UNVEILING LADA: PREVALENCE AND CHARACTERISTICS AMONG TYPE 2 DIABETIC PATIENTS IN PORT SUDAN, SUDAN

Abstract

Background: The intermediate type of diabetes, known as latent autoimmune diabetes in adults (LADA), has traits in common with both type 1 and type 2 diabetic mellitus (T2DM). Initial insulin independence leads to misdiagnosis of type 2 diabetes.

Aim: This study sought to ascertain the prevalence and features of LADA in patients with type 2 diabetes in Port Sudan, Sudan.

Methods: A comparative cross-sectional study was conducted from April 2020 to January 2024 at the Osman Degna Hospital and Ahmed Hassan Diabetic Center, Port Sudan. A total of 250 T2DM patients were recruited: 150 insulin-requiring patients after years of diagnosis (study group) and 100 non-insulin-requiring patients (control group). Structured interviews were used to gather demographic and clinical information, and a fully automated chemiluminescence immunoassay (CLIA) was used to quantify the blood levels of C-peptide, GAD-65A (glutamic acid decarboxylase 65 autoantibody), and IA-2A (Insulinoma-Associated Protein 2 Autoantibody) autoantibodies. SPSS version 26 was used for statistical analysis, and p<0.05 was chosen as the significance level.

Results: 10.7% of patients with type 2 diabetes had LADA. Compared to the non-LADA group (1.47±0.04 ng/ml, p<0.0001), the C-peptide levels in the LADA group were significantly lower (0.50±0.18 ng/ml). Compared to non-LADA patients, GAD-65A and IA-2A autoantibody titers were higher in LADA patients (p<0.0001). Patients with LADA had lower waist circumferences (79.62±15.42 cm vs. 92.55±17.24 cm, p<0.0001) and BMIs (Body Mass Index) (21.02±4.21 kg/m2 vs. 24.02±3.48 kg/m2, p<0.0001). Furthermore, 68.75% of patients with LADA had a first-degree family history of diabetes, compared to 50% of non-LADA patients.

Conclusion: LADA is underdiagnosed, with a prevalence of 10.7% among T2DM Sudanese patients. GAD-65A autoantibodies are the most sensitive biomarker. For prompt diagnosis and treatment, early screening is recommended.