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Clinical and metabolic characteristics of patients with latent autoimmune diabetes in adults (LADA): absence of rapid beta-cell loss in patients with tight metabolic control.
Diabetes Metab 2010; 36(1):64-70DM

Abstract

AIM AND METHODS

The present study compared the clinical and metabolic characteristics of latent autoimmune diabetes in adults (LADA) with type 2 diabetes, as well as the residual beta-cell function and progression to insulin treatment, over a 2-year follow-up period, of antibody (Ab)-positive and Ab-negative patients who achieved tight glycaemic control (HbA(1c) 7.0+/-0.8% and 6.5+/-0.9%, respectively, at the time of entry into the study).

RESULTS

Glutamic acid decarboxylase antibodies (GADA) and/or islet cell antibodies (ICA) were detected in 10% of patients presenting with non-insulin-dependent diabetes. Around half of Ab-positive patients required insulin treatment during the follow-up. Ab-positive patients displayed lower stimulated C-peptide levels both at entry and during the follow-up compared with Ab-negative patients, although no significant decline in C-peptide levels was observed in either subgroup over two years. Nevertheless, Ab-positive patients progressed more frequently to insulin treatment, and stimulated C-peptide tended to decrease in LADA patients who subsequently required insulin, whereas it remained stable in those who were non-insulin-dependent. In those who progressed, the trend towards C-peptide decline persisted even after starting insulin treatment.

CONCLUSION

LADA patients demonstrate lower residual beta-cell function than do type 2 diabetes patients. However, those who achieve tight metabolic control do not present with a rapid decline in beta-cell function. Further studies are needed to determine the optimal treatment strategy in such patients.

Authors+Show Affiliations

Clinique d'endocrinologie, maladies métaboliques et nutrition, institut du thorax, hôpital Laennec, boulevard Jacques-Monod, Nantes cedex 1, France. lucy.chaillous@wanadoo.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20060765

Citation

Chaillous, L, et al. "Clinical and Metabolic Characteristics of Patients With Latent Autoimmune Diabetes in Adults (LADA): Absence of Rapid Beta-cell Loss in Patients With Tight Metabolic Control." Diabetes & Metabolism, vol. 36, no. 1, 2010, pp. 64-70.
Chaillous L, Bouhanick B, Kerlan V, et al. Clinical and metabolic characteristics of patients with latent autoimmune diabetes in adults (LADA): absence of rapid beta-cell loss in patients with tight metabolic control. Diabetes Metab. 2010;36(1):64-70.
Chaillous, L., Bouhanick, B., Kerlan, V., Mathieu, E., Lecomte, P., Ducluzeau, P. H., ... Charbonnel, B. (2010). Clinical and metabolic characteristics of patients with latent autoimmune diabetes in adults (LADA): absence of rapid beta-cell loss in patients with tight metabolic control. Diabetes & Metabolism, 36(1), pp. 64-70. doi:10.1016/j.diabet.2009.07.004.
Chaillous L, et al. Clinical and Metabolic Characteristics of Patients With Latent Autoimmune Diabetes in Adults (LADA): Absence of Rapid Beta-cell Loss in Patients With Tight Metabolic Control. Diabetes Metab. 2010;36(1):64-70. PubMed PMID: 20060765.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and metabolic characteristics of patients with latent autoimmune diabetes in adults (LADA): absence of rapid beta-cell loss in patients with tight metabolic control. AU - Chaillous,L, AU - Bouhanick,B, AU - Kerlan,V, AU - Mathieu,E, AU - Lecomte,P, AU - Ducluzeau,P-H, AU - Delamaire,M, AU - Sonnet,E, AU - Maugendre,D, AU - Maréchaud,R, AU - Rohmer,V, AU - Saï,P, AU - Charbonnel,B, Y1 - 2010/01/08/ PY - 2009/04/01/received PY - 2009/07/26/revised PY - 2009/07/29/accepted PY - 2010/1/12/entrez PY - 2010/1/12/pubmed PY - 2010/4/21/medline SP - 64 EP - 70 JF - Diabetes & metabolism JO - Diabetes Metab. VL - 36 IS - 1 N2 - AIM AND METHODS: The present study compared the clinical and metabolic characteristics of latent autoimmune diabetes in adults (LADA) with type 2 diabetes, as well as the residual beta-cell function and progression to insulin treatment, over a 2-year follow-up period, of antibody (Ab)-positive and Ab-negative patients who achieved tight glycaemic control (HbA(1c) 7.0+/-0.8% and 6.5+/-0.9%, respectively, at the time of entry into the study). RESULTS: Glutamic acid decarboxylase antibodies (GADA) and/or islet cell antibodies (ICA) were detected in 10% of patients presenting with non-insulin-dependent diabetes. Around half of Ab-positive patients required insulin treatment during the follow-up. Ab-positive patients displayed lower stimulated C-peptide levels both at entry and during the follow-up compared with Ab-negative patients, although no significant decline in C-peptide levels was observed in either subgroup over two years. Nevertheless, Ab-positive patients progressed more frequently to insulin treatment, and stimulated C-peptide tended to decrease in LADA patients who subsequently required insulin, whereas it remained stable in those who were non-insulin-dependent. In those who progressed, the trend towards C-peptide decline persisted even after starting insulin treatment. CONCLUSION: LADA patients demonstrate lower residual beta-cell function than do type 2 diabetes patients. However, those who achieve tight metabolic control do not present with a rapid decline in beta-cell function. Further studies are needed to determine the optimal treatment strategy in such patients. SN - 1878-1780 UR - https://www.unboundmedicine.com/medline/citation/20060765/Clinical_and_metabolic_characteristics_of_patients_with_latent_autoimmune_diabetes_in_adults__LADA_:_absence_of_rapid_beta_cell_loss_in_patients_with_tight_metabolic_control_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1262-3636(09)00249-3 DB - PRIME DP - Unbound Medicine ER -