Abstract
AimsWe investigated the risk of latent autoimmune diabetes in adults (LADA) and type 2 diabetes in relation to a healthy lifestyle, the proportion of patients attributable to an unhealthy lifestyle, and the influence of family history of diabetes (FHD) and genetic susceptibility. MethodsThe population-based study included incident LADA (n = 571), type 2 diabetes (n = 1962), and matched controls (n = 2217). A healthy lifestyle was defined by BMI < 25 kg/m2, moderate-to-high physical activity, a healthy diet, no smoking, and moderate alcohol consumption. We estimated odds ratios (OR) with 95% confidence intervals (CIs) adjusted for age, sex, education, and FHD. ResultsCompared to a poor/moderate lifestyle, a healthy lifestyle was associated with a reduced risk of LADA (OR 0.51, CI 0.34–0.77) and type 2 diabetes (OR 0.09, CI 0.05–0.15). A healthy lifestyle conferred a reduced risk irrespective of FHD and high-risk HLA genotypes. Having a BMI < 25 kg/m2 conferred the largest risk reduction for both LADA (OR 0.54, CI 0.43–0.66) and type 2 diabetes (OR 0.12, CI 0.10–0.15) out of the individual items. ConclusionPeople with a healthy lifestyle, especially a healthy body weight, have a reduced risk of LADA including those with genetic susceptibility to diabetes.
Highlights
Observational studies indicate that adherence to a healthy lifestyle, including normal body weight [1] physical activity [2] a healthy diet [3,4] non-smoking [5] and moderate alcohol consumption [6] may prevent 75–91% of all cases of type 2 diabetes [4,7]
Latent autoimmune diabetes in adults (LADA) is a hybrid from of diabetes [9]; similar to type 1 diabetes it is characterised by autoimmune reactivity, HLA-DQB1 genotypes associated with autoimmunity [10,11] and excess risk conferred by family history of type 1 diabetes [12]
We investigated whether a healthy lifestyle may reduce the risk of LADA in individuals with family history of diabetes (FHD) or genetic susceptibility as indicated by high-risk genotypes of HLA or TC7FL2
Summary
Observational studies indicate that adherence to a healthy lifestyle, including normal body weight [1] physical activity [2] a healthy diet [3,4] non-smoking [5] and moderate alcohol consumption [6] may prevent 75–91% of all cases of type 2 diabetes [4,7]. Lifestyle factors linked to type 2 diabetes have been associated with LADA [17] including overweight [18] physical inactivity [19,20] diet [21,22] smoking [23] and alcohol consumption [24]. We investigated whether a healthy lifestyle may reduce the risk of LADA in individuals with family history of diabetes (FHD) or genetic susceptibility as indicated by high-risk genotypes of HLA or TC7FL2
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