Evaluating peripheral nerve function in asymptomatic patients with type 2 diabetes or latent autoimmune diabetes of adults (LADA): results from nerve conduction studies.

To assess the involvement of peripheral nerve dysfunction in asymptomatic patients with latent autoimmune diabetes of adults (LADA) or type 2 diabetes (T2DM), and compare nerve conduction (NC) parameters between the two groups. A total of 1635 patients without symptoms and signs relevant to diabetic polyneuropathy (1275 with T2DM and 360 with LADA) were included and were further categorized into 3 groups according to diabetes duration: <5years, 5-14 years and ≥15years. All subjects underwent nerve conduction studies. Abnormal NC was defined as the abnormality of NC parameters in two or more anatomical nerves. In both LADA and T2DM patients, the proportions of abnormal NC increased significantly with increasing durations (both P for trend <0.001). Specifically, abnormal NC was present in 18.5%, 38.8% and 66.7% of LADA patients with duration of <5 years, 5-14 years and ≥15 years, respectively. Those numbers were 24.8% (P=0.152, vs. LADA), 25.3% (P=0.023, vs. LADA) and 62.8% (P=0.723, vs. LADA) in T2DM. Regarding NC parameters, T2DM patients had higher composite Z-scores of latency than LADA patients within 5 years of duration (P=0.001). In patients with duration of 5-14years, the latency Z-scores were comparable between the two groups (P=0.164), whereas the Z-scores of amplitude were lower (the lower the worse) in LADA than in T2DM (P=0.035). Peripheral nerve dysfunction is common in asymptomatic patients with LADA or T2DM. Findings of the study suggest that LADA and T2DM differ in the pattern of peripheral nerve involvement over diabetes duration.

Wang C ，Lu J ，Lu W ，Yu H ，Jiang L ，Li M ，Chen H ，Yu H ，Zhou J ，Liu F ，Bao Y ，Jia W ... -  《-》

Associations between clinical characteristics and chronic complications in latent autoimmune diabetes in adults and type 2 diabetes.

This study aimed to assess the associations between clinical characteristics and chronic complications in latent autoimmune diabetes in adults (LADA) and type 2 diabetes. This is a retrospective study. Our diabetes registry included 6975 patients aged 30-75 years old with phenotypic type 2 diabetes who underwent islet autoantibody screening between 2003 and 2012; 384 patients were identified to have LADA. Rates of chronic complications for LADA and type 2 diabetes were compared using a 1 : 2 matched design. Logistic models were fitted to identify the presence of chronic diabetic complications using clinical characteristics including gender, age, duration of diabetes, glycemic control and metabolic syndrome. When duration of diabetes is <5 years, the prevalence of diabetic nephropathy (nephropathy; 12.2% versus 21.8%, p = 0.018) and diabetic retinopathy (retinopathy; 8.1% versus 15.9%, p = 0.011) were significantly lower in patients with LADA than in patients with type 2 diabetes; the prevalence of nephropathy and retinopathy were comparable between both groups when duration is ≥5 years. There was no significant difference in the prevalence of macrovascular complications between groups. The areas under the receiver operating characteristic curves based on the nephropathy and retinopathy models were larger for LADA than for type 2 diabetes (0.72 versus 0.61, p = 0.013; 0.76 versus 0.68, p = 0.056). Patients with LADA had a lower prevalence of microvascular complications than patients with type 2 diabetes when the duration of diabetes was <5 years. Regression equation fitted by clinical characteristics can better predict the risk of microvascular complications in LADA than in type 2 diabetes.

Lu J ，Hou X ，Zhang L ，Hu C ，Zhou J ，Pang C ，Pan X ，Bao Y ，Jia W ... -  《-》

Diabetic neuropathy in patients with "latent autoimmune diabetes of the adults" (LADA) compared with patients with type 1 and type 2 diabetes.

Baum P ，Hermann W ，Verlohren HJ ，Wagner A ，Lohmann T ，Grahmann F ... -  《-》

Serum albumin is associated with peripheral nerve function in patients with type 2 diabetes.

Li L ，Liu B ，Lu J ，Jiang L ，Zhang Y ，Shen Y ，Wang C ，Jia W ... -  《-》

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

To assess if latent autoimmune diabetes of adulthood (LADA) is associated with small fibre neuropathy. 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. 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. 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.

Alam U ，Jeziorska M ，Petropoulos IN ，Pritchard N ，Edwards K ，Dehghani C ，Srinivasan S ，Asghar O ，Ferdousi M ，Ponirakis G ，Marshall A ，Boulton AJM ，Efron N ，Malik RA ... -  《-》