title: Latent Autoimmune Diabetes in Adults in the United Arab Emirates: Clinical Features and Factors Related to Insulin-Requirement.
abstract: OBJECTIVE
  To describe and to characterize clinical features of latent autoimmune diabetes in adults (LADA) compared to type 1 and type 2 diabetes in the UAE.
  
  
  METHODS
  In this cross-sectional study a dataset including 18,101 subjects with adult-onset (>30 years) diabetes was accessed. 17,072 subjects fulfilled the inclusion/exclusion criteria. Data about anthropometrics, demographics, autoantibodies to Glutamic Acid Decarboxylase (GADA) and to Islet Antigen 2 (anti-IA2), HbA1c, cholesterol and blood pressure were extracted. LADA was diagnosed according to GADA and/or anti-IA2 positivity and time to insulin therapy.
  
  
  RESULTS
  437 (2.6%) patients were identified as LADA and 34 (0.2%) as classical type 1 diabetes in adults. Mean age at diagnosis, BMI, waist circumference, systolic blood pressure and HbA1c significantly differed between, LADA, type 2 and type 1 diabetes, LADA showing halfway features between type 2 and type 1 diabetes. A decreasing trend for age at diagnosis and waist circumference was found among LADA subjects when subdivided by positivity for anti-IA2, GADA or for both antibodies (p=0.013 and p=0.011 for trend, respectively). There was a gradual downward trend in autoantibody titre in LADA subjects requiring insulin within the first year from diagnosis to subjects not requiring insulin after 10 years of follow-up (p<0.001).
  
  
  CONCLUSIONS
  This is the first study describing the clinical features of LADA in the UAE, which appear to be different from both type 1 and type 2 diabetes. Furthermore, we showed that the clinical phenotype of LADA is dependent on different patterns of antibody positivity, influencing the time to insulin requirement.
authors.affiliation: Department of Endocrinology and Diabetes, University Campus Bio-Medico, Rome, Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Maddaloni
authors.affiliation: Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates.
authors.forename: Nader
authors.initials: N
authors.lastname: Lessan
authors.affiliation: Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates.
authors.forename: Alia
authors.initials: A
authors.lastname: Al Tikriti
authors.affiliation: Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Buzzetti
authors.affiliation: Department of Endocrinology and Diabetes, University Campus Bio-Medico, Rome, Italy; Centre for Diabetes, The Blizard Building, Barts and The London School of Medicine, Queen Mary, University of London, London, United Kingdom.
authors.forename: Paolo
authors.initials: P
authors.lastname: Pozzilli
authors.affiliation: Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates.
authors.forename: Maha T
authors.initials: MT
authors.lastname: Barakat
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000276:immunology; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000453:epidemiology* / Q000276:immunology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology; D006801:Humans; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014479:United Arab Emirates / Q000453:epidemiology
chemical_list: D001323:Autoantibodies; D007328:Insulin; D005968:Glutamate Decarboxylase