LADA (latent autoimmune diabetes in adults) in Norway – occurrence, risk factors, treatment and complications

Abstract

LADA (latent autoimmune diabetes in adults) may be the most common form of autoimmune diabetes and thus encompasses a significant proportion of the diabetic population. Still, knowledge about this common form of diabetes is limited. In this paper we give an overview of some aspects of LADA, primarily using data from the Nord-Trøndelag Health Study (HUNT). In HUNT, LADA accounts for 7% of all incident cases of diabetes in adults. Data from HUNT indicate that risk factors for LADA include overweight, physical inactivity, family history of diabetes and low psychosocial well-being. Risk factors thus seem to be largely similar to those of type 2 diabetes which suggests a partially shared pathogenesis, in spite of the autoimmune nature of LADA. With regard to genetic factors LADA may be a genetic mix of type 1 and type 2 diabetes, as LADA patients seem to have an increased prevalence of HLA haplotypes linked to type 1 diabetes, and possibly also genes associated with type 2 diabetes. Patients with LADA are at increased mortality risk, primarily from cardiovascular disease. The excess risk seems to be linked to poor glycemic control rather than metabolic risk factors. These results emphasise the importance of optimal treatment modalities to improve survival in LADA. Documentation of optimal treatment for LADA is still lacking and there is an urgent need for studies in this field.