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- Title
Latent autoimmune diabetes of adulthood (LADA) is associated with small fibre neuropathy.
- Authors
Alam, U.; Jeziorska, M.; Petropoulos, I. N.; Pritchard, N.; Edwards, K.; Dehghani, C.; Srinivasan, S.; Asghar, O.; Ferdousi, M.; Ponirakis, G.; Marshall, A.; Boulton, A. J. M.; Efron, N.; Malik, R. A.
- Abstract
Aim: To assess if latent autoimmune diabetes of adulthood (LADA) is associated with small fibre neuropathy. Methods: Participants with LADA (n=31), Type 2 diabetes (n=31) and healthy control participants without diabetes (n=31) underwent a detailed assessment of neurologic deficits, quantitative sensory testing, electrophysiology, skin biopsy and corneal confocal microscopy. Results: The groups were matched for age (healthy control without diabetes: 53.5±9.1 vs. Type 2 diabetes: 58.0±6.5 vs. LADA: 53.2±11.6 years), duration of diabetes (Type 2 diabetes: 10.0±8.3 vs. LADA: 11.0±9.1 years) and blood pressure. However, BMI (P=0.01) and triglycerides (P=0.0008) were lower and HbA1c (P=0.0005), total cholesterol (P=0.01) and HDL (P=0.002) were higher in participants with LADA compared with Type 2 diabetes. Peroneal motor nerve conduction velocity (P=0.04) and sural sensory nerve conduction velocity (P=0.008) were lower in participants with latent autoimmune diabetes in adults compared with Type 2 diabetes. Intra‐epidermal nerve fibre density (P=0.008), corneal nerve fibre density (P=0.003) and corneal nerve branch density (P=0.006) were significantly lower in participants with LADA compared with Type 2 diabetes. There were no significant differences in the other neuropathy parameters. Conclusions: Despite comparable age and duration of diabetes, participants with LADA demonstrate more severe neuropathy and particularly small fibre neuropathy, compared with participants with Type 2 diabetes. What's new?: Treatment inertia in latent autoimmune diabetes of adulthood (LADA) leads to a prolonged period of poor glycaemic control, which may lead to complications.We demonstrate an excess of small fibre neuropathy in a cohort of patients with LADA compared with age‐ and diabetes duration‐matched people with Type 2 diabetes.Small fibre neuropathy can be diagnosed comparably using corneal confocal microscopy or skin biopsy, further supporting the utility of corneal confocal microscopy as a valid method to screen for diabetic neuropathy in at risk populations.
- Subjects
NEUROPATHY; ELECTROPHYSIOLOGY; GLYCOSYLATED hemoglobin; TYPE 1 diabetes; MICROSCOPY; NEURAL conduction; TYPE 2 diabetes; RESEARCH; TRIGLYCERIDES; MATHEMATICAL variables; QUANTITATIVE research; DISEASE complications; ADULTS; DISEASE risk factors
- Publication
Diabetic Medicine, 2019, Vol 36, Issue 9, p1118
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/dme.13888