title: Time to insulin initiation cannot be used in defining latent autoimmune diabetes in adults.
abstract: OBJECTIVE
  Latent autoimmune diabetes in adults is type 1 diabetes presenting as non-insulin dependent diabetes. One feature of the selection criteria is time independent of insulin treatment. We examine the validity of this criterion.
  
  
  METHODS
  Patients were recruited in nine European centers, and clinicians reported on criteria for initiating insulin. All patients were tested for GAD antibodies (GADAs) in a central laboratory. We examined time to insulin treatment for GADA-positive patients in six participating centers.
  
  
  RESULTS
  There was intercenter variation in the criteria used to initiate insulin. Median time to insulin was 16.15 months (interqartile range 6.7-25.5) in centers with GADA testing compared with 45.6 months (29.5-61.8) in centers without routine GADA testing (P < 0.002).
  
  
  CONCLUSIONS
  Time to insulin should not be used to define patients with LADA because it is dependent on local clinical judgment and the use of laboratory tests for GADA.
authors: School of Medicine, Swansea University, Swansea SA2 8PP, UK. s.brophy@swansea.ac.uk
authors: Sinead
authors: S
authors: Brophy
authors: Knud
authors: K
authors: Yderstraede
authors: Didac
authors: D
authors: Mauricio
authors: Stephen
authors: S
authors: Hunter
authors: Mohammed
authors: M
authors: Hawa
authors: Paolo
authors: P
authors: Pozzilli
authors: Guntram
authors: G
authors: Schernthaner
authors: Nanette
authors: N
authors: Schloot
authors: Nanette
authors: N
authors: Schoot
authors: Raffaella
authors: R
authors: Buzzetti
authors: Helen
authors: H
authors: Davies
authors: David
authors: D
authors: Leslie
authors: Rhys
authors: R
authors: Williams
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D005968:Glutamate Decarboxylase / Q000276:immunology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use*; D008875:Middle Aged; D013997:Time Factors
chemical_list: D001323:Autoantibodies; D007004:Hypoglycemic Agents; D007328:Insulin; D005968:Glutamate Decarboxylase