LADA and CARDS: A Prospective Study of Clinical Outcome in Established Adult-Onset Autoimmune Diabetes
| العنوان: | LADA and CARDS: A Prospective Study of Clinical Outcome in Established Adult-Onset Autoimmune Diabetes |
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| المؤلفون: | Graham A. Hitman, Richard David Leslie, H. Andrew W. Neil, Thomas O. Ola, Chuan Chuan Wun, David A. DeMicco, Paul N. Durrington, D. John Betteridge, Mohammed I. Hawa, Weihang Bao, Ana Paula Buchan, Helen M. Colhoun, John H. Fuller |
| المصدر: | Diabetes Care. 37:1643-1649 |
| بيانات النشر: | American Diabetes Association, 2014. |
| سنة النشر: | 2014 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Atorvastatin, medicine.medical_treatment, Type 2 diabetes, Double-Blind Method, Risk Factors, Germany, Diabetes mellitus, Internal medicine, Glucose Intolerance, Prevalence, Internal Medicine, medicine, Humans, Hypoglycemic Agents, Insulin, Pyrroles, Prospective Studies, Age of Onset, Prospective cohort study, Aged, Autoantibodies, Metabolic Syndrome, Advanced and Specialized Nursing, Glutamate Decarboxylase, business.industry, Anticholesteremic Agents, Autoantibody, Middle Aged, medicine.disease, Diabetes Mellitus, Type 1, Phenotype, Endocrinology, Diabetes Mellitus, Type 2, Heptanoic Acids, Female, Metabolic syndrome, Age of onset, business, medicine.drug |
| الوصف: | OBJECTIVE Diabetes-associated autoantibodies can be detected in adult-onset diabetes, even when initially non–insulin requiring, i.e., with latent autoimmune diabetes. We aimed to identify adult-onset autoimmune diabetes in patients with established “type 2 diabetes” participating in the Collaborative Atorvastatin Diabetes Study (CARDS) to characterize their phenotype and clinical outcome. RESEARCH DESIGN AND METHODS We prospectively studied 2,425 European patients with presumed type 2 diabetes (mean age 62 years, diabetes duration 7.9 years) for outcomes at 3.9 years after randomization to either atorvastatin or placebo. Subjects were screened for autoantibodies to GAD (GADA), insulinoma-associated antigen-2 (IA-2A), and zinc-transporter 8 (ZnT8A). RESULTS A total of 173 patients (7.1%) had GADA, of whom 11 (0.5%) and 5 (0.2%) were also positive for IA-2A and ZnT8A, respectively. At baseline, 44% of GADA-positive patients were not on insulin. Fewer autoantibody-positive than autoantibody-negative patients had metabolic syndrome (64 vs. 80%), and more were on insulin (56 vs. 17%) (P < 0.0001 for each) without lower HbA1c (69 mmol/mol [8.5%] vs. 62 mmol/mol [7.8%]). The frequency of microvascular and macrovascular events was similar in both cohorts, independent of atorvastatin. CONCLUSIONS Adult-onset autoimmune diabetes was prevalent, even in patients with established diabetes presumed to have type 2 diabetes. After 11.8 years’ diabetes duration, nearly half the patients with autoimmune diabetes were not on insulin treatment and almost two-thirds had metabolic syndrome. The type of diabetes, whether autoimmune diabetes or type 2 diabetes, did not impact the risk of microvascular disease. |
| تدمد: | 1935-5548 0149-5992 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2bf3a782882c8b53a6d6c0a157c6a2fdTest https://doi.org/10.2337/dc13-2383Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....2bf3a782882c8b53a6d6c0a157c6a2fd |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19355548 01495992 |
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