Aim
Latent autoimmune diabetes in adults ( LADA) is a heterogeneous and slowly progressive autoimmune diabetes. We aim to provide new insights into the long-term prognosis of LADA with varying degrees of autoimmunity by comparing it with type 2 diabetes and adult-onset type 1 diabetes.
Methods
This Swedish population-based study included newly diagnosed LADA (n = 550, stratified into low LADA and high LADA based on mean level of autoimmunity), type 2 diabetes (n = 2001), adult-onset type 1 diabetes ( n = 1573) and control subjects without diabetes (n = 2355) in 2007-2019.
Registry links provided information on all-cause mortality, cardiovascular disease (CVD), diabetic retinopathy, nephropathy, and clinical characteristics during follow-up.
Results
Mortality was higher in LADA (hazard ratio [HR] 1.44; 95% CI: 1.03, 2.02), type 1 diabetes (2.31 [1.75, 3.05]), and type 2 (1.31 [1.03, 1.67]) than in control subjects.
The incidence of CVD was elevated in high LADA (HR 1.67; 95% CI: 1.04, 2.69) and type 2 diabetes (1.53 [1.17, 2.00]), but not in Low LADA or type 1 diabetes.
The incidence of retinopathy, but not nephropathy, was higher in LADA (HR 2.25, 95% CI 1.64, 3.09), including LADA high and LADA low, than in type 2 diabetes (not available in type 1 diabetes).
More favorable blood pressure and lipid profiles, but higher HbA 1c levels, were observed in LADA than in type 2 diabetes at baseline and throughout follow-up, especially in LADA with high levels that resembled type 1 diabetes at this time. aspect.
Conclusions Despite having fewer metabolic risk factors than type 2 diabetes, LADA has equal risks of death, cardiovascular disease, and retinopathy. Poor glycemic control, particularly at high LADA, highlights the need for improved LADA management. |
