July 22, 2013

T1D, T2D, and LADA Comparison


LADA2The understanding of LADA is a little shady. A study published in Diabetes Metabolism Reserve Review has cleared up the characteristics of this type of diabetes, based on the LADA population in Spain.

This study was designed to define the clinical characteristics and insulin secretion in adults with latent autoimmune diabetes (LADA). These results were compared with people who had antibody-negative  T2D or adult-onset T1D.

For the sake of science, 82 patients with LADA, 78 with T1D and 485 with T2D were studied. Clinical and metabolic data, in particular those that related to metabolic syndrome, fasting C-peptide and islet-cell autoantibodies GADAb and IA2  were measured.

During the first 3 years of disease onset, the C-peptide concentration in LADA patients was higher than in people with T1D but was lower than in people with T2D. In other words, beta cells lingered longer in LADA, but were aggressively attacked in T1D.

Beta cell function is related to GADAb in people with LADA. IA2 seems to be more prevalent in people with T1D. The frequency of metabolic syndrome in patients with LADA was higher than in those with T1D and lower than in patients with T2D.

Glucose control in LADA patients was worse than in patients with T2D. An inverse association between GADAb and C-peptide concentrations was found in people with LADA. Finally, LADA patients rapidly progressed to insulin treatment.

People with LADA in Spain have a distinct metabolic profile compared with people who have T1D or T2D. LADA is also associated with higher impairment of beta-cell function and worse glucose control than in people who have T2D.

Pretend diabetes was a race and the finish line was insulin treatment. If you have 3 competitors: T1D, LADA, and T2D. T1D, who  reaches the finish line first?. T1D finishes the race before LADA and get on the track. T2D may never finish the race. But LADA gets to the finish line with more certainty than T2D. It’s the tortoise and the hare, in diabetes.

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