Prior diagnosis of infection does not increase the risk of LADA

In a recently published study researchers from IMM, Karolinska Institutet investigated the possible link between infectious diseases and a diagnosis of latent autoimmune diabetes in adults (LADA). LADA shares similarities with type 1 diabetes, and previous studies have suggested that infections are a risk factor for childhood-onset type 1 diabetes.

Birth cohort studies, including TEDDY, TRIGR, MIDIA, BABYDIET och DIABIMMUNE, suggest an increased risk of islet autoantibody seroconversion and type 1 diabetes associated with childhood respiratory infections and bacterial infections. In addition, enteroviruses, a group that causes respiratory and gastrointestinal infections, have been consistently associated with type 1 diabetes.

The study was a Swedish population-based case-control study, including 597 incident LADA cases and 2386 matched controls. Further, national and regional patient registries was linked with the data to assess the history of infectious diseases.

Results showed no significant increase in the prevalence of infectious diseases within 1 to 10 years before diabetes diagnosis in people with LADA. In particular, respiratory, gastrointestinal, skin herpetic and other infectious diseases did not confer an increased risk of LADA. 

Consistent estimates for infectious diseases in different exposure windows were observed, except for an increased risk associated with lower respiratory tract infections and other infectious diseases in the year before diabetes diagnosis. This suggests a potential susceptibility to infections associated with hyperglycaemia. Analyses restricted to LADA cases with HLA high-risk genotypes and high GADA levels showed similar results. The study also found no significant associations between self-reported infectious diseases and LADA, except for a reduced risk for gastrointestinal infections.

Overall, the research suggests a nuanced relationship between infectious diseases and LADA, highlighting the need for further research into the complex interplay between infection and autoimmune diabetes in adults.

First author of the recently published article is Jessica Edstorp from the ESTRID group.

Publication

Does a prior diagnosis of infectious disease confer an increased risk of latent autoimmune diabetes in adults?
Edstorp J, Rossides M, Ahlqvist E, Rasouli B, Tuomi T, Carlsson S
Diabetes Metab Res Rev 2023 Dec;():e3758