Diabetes, Metabolic Syndrome and Obesity (Aug 2019)
Prevalence and identification of type 1 diabetes in Chinese adults with newly diagnosed diabetes
Abstract
Xiaohan Tang,1–3 Xiang Yan,1–3 Houde Zhou,1,3–4 Xilin Yang,5 Xiaohong Niu,6 Jing Liu,7 Qiuhe Ji,8 Linong Ji,9 Xia Li,1–3 Zhiguang Zhou1–3 On behalf of the National Clinical Research Center for Metabolic Diseases Study Group1Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 2Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Changsha, People’s Republic of China; 3National Clinical Research Center for Metabolic Diseases, Changsha, People’s Republic of China; 4Hunan Key Laboratory for Metabolic Bone Diseases, Changsha, People’s Republic of China; 5Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China; 6Department of Endocrinology, Heji Hospital Affiliated to Changzhi Medical College, Changzhi, People’s Republic of China; 7Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, People’s Republic of China; 8Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi’an, People’s Republic of China; 9Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing, People’s Republic of ChinaCorrespondence: Zhiguang ZhouDepartment of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, No.139 Renmin Middle Road, Furong District, Changsha, Hunan 410011, People’s Republic of ChinaTel +86 7 318 529 2154Email [email protected]: 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: diabetes, autoimmune, metabolism, differentiation
