Abstract
Background
Latent Autoimmune Diabetes in Adults (LADA) is the second most common form of diabetes,
but data on its clinical course and prognosis are scarce. We compared long-term risk
of mortality and cardiovascular outcomes in patients with LADA, type 2 diabetes mellitus
(T2D), and insulin deficient diabetes (IDD).
Methods
We conducted a cohort study of 4368 adults with diabetes referred to the Department
of Endocrinology, Odense University Hospital, Denmark, between 1997 and 2012. Data
on comorbidity, cardiovascular outcomes and death were obtained from prospective medical
databases. We compared adjusted hazard ratios (HRs) of mortality and cardiovascular
outcomes for patients with LADA, T2D and IDD, respectively.
Results
We included 327 patients with LADA, 3539 with T2D and 502 with IDD. At diagnosis,
patients with LADA were older (50 years (IQR 37–59)) than IDD patients (40 years (IQR
28–52)), but younger than patients with T2D (55 years (IQR 45–64)). During a median
follow-up period of 6.6 years (IQR 3.4–9.4), patients with IDD had higher mortality
than patients with LADA, age- and gender-adjusted HR 2.2 (95% CI, 1.5–3.2). T2D also
conferred higher mortality than LADA, HR 1.4 (95% CI, 1.0–1.9). Compared with LADA
patients, cardiovascular outcome rates were increased both with IDD, HR 1.2 (95% CI,
0.7–2.0) and T2D, HR 1.2 (95% CI, 0.8–1.8), with the strongest association observed
for T2D vs. LADA and acute myocardial infarction HR 1.7 (95% CI, 0.8–3.5).
Conclusion
LADA seems to be associated with lower mortality and lower risk of cardiovascular
events, compared with both T2D and IDD.
Keywords
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Article info
Publication history
Published online: March 05, 2018
Accepted:
February 27,
2018
Received in revised form:
February 2,
2018
Received:
December 18,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
