Author(s): Alam U.; Jeziorska M.; Asghar O.; Ferdousi M.; Marshall A.; Boulton A.J.M.; Malik R.A.; Petropoulos I.N.; Ponirakis G.; Pritchard N.; Edwards K.; Dehghani C.; Srinivasan S.; Efron N.
Source: Diabetic Medicine; 2019
Publication Date: 2019
Publication Type(s): Article
Available at Diabetic Medicine – from Wiley Online Library Full Collection
Abstract:Aim: To assess if latent autoimmune diabetes of adulthood (LADA) is associated with small fibre neuropathy. Method(s): Participants with LADA (n=31), Type 2 diabetes (n=31) and healthy control participants without diabetes (n=31) underwent a detailed assessment of neurologic deficits, quantitative sensory testing, electrophysiology, skin biopsy and corneal confocal microscopy. Result(s): The groups were matched for age (healthy control without diabetes: 53.5+/-9.1 vs. Type 2 diabetes: 58.0+/-6.5 vs. LADA: 53.2+/-11.6 years), duration of diabetes (Type 2 diabetes: 10.0+/-8.3 vs. LADA: 11.0+/-9.1 years) and blood pressure. However, BMI (P=0.01) and triglycerides (P=0.0008) were lower and HbA1c (P=0.0005), total cholesterol (P=0.01) and HDL (P=0.002) were higher in participants with LADA compared with Type 2 diabetes. Peroneal motor nerve conduction velocity (P=0.04) and sural sensory nerve conduction velocity (P=0.008) were lower in participants with latent autoimmune diabetes in adults compared with Type 2 diabetes. Intra-epidermal nerve fibre density (P=0.008), corneal nerve fibre density (P=0.003) and corneal nerve branch density (P=0.006) were significantly lower in participants with LADA compared with Type 2 diabetes. There were no significant differences in the other neuropathy parameters. Conclusion(s): Despite comparable age and duration of diabetes, participants with LADA demonstrate more severe neuropathy and particularly small fibre neuropathy, compared with participants with Type 2 diabetes.Copyright © 2018 Diabetes UK