ICEECE2012 Poster Presentations Diabetes (248 abstracts)
High GADA titre: a marker of insulin dependence in adult onset autoimmune diabetes
M. Spoletini 1 , S. Zampetti 1 , M. Capizzi 1 , C. Tiberti 1 , C. Venditti 1 , G. Campagna 1 , E. Bosi 2 , R. Buzzetti 1 & Nirad Study Group Italian Society of Diabetes 1
1Sapienza University, Rome, Italy; 2San Raffaele Vita-Salute University, Milan, Italy.
Introduction: In latent autoimmune diabetes of adults (LADA), the progression to insulin-dependent diabetes is usually faster than in type 2 diabetes (T2DM) but the factors influencing this progression are not completely known. The aim of the present study was to determine whether GADA could be used as predictors of insulin dependence and whether GADA titre could define the risk of progression to insulin therapy in LADA patients. We looked for other biochemical and clinical parameters associated with early development of insulin dependence.
Methods: Adult onset GADA positive autoimmune diabetes subjects (n=191) were selected from the Non Insulin Requiring Autoimmune Diabetes (NIRAD) cohort of 4,250 T2DM subjects. GADA titre showed a bimodal distribution which identified two subgroups of patients with high (>32 GADA U) or low GADA titre (≤32 GADA U). One hundred ninety one GADA positive patients were followed for 6 years from diagnosis to evaluate the progression of patients started insulin therapy. Kaplan-Meir curves were plotted and log-rank test was performed to identify possible markers capable to influence the progression to insulin dependence. During the follow up 6/191 GADA positive patients dropped out from the study.
Results: The number of LADA patients who required insulin therapy was 93/191 (48.7%). We observed, that a significant higher number of high GADA titre patients 61/93 (65.6%) progressed to insulin dependence within 6 years of diagnosis compared to low GADA titre patients 32/93 (34.4%) (p=0.003). LADA patients with BMI<25 kg/m2 could have a faster progression towards insulin therapy compared to patients with BMI ≧ 25 kg/m2 (p=0.07).
Conclusion: We observed that neither TPO Ab titre neither gender were predictive markers of progression to insulin dependence. High GADA titre is a marker of progression towards insulin dependence in LADA patients.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This work was supported, however funding details unavailable.
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Endocrine Abstracts
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