Factors associated with latent autoimmune diabetes outlined
MedWire News: Study results suggest that around 9% of patients diagnosed with Type 2 diabetes in China actually have latent autoimmune diabetes (LADA).
The researchers found that having a family history of diabetes, hypertension, or central obesity, and being exposed to major stressful events all increased the risk for having LADA.
"LADA is considered a 'mild' form of Type 1 diabetes, which shows slow progression to insulin dependence," explain Xiuying Qi (Tianjin Medical University, China) and colleagues. It is less well understood than Type 1 and 2 diabetes and data regarding potential risk factors for this condition are limited.
To investigate further, the researchers recruited 8109 individuals from the Tianjin area (aged 15 years or above; 52.2% women) who were representative of the general population. Of the 498 (6.1% of total cohort) individuals who were initially diagnosed as having Type 2 diabetes, 46 (9.2% of diabetic group) were found to have LADA.
Type 2 diabetes was defined as having a fasting plasma glucose of 7 mmol/l or above or a 2-hour postprandial plasma glucose of 11.1 mmol/l or above. LADA was defined as having similar glucose levels to someone with Type 2 diabetes, being aged 35 years or older, not requiring insulin for at least 6 months after diagnosis, and testing positive for the glutamic acid decarboxylase antibody.
Using the overall cohort as a representation of the general Chinese population, the researchers calculated that the prevalence of LADA in China is likely to be around 0.6%. They found that the prevalence of LADA increased with age until 50-59 years, after which it began to decline. In contrast, the prevalence of Type 2 diabetes continued to increase significantly with age beyond the age of 60 years.
Qi and co-workers observed that having a family history of diabetes significantly increased the risk for LADA 17.59 fold compared with having no family history. Similarly, having hypertension, central obesity (waist circumference of 85 cm or more), or being exposed to major stressful events significantly increased the risk for LADA 1.93, 5.37, and 4.09 fold, respectively.
Of note, these factors also significantly increased the risk for Type 2 diabetes, with corresponding risk increases of 16.06, 2.50, 4.60, and 4.98 fold.
"Given the high prevalence of Type 2 diabetes worldwide, our findings highlight the need to identify patients with LADA for proper treatment," write Qi et al in the journal Diabetes Care.
"Further population-based longitudinal studies are required to verify the risk factors for the development of LADA," they suggest.
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By Helen Albert