Latent autoimmune diabetes of adulthood (LADA) is associated with small fibre neuropathy

U. Alam; M. Jeziorska; I. N. Petropoulos; N. Pritchard; K. Edwards; C. Dehghani; S. Srinivasan; O. Asghar; M. Ferdousi; G. Ponirakis; A. Marshall; A. J.M. Boulton; N. Efron; R. A. Malik

doi:10.1111/dme.13888

Latent autoimmune diabetes of adulthood (LADA) is associated with small fibre neuropathy

U. Alam, M. Jeziorska, I. N. Petropoulos, N. Pritchard, K. Edwards, C. Dehghani, S. Srinivasan, O. Asghar, M. Ferdousi, G. Ponirakis, A. Marshall, A. J.M. Boulton, N. Efron, R. A. Malik

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Abstract

Aim: To assess if latent autoimmune diabetes of adulthood (LADA) is associated with small fibre neuropathy. Methods: Participants with LADA (n=31), Type 2 diabetes (n=31) and healthy control participants without diabetes (n=31) underwent a detailed assessment of neurologic deficits, quantitative sensory testing, electrophysiology, skin biopsy and corneal confocal microscopy. Results: The groups were matched for age (healthy control without diabetes: 53.5±9.1 vs. Type 2 diabetes: 58.0±6.5 vs. LADA: 53.2±11.6 years), duration of diabetes (Type 2 diabetes: 10.0±8.3 vs. LADA: 11.0±9.1 years) and blood pressure. However, BMI (P=0.01) and triglycerides (P=0.0008) were lower and HbA_1c (P=0.0005), total cholesterol (P=0.01) and HDL (P=0.002) were higher in participants with LADA compared with Type 2 diabetes. Peroneal motor nerve conduction velocity (P=0.04) and sural sensory nerve conduction velocity (P=0.008) were lower in participants with latent autoimmune diabetes in adults compared with Type 2 diabetes. Intra-epidermal nerve fibre density (P=0.008), corneal nerve fibre density (P=0.003) and corneal nerve branch density (P=0.006) were significantly lower in participants with LADA compared with Type 2 diabetes. There were no significant differences in the other neuropathy parameters. Conclusions: Despite comparable age and duration of diabetes, participants with LADA demonstrate more severe neuropathy and particularly small fibre neuropathy, compared with participants with Type 2 diabetes.

Original language	English
Pages (from-to)	1118-1124
Number of pages	7
Journal	Diabetic Medicine
Volume	36
Issue number	9
DOIs	https://doi.org/10.1111/dme.13888
Publication status	Published - Sept 2019
Externally published	Yes

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Alam, U., Jeziorska, M., Petropoulos, I. N., Pritchard, N., Edwards, K., Dehghani, C., Srinivasan, S., Asghar, O., Ferdousi, M., Ponirakis, G., Marshall, A., Boulton, A. J. M., Efron, N., & Malik, R. A. (2019). Latent autoimmune diabetes of adulthood (LADA) is associated with small fibre neuropathy. Diabetic Medicine, 36(9), 1118-1124. https://doi.org/10.1111/dme.13888

@article{412b2c4ae8894796953b32c80b21afe7,

title = "Latent autoimmune diabetes of adulthood (LADA) is associated with small fibre neuropathy",

abstract = "Aim: To assess if latent autoimmune diabetes of adulthood (LADA) is associated with small fibre neuropathy. Methods: Participants with LADA (n=31), Type 2 diabetes (n=31) and healthy control participants without diabetes (n=31) underwent a detailed assessment of neurologic deficits, quantitative sensory testing, electrophysiology, skin biopsy and corneal confocal microscopy. Results: The groups were matched for age (healthy control without diabetes: 53.5±9.1 vs. Type 2 diabetes: 58.0±6.5 vs. LADA: 53.2±11.6 years), duration of diabetes (Type 2 diabetes: 10.0±8.3 vs. LADA: 11.0±9.1 years) and blood pressure. However, BMI (P=0.01) and triglycerides (P=0.0008) were lower and HbA1c (P=0.0005), total cholesterol (P=0.01) and HDL (P=0.002) were higher in participants with LADA compared with Type 2 diabetes. Peroneal motor nerve conduction velocity (P=0.04) and sural sensory nerve conduction velocity (P=0.008) were lower in participants with latent autoimmune diabetes in adults compared with Type 2 diabetes. Intra-epidermal nerve fibre density (P=0.008), corneal nerve fibre density (P=0.003) and corneal nerve branch density (P=0.006) were significantly lower in participants with LADA compared with Type 2 diabetes. There were no significant differences in the other neuropathy parameters. Conclusions: Despite comparable age and duration of diabetes, participants with LADA demonstrate more severe neuropathy and particularly small fibre neuropathy, compared with participants with Type 2 diabetes.",

author = "U. Alam and M. Jeziorska and Petropoulos, {I. N.} and N. Pritchard and K. Edwards and C. Dehghani and S. Srinivasan and O. Asghar and M. Ferdousi and G. Ponirakis and A. Marshall and Boulton, {A. J.M.} and N. Efron and Malik, {R. A.}",

note = "Funding Information: This research was kindly supported by JDRFI (8-2008-362), NIH (R105991) and the National Health and Medical Research Council (Australia) (497230). Funding Information: Support from the NIHR/Wellcome Trust Clinical Research Facility (Manchester) is kindly acknowledged. We thank Dr Mitra Tavakoli and Dr Hassan Fadavi for undertaking corneal confocal microscopy and neuropathy assessments in a proportion of participants, respectively. Publisher Copyright: {\textcopyright} 2018 Diabetes UK",

year = "2019",

month = sep,

doi = "10.1111/dme.13888",

language = "English",

volume = "36",

pages = "1118--1124",

journal = "Diabetic Medicine",

issn = "0742-3071",

publisher = "Wiley-Blackwell",

number = "9",

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TY - JOUR

T1 - Latent autoimmune diabetes of adulthood (LADA) is associated with small fibre neuropathy

