Equivalent insulin resistance in latent autoimmune diabetes in adults (LADA) and type 2 diabetic patients

Chiu, Harvey K.; Tsai, Elaine C.; Juneja, Rattan; Stoever, James A.; Brooks-Worrell, Barbara; Goel, Amit; Palmer, Jerry P.

doi:10.1016/j.diabres.2006.12.013

Cited by 76 publications

(53 citation statements)

References 31 publications

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“…As in LADA compared to type 1 diabetes, C-peptide is better preserved at diagnosis and declines at a lower rate [34,35,55]. LADA patients have comparable insulin resistance to patients with established type 1 diabetes but are less insulin resistant than type 2 diabetes patients, [56,57] although a recent study in Asia showed similar insulin resistance between patients with LADA and those with type 2 diabetes [58]. Regarding the frequency of the metabolic syndrome, it appears to be more prevalent in LADA than in type 1 diabetes patients [59], though the latter are much younger, but less prevalent than in type 2 diabetes (74.1% versus 83.7% respectively) [57].…”

Section: Insulin Secretion and Sensitivitymentioning

confidence: 90%

Diabetes classification: grey zones, sound and smoke: Action LADA 1

Leslie

Kolb

Schloot

et al. 2008

Diabetes Metabolism Res

123

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Diseases gain identity from clinical phenotype as well as genetic and environmental aetiology. The definition of type 1 diabetes is clinically exclusive, comprising patients who are considered insulin dependent at diagnosis, whilst the definition of type 2 diabetes is inclusive, only excluding those who are initially insulin dependent. Ketosis-prone diabetes (KPD) and latent autoimmune diabetes in adults (LADA) are each exclusive forms of diabetes which are, at least initially, clinically distinct from type 2 diabetes and type 1 diabetes, and each have a different natural history from these major types of diabetes.KPD can be diagnosed unequivocally as diabetes presenting with the categorical clinical feature, ketoacidosis. In contrast, LADA can be diagnosed by the co-occurrence of three traits, not one of which is categorical or exclusive to the condition: adult-onset non-insulin-requiring diabetes, an islet autoantibody such as glutamic acid decarboxylase autoantibodies (GADA) or cytoplasmic islet cell autoantibodies (ICA), and no need for insulin treatment for several months post-diagnosis. But while some would split diabetes into distinct subtypes, there is a strong case that these subtypes form a continuum of varying severity of immune and metabolic dysfunction modified by genetic and non-genetic factors. This article discusses the nature of disease classification in general, and KPD and LADA in particular, emphasizing the potential value and pitfalls in classifying diabetes and suggesting a need for more research in this area.

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Section: Insulin Secretion and Sensitivitymentioning

confidence: 90%

Diabetes classification: grey zones, sound and smoke: Action LADA 1

Leslie

Kolb

Schloot

et al. 2008

Diabetes Metabolism Res

123

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“…In addition, LADA patients tend to have features of type 2 diabetes including overweight and insulin resistance. 14 Risk factors are largely unexplored and as far as we know, the risk of LADA in relation to intake of fatty fish has never been investigated before.…”

Section: Introductionmentioning

confidence: 99%

Fatty fish consumption and risk of latent autoimmune diabetes in adults

et al. 2014

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Objective:It has been suggested that intake of fatty fish may protect against both type 1 and type 2 diabetes. Hypotheses rest on the high marine omega-3 fatty acid eicosapentaenoic acid+docosahexaenoic acid (EPA+DHA) and vitamin D contents, with possible beneficial effects on immune function and glucose metabolism. Our aim was to investigate, for the first time, fatty fish consumption in relation to the risk of latent autoimmune diabetes in adults (LADA).Methods:Analyses were based on data from a Swedish case–control study with incident cases of LADA (n=89) and type 2 diabetes (n=462) and randomly selected diabetes-free controls (n=1007). Diabetes classification was based on the onset of age (⩾35), glutamic acid decarboxylase autoantibodies, and C-peptide. A validated food frequency questionnaire was used to derive information on previous intake of fish, polyunsaturated long-chain omega-3 fatty acids (n-3 PUFA) and supplementation of fish oil and vitamin D. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using logistic regression, adjusted for age, gender, body mass index (BMI), family history of diabetes, physical activity, smoking, education, and consumption of alcohol, fruit, vegetables and red meat.Results:Weekly fatty fish consumption (⩾1 vs <1 serving per week), was associated with a reduced risk of LADA but not type 2 diabetes (OR 0.51, 95% CI 0.30–0.87, and 1.01, 95% CI 0.74–1.39, respectively). Similar associations were seen for estimated intake of n-3 PUFA (⩾0.3 g per day; LADA: OR 0.60, 95% CI 0.35–1.03, type 2 diabetes: OR 1.14, 95% CI 0.79–1.58) and fish oil supplementation (LADA: OR 0.47, 95% CI 0.19–1.12, type 2 diabetes: OR 1.58, 95% CI 1.08–2.31).Conclusions:Our findings suggest that fatty fish consumption may reduce the risk of LADA, possibly through effects of marine-originated omega-3 fatty acids.

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“…Insulin resistance, an integral part of the pathophysiology of T2D, is affected by many variables, including age, body mass index, ethnicity, physical activity, and medications. When insulin resistance is assessed by the homeostasis model and corrected for body mass index, autoimmune and nonautoimmune T2D patients show no difference in insulin resistance (38 ). Insulin resistance has also been recognized in T1D and is associated with progression to disease in people at risk for T1D (39 -42 ).…”

Section: Pathophysiologymentioning

confidence: 99%

Is Diabetes Mellitus a Continuous Spectrum?

Brooks-Worrell

Palmer

2011

Clinical Chemistry

Self Cite

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BACKGROUND Diabetes mellitus has been historically divided into type 1 and type 2 diabetes, with type 1 being an autoimmune disease and type 2 being primarily a metabolic disease. CONTENT The current diabetes classification scheme needs to be reevaluated because of the accumulating evidence of immune system involvement in the pathophysiology of type 2 diabetes. SUMMARY There are similarities and differences between type 1 and type 2 diabetes with regard to pathogenesis, pathophysiology, and genetics. We propose a resolution to the dilemma of the current classification scheme.

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Equivalent insulin resistance in latent autoimmune diabetes in adults (LADA) and type 2 diabetic patients

Cited by 76 publications

References 31 publications

Diabetes classification: grey zones, sound and smoke: Action LADA 1

Diabetes classification: grey zones, sound and smoke: Action LADA 1

Fatty fish consumption and risk of latent autoimmune diabetes in adults

Is Diabetes Mellitus a Continuous Spectrum?

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