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Article Type

Original Study

Abstract

Background Patients with latent autoimmune diabetes in adults may develop early loss of β-cell mass. They are often misdiagnosed as having type 2 diabetes mellitus (T2DM). This is because latent autoimmune diabetes in adults condition does share characteristics of both type 1 and T2DM. Aim To estimate the prevalence of unrecognized cases with glutamic acid decarboxylase auto-antibodies (GADA) among patients with T2DM in a sample of the Egyptian population, describing their clinical and laboratory features, and investigating the relationship with chronic complications of diabetes. Settings and design A total of 1515 Egyptian patients previously diagnosed as having T2DM were divided into two groups based on presence versus absence of GADA. Demographic and clinical characteristics were compared. Patients and methods Patients were selectively admitted according to clear criteria after informed consent and approval of the Ethics Committee. Patients underwent comprehensive history taking and examination. Laboratory investigations included blood chemistry, C-peptide, and GADA. Statistical analysis Data were analyzed using SPSS. Results Overall, 12.8% of patients with T2DM were GADA positive, showing lower C-peptide levels (P < 0.001). GADA-positive patients with T2DM demonstrated a positive correlation of GADA levels with central obesity (r = 0.175; P = 0.015) and systolic blood pressure (r = 0.171; P = 0.018). Moreover, a negative correlation with cardiovascular diseases (r=−0.0175; P = 0.015) was observed. Conclusion Prevalence of GADA among patients with T2DM in the analyzed sample was 12.8%, which agrees with the findings in other populations. These patients had lower C-peptide levels. GADA measurements are recommended in patients with T2DM with low C-peptide levels, especially in newly diagnosed patients, to help identify positive cases and initiate early insulin treatment to help preserve β-cell function and decrease the risk of long-term complications.

Keywords

Glutamic acid decarboxylase auto-antibodies, latent autoimmune diabetes in adults, type 2 diabetes mellitus

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