Prevalence and Clinical Characteristics of Recently Diagnosed Type 2 Diabetes Patients with Positive Anti-Glutamic Acid Decarboxylase Antibody

Abstract

BackgroundLatent autoimmune diabetes in adults (LADA) refers to a specific type of diabetes characterized by adult onset, presence of islet auto-antibodies, insulin independence at the time of diagnosis, and rapid decline in β-cell function. The prevalence of LADA among patients with type 2 diabetes varies from 2% to 20% according to the study population. Since most studies on the prevalence of LADA performed in Korea were conducted in patients who had been tested for anti-glutamic acid decarboxylase antibody (GADAb), a selection bias could not be excluded. In this study, we examined the prevalence and clinical characteristics of LADA among adult patients recently diagnosed with type 2 diabetes.MethodsWe included 462 patients who were diagnosed with type 2 diabetes within 5 years from the time this study was performed. We measured GADAb, fasting insulin level, fasting C-peptide level, fasting plasma glucose level, HbA1c, and serum lipid profiles and collected data on clinical characteristics.ResultsThe prevalence of LADA was 4.3% (20/462) among adult patients with newly diagnosed type 2 diabetes. Compared with the GADAb-negative patients, the GADAb-positive patients had lower fasting C-peptide levels (1.2±0.8 ng/mL vs. 2.0±1.2 ng/mL, P=0.004). Other metabolic features were not significantly different between the two groups.ConclusionThe prevalence of LADA is 4.3% among Korean adult patients with recently diagnosed type 2 diabetes. The Korean LADA patients exhibited decreased insulin secretory capacity as reflected by lower C-peptide levels.

Low prevalence of latent autoimmune diabetes in adults in northern India

“…In other racial groups, such as African‐Americans and Hispanics, the prevalence of LADA is lower than in white people . Studies from Asian countries such as China, Japan and Korea report a relatively low prevalence of 4–6% for LADA .…”

Distinct clinical and laboratory characteristics of latent autoimmune diabetes in adults in relation to type 1 and type 2 diabetes mellitus

“…Factually, guidelines on LADA treatment do not exist and is controversial whether sulphonylurea, insulin, vitamin D or alternative therapies such as GAD65, can influence the beta-cell loss progression and metabolic control [59] . Since LADA patients are presented not only with gradually developing insulin deficiency, but also with insulin resistance, a unique treatment strategy should be designed, in order to treat hyperglycaemia and to preserve b-cell function [60] .…”

Long‐term effects on glycaemic control and β‐cell preservation of early intensive treatment in patients with newly diagnosed type 2 diabetes: A multicentre randomized trial

“…In the present study, the rate of anti‐GAD Ab in the patients with T2DM was found to be 8.3%. The reported prevalence rates of anti‐GAD Ab in Korean patients with T2DM ranges from 1.7% to 12.6% . It has also been reported that patients with low titres (<10 U) of anti‐GAD Ab exhibit significantly higher C‐peptide levels than those with high titres (≥10 U); there were no insulin‐users among participants with low titres of anti‐GAD Ab .…”

“…The reported prevalence rates of anti‐GAD Ab in Korean patients with T2DM ranges from 1.7% to 12.6% . It has also been reported that patients with low titres (<10 U) of anti‐GAD Ab exhibit significantly higher C‐peptide levels than those with high titres (≥10 U); there were no insulin‐users among participants with low titres of anti‐GAD Ab . Another follow‐up study of Korean patients reported that only 3 of 39 patients who were initially classified as having late autoimmune diabetes in adults (LADA) became insulin‐dependent after 36 months; these 3 patients were all positive for multiple autoantibodies (GAD, islet antigen 2, and zinc transporter 8 antibody).…”