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Worse glycaemic control in LADA patients than in those with type 2 diabetes, despite a longer time on insulin therapy
Department of Clinical Sciences, Lund University, Malmö, Sweden.
Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.ORCID iD: 0000-0002-5095-3454
Department of Primary Health Care, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
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2013 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 56, no 2, 252-258 p.Article in journal (Refereed) Published
Abstract [en]

Our aim was to study whether glycaemic control differs between individuals with latent autoimmune diabetes in adults (LADA) and patients with type 2 diabetes, and whether it is influenced by time on insulin therapy. We performed a retrospective study of 372 patients with LADA (205 men and 167 women; median age 54 years, range 35-80 years) from Swedish cohorts from SkAyenne (n = 272) and Vasterbotten (n = 100). Age- and sex-matched patients with type 2 diabetes were included as controls. Data on the use of oral hypoglycaemic agents (OHAs), insulin and insulin-OHA combination therapy was retrieved from the medical records. Poor glycaemic control was defined as HbA(1c) a parts per thousand yen7.0% (a parts per thousand yen53 mmol/mol) at follow-up. The individuals with LADA and with type 2 diabetes were followed for an average of 107 months. LADA patients were leaner than type 2 diabetes patients at diagnosis (BMI 27.7 vs 31.0 kg/m(2); p < 0.001) and follow-up (BMI 27.9 vs 30.2 kg/m(2); p < 0.001). Patients with LADA had been treated with insulin for longer than those with type 2 diabetes (53.3 vs 28.8 months; p < 0.001). There was no significant difference between the patient groups with regard to poor glycaemic control at diagnosis, but more patients with LADA (67.8%) than type 2 diabetes patients (53.0%; p < 0.001) had poor glycaemic control at follow-up. Patients with LADA had worse glycaemic control at follow-up compared with participants with type 2 diabetes (OR = 1.8, 95% CI 1.2, 2.7), adjusted for age at diagnosis, HbA(1c), BMI at diagnosis, follow-up time and duration of insulin treatment. Individuals with LADA have worse glycaemic control than patients with type 2 diabetes despite a longer time on insulin therapy.

Place, publisher, year, edition, pages
2013. Vol. 56, no 2, 252-258 p.
Keyword [en]
GAD isoform 65, HbA(1c), Latent autoimmune diabetes in adults
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Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-64935DOI: 10.1007/s00125-012-2759-yISI: 000313075500004OAI: oai:DiVA.org:umu-64935DiVA: diva2:603621
Available from: 2013-02-06 Created: 2013-02-04 Last updated: 2017-12-06Bibliographically approved

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Nyström, LennarthRolandsson, Olov

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