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Latent autoimmune diabetes of adulthood: time to take action.
The Lancet Diabetes & Endocrinology ( IF 44.0 ) Pub Date : 2020-02-04 , DOI: 10.1016/s2213-8587(20)30029-2
Didac Mauricio 1
Affiliation  

In The Lancet Diabetes & Endocrinology, Ernesto Maddaloni and colleagues report on the incidence of microvascular complications in latent autoimmune diabetes of adulthood (LADA) compared with type 2 diabetes in adults in the UK Prospective Diabetes Study (UKPDS) follow-up cohort. The results show that, although initially at a lower risk of microvascular disease than patients with type 2 diabetes (adjusted HR 0·45 [95% CI 0·30–0·68], p<0·0001), beyond the initial 9-year period after diagnosis those with latent autoimmune diabetes were at an increased risk of microvascular disease (1·25 [1·01–1·54], p=0·047). According to the analyses, this worse long-term outcome is mainly attributable to higher glycaemic exposure, determined by higher HbA 1c levels, in patients with latent autoimmune diabetes over a prolonged time period than in those with type 2 diabetes. The evidence produced is of major relevance, as the data were from a large number of patients with latent autoimmune diabetes together with a prolonged follow-up from the onset of the disease. The study was adequately powered to answer the research question and a robust conclusion on this matter is derived.

中文翻译:

成年潜伏性自身免疫性糖尿病:采取行动的时间。

Ernesto Maddaloni及其同事在《柳叶刀糖尿病与内分泌学》杂志中报告了英国前瞻性糖尿病研究(UKPDS)随访队列中,成人潜伏性自身免疫性糖尿病(LADA)与2型糖尿病相比微血管并发症的发生率。结果表明,尽管最初比2型糖尿病患者的微血管疾病风险要低(校正后的HR 0·45 [95%CI 0·30-0·68],p <0·0001),但超过最初的9潜在的自身免疫性糖尿病患者在诊断后的一年中微血管疾病的风险增加(1·25 [1·01-1·54],p = 0·047)。根据分析,这种较差的长期结果主要归因于较高的血糖暴露,这由较高的HbA 1c决定。与2型糖尿病患者相比,潜在的自身免疫性糖尿病患者在较长时间内的血脂水平升高。产生的证据具有重大意义,因为这些数据来自大量潜在的自身免疫性糖尿病患者,以及从疾病发作开始的长期随访。该研究有足够的能力回答研究问题,并得出关于该问题的可靠结论。
更新日期:2020-02-19
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