Retinopathy in latent autoimmune diabetes of adults: the Fremantle Diabetes Study.
OBJECTIVE
To determine the prevalence of retinopathy and its associations in patients diagnosed clinically with Type 2 diabetes and serum antibodies to glutamic acid decarboxylase (GADA) from a community-based sample.


METHODS
In a case-control design, 24 GADA-positive Type 2 patients from the Fremantle Diabetes Study (FDS) cohort were recruited and matched as closely as possible for age, sex and diabetes duration with 72 GADA-negative Type 2 patients from the FDS. Each patient had a detailed clinical and biochemical assessment including slit lamp biomicroscopy and colour fundus photography with Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) grading.


RESULTS
The GADA-positive patients had a significantly higher HbA1c (median (interquartile range); 8.4 (7.3, 9.6)%) than those who were GADA-negative (7.2 (6.5, 8.1)%: P = 0.002). The overall prevalence of retinopathy amongst the 96 subjects was 26.0%. The majority (92%) of the retinopathy detected was mild and non-proliferative. GADA-positive patients had double the retinopathy prevalence of the GADA-negative group (41.7% vs. 20.8%; P = 0.044). In a logistic regression model, diabetes duration, HbA1c, systolic blood pressure and current smoking were each significantly and independently predictive of retinopathy (P < 0.025), but GADA status was not.


CONCLUSIONS
These data show that GADA-positive patients have an increased prevalence of retinopathy compared with GADA-negative controls with Type 2 diabetes from an urban Australian community. This increased prevalence is due mainly to relatively poor glycaemic control in the GADA-positive group.
Balme
M
M
University of Western Australia, Department of Medicine, Fremantle Hospital, Western Australia.
McAllister
I
I
Davis
W A
WA
Davis
T M E
TM
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005968:Glutamate Decarboxylase; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology; D014504:Urban Health; D014904:Western Australia / Q000453:epidemiology
D005968:Glutamate Decarboxylase; D006442:Glycated Hemoglobin