Diabetic neuropathy in patients with "latent autoimmune diabetes of the adults" (LADA) compared with patients with type 1 and type 2 diabetes.
OBJECTIVE
In previous studies, a lower incidence of diabetes-related complications such as diabetic neuropathy has been reported in patients with early stages of type 1 diabetes compared with type 2 diabetes. The aim of this study was to compare the prevalence of diabetic neuropathy in patients with manifestation of a slow onset type 1 diabetes in adulthood - latent autoimmune diabetes in adults (LADA) - with classical type 1 and type 2 diabetes patients.


METHODS
Altogether, 37 patients (14 LADA, 9 type 1 and 14 type 2 diabetes) with short term diabetes (duration < 5 years) were investigated for diabetic neuropathy on the basis of clinical and neuroelectrophysiological evaluations. The neurological functions were evaluated by a standardized questionnaire and clinical examination. In electrophysiological evaluations the different nerve fibres were investigated using motor and sensory nerve conduction studies, quantitative thermotesting, vibratometry and autonomic function tests (heart rate variability).


RESULTS
LADA patients had a significantly lower clinical examination score (p = 0.008), cardiorespiratory reflex index (p = 0.009) and cold perception threshold index (p = 0.004). The neurological symptom score, the indices of motor and sensory nerve conduction, the index of thermotesting (warm perception threshold) and the vibratometry showed a trend to higher values in LADA patients than in type 2 diabetes patients. There were no significant differences between LADA and type 1 diabetes patients.


CONCLUSIONS
LADA patients had fewer features of diabetic neuropathy than type 2 diabetes patients in the early stages of disease, thus being more similar to classical type 1 diabetes patients who normally develop diabetic neuropathy rather late.
Baum
Petra
P
Department of Neurology, University of Leipzig, Germany. baump@medizin.uni-leipzig.de
Hermann
Wieland
W
Verlohren
Hans-Jochen
HJ
Wagner
Armin
A
Lohmann
Tobias
T
Grahmann
Friedrich
F
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000453:epidemiology / Q000503:physiopathology*; D004594:Electrophysiology; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D009460:Neurologic Examination; D015995:Prevalence; D012684:Sensory Thresholds; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires