Latent autoimmune diabetes in adults: A distinct but heterogeneous clinical entity
Open Access
- 1 January 2010
- journal article
- Published by Baishideng Publishing Group Inc. in World Journal of Diabetes
- Vol. 1 (4), 111-115
- https://doi.org/10.4239/wjd.v1.i4.111
Abstract
Latent autoimmune diabetes in adults (LADA) accounts for 2%-12% of all cases of diabetes. Patients are typically diagnosed after 35 years of age and are often misdiagnosed as type II Diabetes Mellitus (DM). Glycemic control is initially achieved with sulfonylureas but patients eventually become insulin dependent more rapidly than with type II DM patients. Although they have a type II DM phenotype, patients have circulating beta (β) cell autoantibodies, a hallmark of type I DM. Alternative terms that have been used to describe this condition include type 1.5 diabetes, latent type I diabetes, slowly progressive Insulin Dependent Diabetes Mellitus, or youth onset diabetes of maturity. With regards to its autoimmune basis and rapid requirement for insulin, it has been suggested that LADA is a slowly progressive form of type I DM. However, recent work has revealed genetic and immunological differences between LADA and type I DM. The heterogeneity of LADA has also led to the proposal of criteria for its diagnosis by the Immunology of Diabetes Society. Although many workers have advocated a clinically oriented approach for screening of LADA, there are no universally accepted criteria for autoantibody testing in adult onset diabetes. Following recent advances in immunomodulatory therapies in type I DM, the same strategy is being explored in LADA. This review deals with the contribution of the genetic, immunological and metabolic components involved in the pathophysiology of LADA and recent approaches in screening of this distinct but heterogeneous clinical entity.Keywords
This publication has 34 references indexed in Scilit:
- Latent Autoimmune Diabetes in Adults in a South Asian Population of the U.K.Diabetes Care, 2007
- T-Cell Responses to Islet Antigens Improves Detection of Autoimmune Diabetes and Identifies Patients With More Severe β-Cell Lesions in Phenotypic Type 2 DiabetesDiabetes, 2007
- A Clinical Screening Tool Identifies Autoimmune Diabetes in AdultsDiabetes Care, 2006
- A Clinical Screening Tool Identifies Autoimmune Diabetes in AdultsDiabetes Care, 2006
- A clinically orientated approach increases the efficiency of screening for latent autoimmune diabetes in adults (LADA) in a large clinic‐based cohort of patients with diabetes onset over 50 yearsDiabetic Medicine, 2004
- Similar Genetic Features and Different Islet Cell Autoantibody Pattern of Latent Autoimmune Diabetes in Adults (LADA) Compared With Adult-Onset Type 1 Diabetes With Rapid ProgressionDiabetes Care, 2003
- Autoantibody Recognition of COOH-Terminal Epitopes of GAD65 Marks the Risk for Insulin Requirement in Adult-Onset Diabetes MellitusJournal of Clinical Endocrinology & Metabolism, 2000
- Number of Autoantibodies (Against Insulin, GAD or ICA512/IA2) Rather than Particular Autoantibody Specificities Determines Risk of Type I DiabetesJournal of Autoimmunity, 1996
- Type I Diabetes Masquerading as Type II Diabetes: Possible implications for prevention and treatmentDiabetes Care, 1994
- A Comparison of Childhood and Adult Type I Diabetes MellitusThe New England Journal of Medicine, 1989