CURRENT CHARACTERISTICS OF PATIENTS WITH LATENT AUTOIMMUNE DIABETES IN ADULTS IN MEXICO: A MULTICENTRIC STUDY
- Raquel N. Faradji, Mexico
- Raquel N. Faradji, Mexico
- Carmen Castillo-galindo, Mexico
- Neftali E. Antonio-villa, Mexico
- Aili L. Garcia-tuomola, Mexico
- Jose J. Ceballos-macias, Mexico
- Claudia Ramirez-renteria, Mexico
- Natalia E. De la garza-hernández, Mexico
- Alejandro Romero-zazueta, Mexico
- Sigfrido Miracle-lopez, Mexico
- Maricela Vidrio-velázquez, Mexico
- Guillermo Gonzalez-galvez, Mexico
- Ana C. Uribe-wiechers, Mexico
- Juan R. Madrigal-sanroman, Mexico
- Paloma Almeda-valdes, Mexico
- RENACED-DT1 Renaced-dt1-research-group, Mexico
Abstract
Background and Aims
Information regarding Latent Autoimmune Diabetes in Adults (LADA) in Mexico is lacking. RENACED-DT1 is a longitudinal national registry for patients with type 1 diabetes (T1D) and LADA in Mexico.
Methods
Currently 1,586 patients have been registered; of those, 48 patients were diagnosed with LADA. We present a descriptive analysis of this group.
Results
58.3% are women, 65.2% over 30 years of age at diagnosis; 30.4% have had diabetes for <5 years, 37%, between 6 and 10 years, 15.2% between 11-15 years and 17.4% >16 years. Mean HbA1c and BMI at diagnosis were 8.42% and 23.7 kg/m2, respectively. GAD65-Ab, evaluated in 15 cases, were positive in 86.6%. At diagnosis 64% were treated with oral agents, 23% with insulin and 12.8% with both. Currently 89.5% are on insulin treatment, 16.7% with insulin pump, 56.3% with multiple daily injections, 8.3% on basal insulin and 4.2% on a co-formulation; 50% have additional treatment with metformin, 23% with DPP-4 inhibitors, 19% with sulfonylureas and 6.3% with SLGT2-inhibitors. Subjects treated with DPP-4-inhibitors have lower HbA1c (7.1% [5.8-7.8] vs 8.5%, [5.8-7.8], respectively p<0.01) (Figure 1). Three patients have retinopathy and 3 neuropathy. No nephropathy was found. Dyslipidemia occurs in 30.6% and hypertension in 16.7%.
Conclusions
A high prevalence of LADA cases are misdiagnosed. In order to improve diagnosis and understand the presentation of this condition the registration and follow-up of more cases is needed. Recognizing this condition is important to start optimal treatment (DPP-4-inhibitors in C-peptide positive patients, insulin in C-peptide negative patients) and delay chronic complications.