Diabetes mellitus in Adults - Aspects of Incidence, Autoimmunity and C-peptide

Abstract: Type 1 and type 2 diabetes increase worldwide, leading to a heavy burden of disease and its complications. All 1666 adults aged 18-100 years with new onset diabetes in Kronoberg during 3 years were registered, and type of diabetes classified by pancreatic autoantibodies and C-peptide. Annual incidences of both type 1 and type 2 diabetes were higher than previously described (27.1/100 000 and 378/100 000). Type 1 incidence was bimodal with peaks in 0-19 and 50-80 years. Patients with latent auto-immune diabetes (LADA) were treated either with insulin or conventionally (diet ± oral hypoglycaemic agents). Beta cell function (glucagon-stimulated Cpeptide)and metabolic control (HbA1c) were followed for 36 months. LADA patients treated with insulin did not demonstrate better preservation of beta cell function but had a better metabolic control compared to those on conventional treatment. Adult type 1 patients with long duration (n=40)were examined for pancreatic antibodies, residual C-peptide, and other autoantibodies and complications, with focus on complications from the connective tissues. After 20-30 years duration of diabetes, 20% of type 1 patients had detectable pancreatic autoantibodies, 23% had still detectable C-peptide. Complications from the connective tissues were as common as retinopathy and increased with duration.