AU - Alam, U.

AU - Jeziorska, M.

AU - Petropoulos, I. N.

AU - Pritchard, N.

AU - Edwards, K.

AU - Dehghani, C.

AU - Srinivasan, S.

AU - Asghar, O.

AU - Ferdousi, M.

AU - Ponirakis, G.

AU - Marshall, A.

AU - Boulton, A. J.M.

AU - Efron, N.

AU - Malik, R. A.

N1 - Funding Information: This research was kindly supported by JDRFI (8-2008-362), NIH (R105991) and the National Health and Medical Research Council (Australia) (497230). Funding Information: Support from the NIHR/Wellcome Trust Clinical Research Facility (Manchester) is kindly acknowledged. We thank Dr Mitra Tavakoli and Dr Hassan Fadavi for undertaking corneal confocal microscopy and neuropathy assessments in a proportion of participants, respectively. Publisher Copyright: © 2018 Diabetes UK

PY - 2019/9

Y1 - 2019/9

N2 - Aim: To assess if latent autoimmune diabetes of adulthood (LADA) is associated with small fibre neuropathy. Methods: Participants with LADA (n=31), Type 2 diabetes (n=31) and healthy control participants without diabetes (n=31) underwent a detailed assessment of neurologic deficits, quantitative sensory testing, electrophysiology, skin biopsy and corneal confocal microscopy. Results: The groups were matched for age (healthy control without diabetes: 53.5±9.1 vs. Type 2 diabetes: 58.0±6.5 vs. LADA: 53.2±11.6 years), duration of diabetes (Type 2 diabetes: 10.0±8.3 vs. LADA: 11.0±9.1 years) and blood pressure. However, BMI (P=0.01) and triglycerides (P=0.0008) were lower and HbA1c (P=0.0005), total cholesterol (P=0.01) and HDL (P=0.002) were higher in participants with LADA compared with Type 2 diabetes. Peroneal motor nerve conduction velocity (P=0.04) and sural sensory nerve conduction velocity (P=0.008) were lower in participants with latent autoimmune diabetes in adults compared with Type 2 diabetes. Intra-epidermal nerve fibre density (P=0.008), corneal nerve fibre density (P=0.003) and corneal nerve branch density (P=0.006) were significantly lower in participants with LADA compared with Type 2 diabetes. There were no significant differences in the other neuropathy parameters. Conclusions: Despite comparable age and duration of diabetes, participants with LADA demonstrate more severe neuropathy and particularly small fibre neuropathy, compared with participants with Type 2 diabetes.

AB - Aim: To assess if latent autoimmune diabetes of adulthood (LADA) is associated with small fibre neuropathy. Methods: Participants with LADA (n=31), Type 2 diabetes (n=31) and healthy control participants without diabetes (n=31) underwent a detailed assessment of neurologic deficits, quantitative sensory testing, electrophysiology, skin biopsy and corneal confocal microscopy. Results: The groups were matched for age (healthy control without diabetes: 53.5±9.1 vs. Type 2 diabetes: 58.0±6.5 vs. LADA: 53.2±11.6 years), duration of diabetes (Type 2 diabetes: 10.0±8.3 vs. LADA: 11.0±9.1 years) and blood pressure. However, BMI (P=0.01) and triglycerides (P=0.0008) were lower and HbA1c (P=0.0005), total cholesterol (P=0.01) and HDL (P=0.002) were higher in participants with LADA compared with Type 2 diabetes. Peroneal motor nerve conduction velocity (P=0.04) and sural sensory nerve conduction velocity (P=0.008) were lower in participants with latent autoimmune diabetes in adults compared with Type 2 diabetes. Intra-epidermal nerve fibre density (P=0.008), corneal nerve fibre density (P=0.003) and corneal nerve branch density (P=0.006) were significantly lower in participants with LADA compared with Type 2 diabetes. There were no significant differences in the other neuropathy parameters. Conclusions: Despite comparable age and duration of diabetes, participants with LADA demonstrate more severe neuropathy and particularly small fibre neuropathy, compared with participants with Type 2 diabetes.

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U2 - 10.1111/dme.13888

DO - 10.1111/dme.13888

M3 - Article

C2 - 30575096

AN - SCOPUS:85062607956

SN - 0742-3071

VL - 36

SP - 1118

EP - 1124

JO - Diabetic Medicine

JF - Diabetic Medicine

IS - 9

ER -

Latent autoimmune diabetes of adulthood (LADA) is associated with small fibre neuropathy

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