This is a corrected version of the editorial that appeared in print. Related Article. Latent autoimmune diabetes in adults LADA is a slowly progressive form of autoimmune diabetes mellitus characterized by older age at diagnosis, the presence of pancreatic autoantibodies, and the lack of an absolute insulin requirement at diagnosis. Although patients with LADA present with more preserved beta cell function than those with classic type 1 diabetes, they tend to have a rapid and progressive loss of beta cell function necessitating intensive insulin intervention. Family physicians care for most patients in the United States with type 2 diabetes and, therefore, should be aware that approximately 10 percent of these patients have LADA.
It's a type of diabetes which seems to straddle Type 1 and Type 2 diabetes. Bits of it are more like Type 1, and other bits are more like Type 2. That's why some people call it Type 1. But they generally come on much slower than they do with Type 1, over months rather than weeks. And whereas being overweight is a major risk factor for Type 2 diabetes , people with LADA tend to have a healthy weight. Diagnosing LADA can be difficult, and some people are diagnosed with having Type 2 diabetes by mistake. If you have LADA, you'll usually have antibodies in your blood that are usually found in people with Type 1. These are found using something called a GADA antibody test. You tend to go on to insulin much quicker than you would normally if you had Type 2 diabetes. Until this study shares its findings, most healthcare professionals agree that the aim of treatment is to keep insulin being produced for as long as possible.
Autoimmune diabetes is a heterogeneous disease which can arise at any age. Subjects with adult-onset autoimmune diabetes who do not necessitate insulin-therapy for at least 6 months after diagnosis are demarcated as having latent autoimmune diabetes in adults LADA. This condition is more heterogeneous than young-onset autoimmune diabetes and shares clinical and metabolic characteristics with both type 2 and type 1 diabetes. These subjects are mostly treated as affected by type 2 diabetes, a factor that might lead to the progression to insulin-dependency quickly. Recent data concerning the use of oral antidiabetic agents as dipeptidyl peptidase 4 inhibitors and glucagon-like peptide 1 receptor agonists indicate up-and-coming results in term of protect C-peptide levels and improving glycaemic control. This review summarises current knowledge on LADA, emphasising controversies regarding its pathophysiology and clinical features. This condition occurs in most cases during childhood or adolescence; however, some patients experience onset in adulthood [ 2 ]. A proportion of subjects with adult-onset autoimmune diabetes does not require insulin-therapy at the time of diagnosis and are clinically similar to patients with type 2 diabetes mellitus T2DM. These patients, who were initially thought to be affected by T2DM, are defined as having latent autoimmune diabetes in adults LADA [ 3 , 4 , 5 ], a form of autoimmune diabetes, distinct from T1DM that shows an older age of onset and slower progression towards insulin requirement [ 6 , 7 , 8 ]. However, the definition of LADA remains controversial and an open debate regarding these diagnostic criteria still exists.
View research View latest news Sign up for updates. Metrics details. Primary care clinicians will see a higher incidence of type 2 diabetes in adult patients, and the diagnosis and management of an initial presentation of type 1 diabetes can pose challenges to clinicians who see it less frequently.