Abstract
Latent autoimmune diabetes in adults (LADA) is classified as type 1 diabetes because of autoantibody positivity. In contrast, individuals classified as having type 2 diabetes are by definition autoantibody negative. However, autoantibodies may fluctuate (1). We therefore examined whether some individuals have transient evidence of autoimmunity preceding a diagnosis of type 2 diabetes and whether their clinical characteristics differ from those of other individuals classified as having type 2 diabetes. The study was performed among participants of the second (HUNT2, 1995–1997) and third (HUNT3, 2006–2008) surveys of the Nord-Trondelag Health Study (HUNT) in Norway. Details about HUNT are available elsewhere (2,3). Participants with self-reported diabetes in HUNT3 ( n = 2,264) were given a detailed diabetes-related questionnaire and invited to a follow-up clinical investigation that included measurements of hemoglobin A1c (HbA1c), fasting glucose, C-peptide, and the autoantibodies GADA and islet antigen-2 (IA-2A). We investigated participants with incident type 2 diabetes between HUNT2 and HUNT3 ( n = 965), defined as diabetes without GADA and IA-2A in HUNT3 and no insulin treatment within 1 year after diagnosis. Among them, 171 participants were excluded due to lack of serum samples or possible unknown diabetes at HUNT2, as indicated by nonfasting serum glucose >11.0 mmol/L in HUNT2. Serum samples that were collected during the HUNT2 …
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