Metabolic syndrome and autoimmune diabetes: action LADA 3.

OBJECTIVE: The purpose of this study was to estimate whether prevalence of metabolic syndrome in adult European diabetic patients is associated with type of diabetes. RESEARCH DESIGN AND METHODS: A consecutive series of patients attending hospital-based diabetes clinics were assessed for the frequency of metabolic syndrome and compared with population-based control subjects as part of the Action LADA study. In total, 2,011 subjects (aged 30-70 years) were studied, including 1,247 patients with recent-onset type 2 diabetes without glutamic acid decarboxylase autoantibodies (GADAs), 117 non-insulin-requiring patients with GADAs who had not received insulin therapy for at least 6 months after diagnosis (designated latent autoimmune diabetes of adults [LADA]), 288 type 1 diabetic patients, and 359 normal subjects. RESULTS: Frequency of metabolic syndrome was significantly different in patients with type 1 diabetes (31.9%) and LADA (41.9%) (P = 0.015) and in both conditions was less frequent than in type 2 diabetic patients (88.8%) (P < 0.0001 for each). Eliminating glucose as a variable, the prevalence of metabolic syndrome was similar in patients with autoimmune diabetes (type 1 diabetes and/or LADA) (17.3%) and control subjects (23.7%) but remained more common in type 2 diabetic patients (47.8%) (P = 0.001 for all groups). In both type 1 diabetic patients and those with LADA, individual components of metabolic syndrome were similar but less common than in type 2 diabetic patients (P < 0.0001 for each). CONCLUSIONS: The prevalence of metabolic syndrome is significantly higher in type 2 diabetic patients than in patients with LADA or adults with type 1 diabetes. Excluding glucose as a variable, metabolic syndrome is not more prevalent in patients with autoimmune diabetes than in control subjects. Metabolic syndrome is not a characteristic of autoimmune diabetes.

Type 1 diabetes and latent autoimmune diabetes in adults.

The review is aimed to explore the clinical and pathogenic spectrum of autoimmune diabetes including Type 1 diabetes and latent autoimmune diabetes in adults (LADA). Genetic susceptibility modifies age at onset in autoimmune diabetes. The most important genetic susceptibility to Type 1 diabetes and LADA is in the HLA region. Because of the age-related genetic factors, LADA can not be distinguished from classic Type 1 diabetes by genetics. Non-genetic factors contribute much to Type 1 diabetes, but little is known in LADA. Diabetes-associated immune process can occur in early childhood and can be predictive of an ongoing beta cell destruction. The management and prevention of LADA need to be investigated in order to define the best therapeutic strategy.