Clinical and metabolic profile of patients with latent autoimmune diabetes in adults in specialized care in Madrid.

Autor:	Arranz Martín A; Servicio de Endocrinología y Nutrición, Hospital Universitario de la Princesa, Madrid, España. Electronic address: alfonso.arranz@salud.madrid.org., Lecumberri Pascual E; Servicio de Endocrinología y Nutrición, Hospital Universitario Fundación Jiménez Díaz, Madrid, España., Brito Sanfiel MÁ; Servicio de Endocrinología y Nutrición, Hospital Universitario Puerta de Hierro, Madrid, España., Andía Melero V; Servicio de Endocrinología y Nutrición, Hospital General Universitario Gregorio Marañón, Madrid, España., Nattero Chavez L; Servicio de Endocrinología y Nutrición, Hospital Universitario Ramón y Cajal, Madrid, España., Sánchez López I; Servicio de Endocrinología y Nutrición, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España., Cánovas Molina G; Servicio de Endocrinología y Nutrición, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España., Arrieta Blanco F; Servicio de Endocrinología y Nutrición, Hospital Universitario Ramón y Cajal, Madrid, España., González Perez Del Villar N; Servicio de Endocrinología y Nutrición, Hospital Universitario La Paz, Madrid, España.
Jazyk:	English; Spanish; Castilian
Zdroj:	Endocrinologia, diabetes y nutricion [Endocrinol Diabetes Nutr] 2017 Jan; Vol. 64 (1), pp. 34-39. Date of Electronic Publication: 2017 Jan 19.
DOI:	10.1016/j.endinu.2016.09.001
Abstrakt:	Objective: To report the clinical characteristics of patients with latent autoimmune diabetes in adults (LADA), and to ascertain their metabolic control and associated chronic complications. Methods: Patients with DM attending specialized medical care in Madrid who met the following criteria: age at diagnosis of DM >30years, initial insulin independence for at least 6months and positive GAD antibodies were enrolled. Clinical profiles, data on LADA diagnosis, associated autoimmunity, C-peptide levels, therapeutic regimen, metabolic control, and presence of chronic complications were analyzed. Results: Number of patients; 193; 56% females. Family history of DM: 62%. Age at DM diagnosis: 49years. Delay in confirmation of LADA: 3.5years. Insulin-independence time: 12months. Baseline serum C-peptide levels: 0.66ng/ml. Basal-bolus regimen: 76.7%. Total daily dose: 35.1U/day, corresponding to 0.51U/Kg. With no associated oral antidiabetic drugs: 33.5%. Other autoimmune diseases: 57%. Fasting plasma glucose: 160.5mg/dL. HbA1c: 7.7%. BMI: 25.4kg/m 2 (overweight, 31.5%; obesity, 8%). Blood pressure: 128/75. HDL cholesterol: 65mg/dL. LDL cholesterol: 96mg/dL. Triglycerides: 89mg/dL. Known chronic complications: 28%. Conclusions: Recognition of LADA may be delayed by several years. There is a heterogeneous pancreatic insulin reserve which is negative related to glycemic parameters. Most patients are poorly controlled despite intensive insulin therapy. They often have overweight, but have adequate control of BP and lipid profile and a low incidence of macrovascular complications. (Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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