Prevalence and identification of type 1 diabetes in Chinese adults with newly diagnosed diabetes

Diabetes Metab Syndr Obes. 2019 Aug 28;12:1527-1541. doi: 10.2147/DMSO.S202193. eCollection 2019.

Abstract

Aim: This study aimed to estimate the prevalence of latent autoimmune diabetes of adults (LADA) and classic type 1 diabetes mellitus (T1DM) in newly diagnosed adult diabetes in China.

Method: This cross-sectional study involved 17,349 newly diagnosed diabetes in adults aged ≥30 years from 46 hospitals within 31 months. Demographic characteristics, clinical features, and medical history were collected by trained researchers. T1DM as a whole was comprised of classic T1DM and LADA. Classic T1DM was identified based on the clinical phenotype of insulin-dependency, and LADA was differentiated from patients with initially an undefined diabetes type with standardized glutamic acid decarboxylase autoantibody testing at the core laboratory. The age and sex distributions from a large national survey of diabetes in China conducted in 2010 were used to standardize the prevalence of classic T1DM and LADA.

Results: Among 17,349 adult patients, the prevalence of T1DM was 5.49% (95% CI: 4.90-6.08%) (5.14% [95% CI: 4.36-5.92%] in males and 6.16% [95% CI: 5.30-7.02%] in females), with 65% of these having LADA. The prevalence of classic T1DM decreased with increasing age (p<0.05), while that of LADA was stable (p>0.05). The prevalence of T1DM in overweight or obese patients was 3.42% (95% CI: 3.20-3.64%) and 2.42% (95% CI: 1.83-3.01%), respectively, and LADA accounted for 76.5% and 79.2% in these two groups.

Conclusion: We draw the conclusion that T1DM, especially LADA, was prevalent in newly diagnosed adult-onset diabetes in China, which highlights the importance of routine islet autoantibodies testing in clinical practice.

Keywords: autoimmune; diabetes; differentiation; metabolism.