Time to insulin initiation cannot be used in defining latent autoimmune diabetes in adults

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Abstract

OBJECTIVE -Latent autoimmune diabetes in adults is type 1 diabetes presenting as non-insulin dependent diabetes. One feature of the selection criteria is time independent of insulin treatment. We examine the validity of this criterion. RESEARCH DESIGN AND METHODS- Patients were recruited in nine European centers, and clinicians reported on criteria for initiating insulin. All patients were tested for GAD antibodies (GADAs) in a central laboratory. We examined time to insulin treatment for GADApositive patients in six participating centers. RESULTS- There was intercenter variation in the criteria used to initiate insulin. Median time to insulin was 16.15 months (interqartile range 6.7-25.5) in centers with GADA testing compared with 45.6 months (29.5-61.8) in centers without routine GADA testing (P < 0.002). CONCLUSION -Time to insulin should not be used to define patients with LADA because it is dependent on local clinical judgment and the use of laboratory tests for GADA. © 2008 by the American Diabetes Association.

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Brophy, S., Yderstræde, K., Mauricio, D., Hunter, S., Hawa, M., Pozzilli, P., … Williams, R. (2008). Time to insulin initiation cannot be used in defining latent autoimmune diabetes in adults. Diabetes Care, 31(3), 439–441. https://doi.org/10.2337/dc07-1308

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