Study to investigate prevalence of latent autoimmune diabetes of adults in type 2 diabetes patients and evaluate characteristics of patients with LADA

Abstract

To study prevalence of LADA in type2 diabetes patients and evaluate characteristics of patients with LADA.This is cross-sectional observational study, conducted in a tertiary care hospital in South India; once consultation by physician was over, diabetic patients were screened for study criteria; written informed consent was taken from all participants, who fulfilled study criteria. A written permission has been obtained from Institutional Ethics Committee for the conduct of the study, patients with type 2 diabetes mellitus having age of onset of diabetes greater than 35 years and duration of type 2 diabetes less than 3 years are included in the study and subjects who are requiring insulin within 6 months after diagnosis of diabetes are excluded from the study. Radioimmunoassay is used for detection of auto antibodies to GAD65. LADA is diagnosed by presence of autoantibodies to GAD65. Other laboratory indices done are C-peptide assay, HbA1c, anti-TPO antibodies and lipid profile. Prevalence is calculated for auto antibody positive subjects and characteristics of patients are determined by age, gender, BMI and other laboratory indices.Out of 100 type 2 diabetes patients included in the study, 30 were diagnosed with LADA. Among these 30 patients with LADA, 84% patients were between 35-50 years of age and 16% were above 50 years of age and 60% were males and 40% were females. 100 % of LADA patients have BMI less than 30, HbA1c greater than 8 is seen among almost all patients of LADA and low c-peptide levels is recorded in all patients with LADA. Anti-thyroid peroxidase antibodies are seen in 93% of patients diagnosed with LADA.Our study established LADA prevalence of 30% among type 2 diabetes mellitus patients and has shown role of GAD auto antibody in screening for LADA and also tried to evaluate association of age, BMI, higher HbA1c and other autoimmune diseases with LADA. This study helps us in recommending criteria for diagnosis of LADA, screen relatives of LADA patients for immune and metabolic markers to identify high risk individuals.