AimsTo describe and to characterize clinical features of latent autoimmune diabetes in adults (LADA) compared to type 1 and type 2 diabetes in the UAE.MethodsIn this cross-sectional study a dataset including 18,101 subjects with adult-onset (>30 years) diabetes was accessed. 17,072 subjects fulfilled the inclusion/exclusion criteria. Data about anthropometrics, demographics, autoantibodies to Glutamic Acid Decarboxylase (GADA) and to Islet Antigen 2 (anti-IA2), HbA1c, cholesterol and blood pressure were extracted. LADA was diagnosed according to GADA and/or anti-IA2 positivity and time to insulin therapy.Results437 (2.6%) patients were identified as LADA and 34 (0.2%) as classical type 1 diabetes in adults. Mean age at diagnosis, BMI, waist circumference, systolic blood pressure and HbA1c significantly differed between, LADA, type 2 and type 1 diabetes, LADA showing halfway features between type 2 and type 1 diabetes. A decreasing trend for age at diagnosis and waist circumference was found among LADA subjects when subdivided by positivity for anti-IA2, GADA or for both antibodies (p=0.013 and p=0.011 for trend, respectively). There was a gradual downward trend in autoantibody titre in LADA subjects requiring insulin within the first year from diagnosis to subjects not requiring insulin after 10 years of follow-up (p<0.001).ConclusionsThis is the first study describing the clinical features of LADA in the UAE, which appear to be different from both type 1 and type 2 diabetes. Furthermore, we showed that the clinical phenotype of LADA is dependent on different patterns of antibody positivity, influencing the time to insulin requirement.

thus be given the opportunity to show if they are "responders" at 16 weeks and "super responders" at 52 weeks; the medication would only be continued long-term in those who may benefit most. Future studies with liraglutide 3 mg and other obesity medications will have to assess long-term cost-effectiveness and the budgetary impact of using these medications to address not only body weight loss, but also the effects upon various obesity-related comorbidities. 15The strengths of our data include the large number of patients, the detailed documentation of follow-up, and the routine clinical practice setting from a single centre. Thus, the findings are probably generalizable to other routine care clinics. The limitations include the dependence on medical records to ascertain compliance, and not accounting for possible gaps in treatment. A further limitation is the short duration of treatment in our study of 4 to 8 months compared with 1 to 3 years in the SCALE study. 6In conclusion, we show that liraglutide 3 mg combined with lifestyle advice is effective in reducing body weight in patients from Arab descent attending routine clinical care. The outcomes achieved as regards the amount of weight lost at 3 months and the percentage of patients achieving 5% weight loss were similar to published randomized controlled trials. Our results show that the treatment is also effective and safe in postbariatric surgery patients. This suggests that data from randomized controlled trials using liraglutide 3 mg can be used to inform clinical practice. The question that now needs to be answered is whether the use of this drug is cost-effective for most patients with obesity, or whether cost-effectiveness will only reach the desired level in a sub-cohort of patients, such as those with obesity and prediabetes.

The indigenous population of the United Arab Emirates (UAE) has a unique demographic and cultural history. Its tradition of endogamy and consanguinity is expected to produce genetic homogeneity and partitioning of gene pools while population movements and intercontinental trade are likely to have contributed to genetic diversity. Emiratis and neighboring populations of the Middle East have been underrepresented in the population genetics literature with few studies covering the broader genetic history of the Arabian Peninsula. Here, we genotyped 1,198 individuals from the seven Emirates using 1.7 million markers and by employing haplotype-based algorithms and admixture analyses, we reveal the fine-scale genetic structure of the Emirati population. Shared ancestry and gene flow with neighboring populations display their unique geographic position while increased intra- versus inter-Emirati kinship and sharing of uniparental haplogroups, reflect the endogamous and consanguineous cultural traditions of the Emirates and their tribes.

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