Time to insulin initiation can not be used in defining Latent Autoimmune Diabetes in Adults [LADA].
- S Brophy (s.brophy{at}swansea.ac.uk),
- K Yderstræde,
- D Mauricio,
- S Hunter,
- M Hawa,
- P Pozzilli, MD,
- G Schernthaner,
- N Schloot,
- R Buzzetti,
- H Davies,
- RDG Leslie and
- D.R.R. Williams on behalf of the Action LADA Group
- Dr S Brophy PhD and H Davies MSc and Professor R Williams MD. Swansea University, Swansea, UK
- University Hospital of Odense, Odense
- Dr Yderstraede MD, PhD, University Hospital of Odense, Odense
- Dr Hunter, MD, Royal Victoria Hospital, Belfast
- Professor Leslie, MD and Mr Hawa BSc, St Bartholomew's Hospital, London
- Professor Pozzilli MD, University Campus Bio-Medico, Rome
- Professor Schernthaner MD, Rudolfstiftung Hospital, Vienna
- Dr Schloot, MD,German Diabetes Centre, University of Duesseldorf, Duesseldorf
- Professor Buzzetti MD, Sapienza, University of Rome
Abstract
Objective: Latent Autoimmune Diabetes in Adults [LADA] is type 1 diabetes presenting as non-insulin dependent diabetes. One feature of the selection criteria is time independent of insulin treatment. We examine the validity of this criterion.
Methods: Patients were recruited in 9 European centres and clinicians reported on criteria for initiating insulin. All patients were tested for glutamic acid decarboxylase autoantibodies (GADA) in a central laboratory. We examined time to insulin treatment for GADA positive patients in 6 participating centres.
Results: There was inter-centre variation in the criteria used to initiate insulin. Median time to insulin was 16.15 months (IQR: 6.7 – 25.5) in centres with GADA testing compared to 45.6 months (IQR: 29.5-61.8) in centres without routine GADA testing (p<0.002).
Conclusions: Time to insulin should not be used to define patients with LADA as it is dependent on local clinical judgment and the use of laboratory tests for GADA.
Footnotes
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- Received July 9, 2007.
- Accepted December 10, 2007.
- Copyright © American Diabetes Association
