Latent autoimmune diabetes of adults is phenotypically similar to type 1 diabetes in a minority population

Abstract

Context: Latent autoimmune diabetes of adults (LADA) is a form of autoimmune diabetes that has been classified as part of type 1 diabetes or as a distinct clinical entity. Its precise place as a disease category is therefore controversial. Objective: The objective of this study was to further examine this issue by comparing the phenotypes of LADA and type 1 diabetes in a predominately minority population. Patients and Methods: We studied 126 subjects who were anti-glutamic acid decarboxylase antibody- positive in two separate studies - 63 subjects in an outpatient study (study 1), and 63 inpatients after resolution of ketoacidosis (study 2). Clinical and biochemical phenotyping was performed in all patients in each group. Results: Few significant differences were found in the clinical or biochemical phenotypes in patients classified as LADA when compared with type 1 diabetes. Adiposity, body mass index, waist/ hip ratio, fasting plasma C-peptide, serum high-density lipoprotein cholesterol, and triglycerides were all similar. The only distinguishing feature was a history of hypertension (study 1) or systolic blood pressure (study 2). Also, a history of ketoacidosis did not influence the phenotype of LADA in the outpatients in any discernable way. Conclusions: We conclude that LADA and type 1 diabetes are phenotypically indistinguishable in this predominantly minority population with a mean duration of glutamic acid decarboxylase antibody-positive diabetes of about 8 yr. Copyright © 2012 by The Endocrine Society.