Latent Autoimmune Diabetes in Adults in a South Asian Population of the U.K.
- Abigail C. Britten, BSC1,
- Karen Jones, BSC1,
- Carina Törn, PHD2,
- Magnus Hillman, PHD2,
- Birgitte Ekholm2,
- Sudhesh Kumar, MD, FRCP3,
- Anthony H. Barnett, MD, FRCP14 and
- Marilyn Ann Kelly, PHD1
- 1Department of Medicine, University of Birmingham, Birmingham, U.K
- 2Clinical Sciences, Lund University, Lund, Sweden
- 3Diabetes and Metabolism, University of Warwick, Coventry, U.K
- 4Heart of England NHS Foundation Trust, Birmingham, U.K
- Address correspondence and reprint requests to Abigail Britten, Diabetes Research Group, ELG54, The Medical School, Vincent Drive, Edgbaston, Birmingham, B15 2TT, U.K. E-mail: a.c.britten{at}bham.ac.uk
Type 2 diabetes is four- to sixfold more common in the South Asian population of the U.K. than in the indigenous white Caucasian population. A subset of all patients initially diagnosed with type 2 diabetes shows evidence of slowly evolving islet autoimmunity, termed latent autoimmune diabetes in adults (LADA). LADA is characterized by the presence of circulating autoantibodies specific for islet proteins and by insulin independence for at least 6 months postdiagnosis (1).
A recent pilot study in Birmingham, U.K., suggested that 27% of South Asians initially presenting with type 2 diabetes were positive for autoantibodies to GAD65 and/or insulinoma-associated protein (IA)-2 (2). This is significantly higher than the islet autoimmunity frequency of 10% observed in white Caucasians diagnosed with type 2 diabetes (3,4). The study in South Asians was carried out in a very small cohort, however, and the findings require confirmation in a much larger study group. The aim of this study was to determine the prevalence of LADA in a larger U.K.-resident South Asian population and to characterize the phenotypic features and genetic basis of the disease in this ethnic group.
RESEARCH DESIGN AND METHODS
A total of 500 South Asian subjects with type 2 diabetes (mean [range] age 55 years [31-89] and disease duration 7 years [0-29]) (Table 1) were consecutively recruited in Birmingham, U.K., and Coventry, U.K., as part of the U.K. Asian Diabetes Study. A total of 206 normoglycemic …
