Barbara Szepietowska, Anna Głębocka, Urszula Puch, Maria Górska, Małgorzata Szelachowska Table I. Clinical and metabolic features of patients with LADA and type 2 diabetes in a population-based cohort of newly diagnosed people with diabetes 48.5 ±9.4 54.8 ±10.6 < 0.01 LADA 19 26.8 ±9.3 9/13 Type 2 diabetes 186 Value of p 29.5 ±5.2 103/87 100.6 ±13.5 < 0.05 NS < 0.05 Fasting C peptide 126.4 ±127.9 446.3 ±592.2 < 0.001 [pmol/l] 81.2 ±64.5 98.6 ±58.3 < 0.05 Total cholesterol 205.5 ±50.7 [mg/dl] 210.5 ±46.7 Waist circumstance 90.5 ±12.7 [cm] Parameter Number Age at diagnosis [years] BMI [kg/m2] Gender M/F Fasting glucose [mmol/l] HbA1c [%] Fasting insulin [pmol/l] HDL-C [mg/dl] LDL-C [mg/dl] TG [mg/dl] HOMA 2%B HOMA IR 189.9 ±108.3 160.1 ±69.9 7.86 ±3.1 7.22 ±1.7 50.1 ±15.6 45.6 ±13.0 139.3 ±37.9 132.5 ±34.8 126 ±46.9 45.7 ±52.7 0.94 ±0.85 153.6 ±98.4 109 ±127 3.6 ±4.4 NS NS NS NS NS NS < 0.05 < 0.001 rural population, mostly due to rapidly increasing socio-economic status and change in lifestyle. In the future, it will be interesting to compare the inci- dence of LADA between rural and urban popula- tions [20]. In conclusion, LADA presents with similar clini- cal onset to type 2 diabetes with significant beta cell dysfunction and lower insulin resistance. In addition to GADA, IAA can also be a useful marker in identifying adults with autoimmune diabetes, before insulin treatment is introduced. In the Pol- ish population, adult autoimmune diabetes accounts for a significant proportion of patients with diabetes mellitus. In this context, screening patients with type 2 diabetes, especially younger and with lower BMI level, may be a worthy effort to screen for LADA and offer these individuals treatment in concor- dance with declining beta cell function [16, 21]. Acknowledgments We thank the patients, diabetes clinic nurses, diabetologists, and general practitioners in Bialystok for providing important collaboration to this study. We thank Garbriela Kozłowska, Elżbieta Otziomek and Agnieszka Nikołajuk for their invaluable assis- tance with this study. We declare that there is no conflict of interest that could be perceived as prejudicing the impar- tiality of the research reported. This work was sup- ported by a research grant for the Medical Univer- sity of Bialystok (grant number 3-50956). R e f e r e n c e s 1. Leslie RD, Kolb H, Schloot NC, et al. Diabetes classifica- tion: grey zones, sound and smoke: Action LADA 1. Dia- betes Metab Res Rev 2008; 24: 511-9, 2. Turner R, Stratton I, Horton V, et al. UKPDS 25: autoanti- bodies to islet-cell cytoplasm and glutamic acid decar- boxylase for prediction of insulin requirement in type 2 diabetes. UK Prospective Diabetes Study Group. Lancet 1997; 350: 1288-93. 3. Wroblewski M, Gottsater A, Lindgarde F, Fernlund P, Sund- kvist G. Gender, autoantibodies, and obesity in newly diag- nosed diabetic patients aged 40-75 years. Diabetes Care 1998; 21: 250-5. 4. Tuomi T, Carlsson A, Li H, et al. Clinical and genetic char- acteristics of type 2 diabetes with and without GAD anti- bodies. Diabetes 1999; 48: 150-7. 5. Davies H, Brophy S, Fielding A, et al. Latent autoimmune diabetes in adults (LADA) in South Wales: incidence and characterization. Diabet Med 2008; 25: 1354-7. 6. Gottsater A, Landin-Olsson M, Fernlund P, Lernmark A, Sundkvist G. Beta-cell function in relation to islet cell anti- bodies during the first 3 yr after clinical diagnosis of dia- betes in type II diabetic patients. Diabetes Care 1993; 16: 902-10. 7. Torn C, Landin-Olsson M, Lernmark A, et al. Prognostic factors for the course of beta cell function in autoimmune diabetes. J Clin Endocrinol Metab 2000; 85: 4619-23. Data are presented as mean and SD. The p values were calculated using the Mann-Whitney U test C peptide levels and were less insulin resistant. These observations are concordant with other stud- ies regarding LADA [16-18]. Patients with newly diag- nosed LADA presented with similar fasting glucose and HbA1c compared to patients with type 2 dia- betes, suggesting rather slow progression and rel- atively asymptomatic clinical onset [17]. To identify individuals with LADA we used both GADA and anti-insulin antibody. We tested IAA in the newly diagnosed population, before insulin treatment was introduced. In our study, 4.5% of all patients with newly diagnosed diabetes and 36% of patients with LADA were positive for IAA. This percentage is lower than in patients with newly diagnosed type 1 diabetes [13, 19]. In the study by Huang et al. [14] Anti-insulin autoantibodies was present in 3.39% of 100 patients with type 2 dia- betes. Anti-insulin autoantibodies when tested at the time of diagnosis may be useful in identifying patients with LADA. This study, however, was limited to the urban population in the city of Bialystok, and it should be noted that in Poland there are differences in dia- betes epidemiology between urban and rural pop- ulations. In the EURODIAB TIGER programme the incidence rate for type 1 diabetes was higher in the 494 Arch Med Sci 3, June / 2012