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, Georgios Ponirakis, A. Marshall, A. J.M. Boulton, N. Efron, Rayaz 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 languageEnglish
JournalDiabetic Medicine
DOIs
Publication statusPublished - 1 Jan 2019

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ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

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. (2019). Latent autoimmune diabetes of adulthood (LADA) is associated with small fibre neuropathy. Diabetic Medicine. https://doi.org/10.1111/dme.13888