Comparative characteristics of newly diagnosed adult diabetic patients: a pilot study.

Abstract

Diabetes is one of the most common chronic diseases. Early and improved classification of the type of diabetes, whether autoimmune (type 1 diabetes mellitus, T1DM, and latent autoimmune diabetes, LADA) or type 2 diabetes mellitus (T2DM), is essential to determine appropriate therapy. We aimed to present the biochemical and immunological characteristics of adult patients with newly diagnosed diabetes without prior drug treatment. This pilot, a cross-sectional study assessed major phenotypic characteristics and antibody titers, including islet cell antibodies (ICA), insulin autoantibodies (IAA), tyrosine phosphatase antibodies (IA-2A), glutamic acid decarboxylase antibodies (GADA), zinc antibodies (ZnT8A), but also selected sphingolipids belongs to ceramides (Cer) and sphingomyelin (SM). A total of 59 participants were included: 21 with T1DM, 15 with T2DM, and 23 with LADA. Saturated fatty acids chain Cer such as Cer-C22:0 and Cer-C24:0 positively correlates with total cholesterol (TC), triglycerides (TC), and low-density lipoprotein cholesterol (LDL), particularly in autoimmune diabetes (LADA, T1DM) while in T2DM group we found a higher frequency of positive correlation only between Cer-C24:0 and TC. In LADA patients, SM-C18:1 and -C:20:4 values rise with increasing fasting and glucagon-stimulated C-peptide values. The prevalence of GADA in patients diagnosed with T1DM is higher in younger patients versus older ones. While patients with LADA were more likely to test positive for multiple (>4) antibodies. In this relatively small cross-sectional study adult patients with newly diagnosed diabetes have fluctuating clinical and metabolic features with variable severity of immune dysfunction, making it easier to diagnose patients.

Keywords

• type 2 diabetes mellitus
• type 1 diabetes mellitus
• lada
• ceramide
• sphingomyelin