The Impact of Thyroid Autoimmunity on the Clinical and Diabetes Parameters of Patients with Latent Autoimmune Diabetes in Adults

Abstract

Aim: We evaluated the clinical and diabetes parameters of latent autoimmune diabetes in adults (LADA) patients according to the presence of thyroid autoimmunity (TA).

Materials and methods: Patients with LADA (diabetes onset after 30 years of age, no need for insulin treatment for at least 6 months after diabetes onset, positive for glutamic acid decarboxylase antibodies (GADA)) were evaluated for the presence of thyroid peroxidase antibodies (TPOAb) and were subjected to clinical and laboratory evaluations of the glycated hemoglobin and basal C peptide levels. The patients were stratified into either group A (with TA) or group B (without TA).

Results: We evaluated 104 (57 female and 47 male) patients with LADA. The mean age at diabetes onset was 44±10 years. The prevalence of TA among the LADA patients was 28.8% (30 patients; 23 female and 7 male). In groups A and B, the mean age at diabetes onset was 41.47±10.15 and 45.07±10 years (p=0.03), the basal C peptide level was 0.69±0.16 and 1.9±1.3 ng/ml (p<0.0001), the glycated hemoglobin level was 9.8±2.2 and 9.1±2.2 (p=0.04), and the time to insulin treatment was 3.2±2.1 years and 4.98±2.2 years (p=0.038), respectively. The use of a basal bolus insulin regimen was more frequent in group A than in group B (56.7% and 35.1%, respectively; p=0.03).

Conclusion: TA identifies a particular phenotype of LADA displaying a higher GADA titer, lower basal C peptide levels and poorer glycemic control.

Key words

LADA - autoimmune diabetes - TPO antibodies - GAD antibodies - C peptide

• References

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