Environmental (Lifestyle) Risk Factors For Lada.

Background To prevent diabetes it is important to identify common, modifiable risk factors in the population. Such knowledge is extensive for type 2 diabetes but limited for autoimmune forms of diabetes. Objective This review aims at summarizing the limited literature on potential environmental (lifestyle) risk factors for LADA. Method A pubmed search identified 15 papers that estimated the risk of LADA in relation to lifestyle. These were based on data from two population-based studies; a Swedish case-control study or a Norwegian cohort-study. Results Studies published to date indicate that the risk of LADA is associated with factors promoting insulin resistance and type 2 diabetes such as overweight, physical inactivity, smoking, low birth weight, sweetened beverage intake and moderate alcohol consumption (protective). There is also some indication of potential effects on autoimmunity exerted by intake of coffee (harmful) and fatty fish (protective). This supports the concept of LADA as a hybrid form of diabetes with an etiology that includes both factors associated with insulin resistance and autoimmunity. Conclusion These findings indicate that LADA may in part be preventable through the same lifestyle modifications as type 2 diabetes including weight loss, physical activity and smoking cessation. Current knowledge is however hampered by the small number of studies and the fact that they exclusively based on Scandinavian populations. There is a great need for additional studies on the role of lifestyle factors in the development of LADA.