Latent autoimmune diabetes of the adult: epidemiology in the Netherlands

T.E.H. Römkens, M.G. Netea, J. Schouten, G.C.M. Kusters, P. Candeloro, A. Falorni, P. Brunetti, P.M. Netten

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    Abstract

    Background and Aims: A fraction of patients with clinically type 2 diabetes have humoral immunological changes and requiring insulin therapy at short time. This type of diabetes is named Latent Autoimmune Diabetes of the Adult (LADA). Special attention should be paid to diagnose such patients because therapy may influence the speed of progression toward insulin dependency. In the Netherlands no epidemiological study exists on this diabetic population.
    The aim of the study is to determine prevalence of LADA on a diabetic outpatient clinical department of a Dutch, non-university hospital and describe patients characteristics in this population.

    Materials and Methods: During a four-month study period, we studied 407 consecutive patients with diabetes mellitus type 2 who visited the outpatient clinic. Blood tests for GAD-antibodies were performed from 230 patients, after informed consent was obtained. History, physical examination, and other laboratory results were obtained from the patients file. 177 Patients were excluded from the study because of refusal, suboptimal thyroidfunction, malignancy, the use of NSAIDs and/or acetylsalicylacid. These exclusion criteria were used because of further studies in the LADA population.

    Results: 26 (11.3%) patients had positive GAD-antibodies (anti-GAD level median 0.55 U). 27% was male. Mean age of this group 59.3±16.3 years. Median time before insulin requirement 18.5 months (range 3-396). BMI was 27.8±4.5 kg/m2. The prevalence of long-term complications was as follows: neuropathy: 30.8%, retinopathy 30.8%, hypertension 46.25%, peripheral vascular damage 30.7%. Laboratory results showed fasting glucose 11.7±4.8 mmol/I HbAlc 8.3±1.6 mmolll, total cholesterol 5.4±1.06 mmolll, HDL-cholesterol 1.73±0.53 mmolll, triglycerides median 1.1 mmolll (range 0.5-9.7), LDL 2.88±1.16 mmoi/l. The prevalence of hypothyreoidism was 19.2%.

    Conclusion: The prevalence of LADA in this Dutch patient group was 11.3%. This is comparable with previous study results in other countries. Concerning late complications, the LADA population has no major difference compared to a normal type 2 diabetes population. Striking is the high concentration of HDL-cholesterol and the high prevalence of hypothyreoidism.
    Original languageEnglish
    Pages (from-to)A61-A61
    JournalDiabetologia
    Volume45
    Issue numberSuppl. 2
    DOIs
    Publication statusPublished - Aug 2002
    Event38th EASD Annual Meeting of the European Association for the Study of Diabetes 2002 - Budapest, Hungary
    Duration: 1 Sep 20025 Sep 2002
    Conference number: 38

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