Latent autoimmune diabetes in adults in a population-based cohort of Polish patients with newly diagnosed diabetes mellitus Barbara Szepietowska, Anna Głębocka, Urszula Puch, Maria Górska, Małgorzata Szelachowska Clinical research Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Poland Submitted: 27 August 2010 Accepted: 24 February 2011 Arch Med Sci 2012; 8, 3: 491-495 DOI: 10.5114/aoms.2012.29405 Copyright © 2011 Termedia & Banach A b s t r a c t Introduction: Latent autoimmune diabetes in adults (LADA) is a slowly devel- oping form of autoimmune diabetes characterized by the presence of type 1 dia- betes-associated autoantibody. The aim of this study was to determine the inci- dence and characteristics of LADA in a population-based cohort of Polish patients with newly-diagnosed diabetes. Material and methods: The study cohort was taken from the resident popula- tion of the city Białystok, Poland, during the period 1 January to 31 December 2003, aged 20-64 years. During this period we identified 231 cases of diabetes. We measured glutamic acid decarboxylase (GADA) and insulin antibody (IAA), insulin, C peptide and glycated hemoglobin (HbA1c). Diagnosis of LADA was made according to Immunology Diabetes Society and Action LADA criteria. Results: The incidence of LADA was 10 per year per 100 000 people. The propor- tion of patients with LADA was 8.9% among newly diagnosed cases with diabetes. Patients with LADA were younger at diagnosis (48.5 ±9.4 years vs. 54.8 ±10.6 years, p < 0.01), had lower body mass index (26.9 ±9.3 kg/m2 vs. 29.5 ±5.2 kg/m2, p < 0.05), C peptide (126 ±127 pmol/l vs. 446 ±592 pmol/l, p < 0.001), and were less insulin resistant (HOMA IR 0.94 ±0.85 vs. 3.6 ±4.4, p < 0.001) compared to patients with type 2 diabetes. Glycated hemoglobin and fasting glucose were sim- ilar in patients with LADA and type 2 diabetes. Conclusions: In addition to GAD, anti-insulin antibodies are useful for diagnos- ing autoimmune diabetes in adults. Patients with LADA have similar glucose control parameters (HbA1c) compared to patients with type 2 diabetes, although they are usually younger and have a lower body mass index. Patients with LADA make up a significant proportion of newly diagnosed people with diabetes mel- litus in a Polish population. Key words: latent autoimmune diabetes in adults, incidence, Poland, anti-glutam- ic acid decarboxylase antibody, anti-insulin autoantibodies. Introduction Latent autoimmune diabetes in adults (LADA) is a slowly progressing form of autoimmune diabetes, characterized by the presence of type 1 dia- betes-associated autoantibody. Although a recent hypothesis proposed that LADA is a mixture of two major types of diabetes, comprising a het- erogeneous population, it can be identified mainly based on the presence of auto-antibodies [1]. Corresponding author: Prof. Małgorzata Szelachowska MD, MD Department of Endocrinology, Diabetology and Internal Medicine Medical University of Bialystok 24 A M. Skłodowskiej-Curie 15-276 Bialystok, Poland Phone: +48 85 746 86 07 Fax: +48 85 744 76 11 E-mail: mszelachowska@ poczta.onet.pl