Diabetes phenotyping, insulin management and complications in latent autoimmune diabetes in adults (LADA): patient-reported outcomes of the Canadian BETTER registry.

AIMS: Latent autoimmune diabetes in adults (LADA), lies between type 1 and type 2 diabetes mellitus and does not require insulin at diagnosis. This study aims to describe Canadian persons living with LADA based on patient-reported data and explore the association between the timing of insulin initiation and diabetes-related complications. METHODS: Cross-sectional analysis of 426 pwLADA in the BETTER registry using descriptive analyses and binary logistic regression in 291 participants to assess associations. RESULTS: 67.5% female; 93.8% White/European ancestry; mean age was 50.7 ± 12.8 years; age at diabetes diagnosis was 41.6 ± 11.8 years; and diabetes duration was 9.3 ± 9.3 years. Overall, 94.6% use insulin, including 19.7% on insulin pump therapy and 91.3% are on 2 or more insulin injections per day, with a median time to insulin initiation of 7 (IQR 1.0-24.0) months after diagnosis. Diabetes-related complications included hypoglycemic episodes in the past month (59.7%), followed by neuropathy (16.1%), nephropathy (11.5%), DKA in the past 12 months (8.7%), cardiovascular diseases (5.0%), and retinopathy (4.5%). Only 52% of the cohort have been prescribed glucagon, 28% have it available, and 2% have used it in the past year. There was no statistically significant association between insulin initiation timing and diabetes-related complications (odds ratio [OR] ranging from 0.999 to 1.022). CONCLUSION: No association was observed between the timing of insulin initiation and diabetes-related complications. This study represents the first Canadian characterization of persons with LADA and aligns with generally accepted criteria for LADA.