years) diabetes was accessed. 17,072 subjects fulfilled the inclusion/exclusion criteria. Data about anthropometrics, demographics, autoantibodies to Glutamic Acid Decarboxylase (GADA) and to Islet Antigen 2 (anti-IA2), HbA1c, cholesterol and blood pressure were extracted. LADA was diagnosed according to GADA and/or anti-IA2 positivity and time to insulin therapy.

Results: 437 (2.6%) patients were identified as LADA and 34 (0.2%) as classical type 1 diabetes in adults. Mean age at diagnosis, BMI, waist circumference, systolic blood pressure and HbA1c significantly differed between, LADA, type 2 and type 1 diabetes, LADA showing halfway features between type 2 and type 1 diabetes. A decreasing trend for age at diagnosis and waist circumference was found among LADA subjects when subdivided by positivity for anti-IA2, GADA or for both antibodies (p=0.013 and p=0.011 for trend, respectively). There was a gradual downward trend in autoantibody titre in LADA subjects requiring insulin within the first year from diagnosis to subjects not requiring insulin after 10 years of follow-up (p<0.001).

Conclusions: This is the first study describing the clinical features of LADA in the UAE, which appear to be different from both type 1 and type 2 diabetes. Furthermore, we showed that the clinical phenotype of LADA is dependent on different patterns of antibody positivity, influencing the time to insulin requirement.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1

Fig 1. A-F Comparison between LADA subjects by antibody positivity (white columns) and type 1 and type 2 diabetes (black columns).

Bars are for standard deviation. *p<0.05; #p<0.001. P-values for trend <0.001 for age at diagnosis, BMI, waist circumference, HbA1c and systolic blood pressure. T1D = type 1 diabetes; T2D = type 2 diabetes; LADA (Anti-IA2) = LADA subjects positive only for anti-IA2; LADA (GADA) = LADA subjects positive only for GADA; LADA (both Abs) = LADA subjects positive for both anti-IA2 and GADA.

Fig 2

Fig 2. GADA titre in LADA subjects by groups of time to insulin.

Bars are for standard deviation. p<0.001 for trend.

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This study was in part supported by Italian Ministry of University and Technological Research (MIUR) and by Centro Internazionale Studi Diabete (CISD).

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