Factors Associated with Latent Autoimmune Diabetes in Adults (LADA) in Patients with HbA1C ≥ 10% in Endocrine Clinic

Abstract

To identify factors associated with the diagnosis of latent autoimmune diabetes in adults in adult patients with diabetes presenting with HbA1c ≥ 10% in Endocrine clinic. This cross-sectional study collected clinical data of T2DM patients who were tested in Endocrine clinic and had HbA1c greater than 10% for over a period of two years. Data were analyzed using descriptive statistics and inferential statistics with univariate and multivariate analysis through applications of SPSS 18.0.

Among diabetes patients who meet inclusion criteria, 62 cases were identified. It was found that 15 cases were diagnosed with LADA (24%). Significant statistical differences (P-value < 0.05) were observed between LADA and T2DM group in the following factors: personal history of autoimmune diseases (33% vs. 4%, P = 0.016), C-peptide levels (0.03 vs. 0.35 millimoles/liter, P = 0.003), history of sulfonylurea use (13.3% vs. 44%, P = 0.029), and hyperglycemic symptoms (86% vs. 59%, P = 0.054). Multivariate logistic regression analysis using variables with a p-value < 0.2, revealed three factors significantly associated with LADA: history of autoimmune diseases (OR = 8.91, 95% CI = 1.30-61.35, p = 0.026), C-peptide level (OR = 0.10, 95% CI = 0.10-0.96, p = 0.046), and fasting blood sugar level (OR = 0.99, 95% CI = 0.98-1.00, p = 0.053).

Among T2DM patients with more than 10% HbA1c in endocrine clinic, two factors significantly associated with LADA were history of autoimmune diseases and low C-peptide. These factors can be used as screening criteria to order Ab test and ensure appropriate treatment.