Latent Autoimmune Diabetes in Adults

Naik, Ramachandra G.; Brooks-Worrell, Barbara; Palmer, Jerry P.

doi:10.1210/jc.2009-1120

Cited by 202 publications

(181 citation statements)

References 101 publications

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“…According to study groups, the age of older than 25 years at onset is a supportive finding towards LADA [19,53] . Furthermore, in comparison to T2D, stimulated as well fasting C-peptide is lower in LADA [5] .…”

Section: Characteristicsmentioning

confidence: 99%

Distinct clinical and laboratory characteristics of latent autoimmune diabetes in adults in relation to type 1 and type 2 diabetes mellitus

Pipi

Marketou

Tsirogianni

2014

WJD

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Ever since its first appearance among the multiple forms of diabetes, latent autoimmune diabetes in adults (LADA), has been the focus of endless discussions concerning mainly its existence as a special type of diabetes. In this mini-review, through browsing important peer-reviewed publications, (original articles and reviews), we will attempt to refresh our knowledge regarding LADA hoping to enhance our understanding of this controversial diabetes entity. A unique combination of immunological, clinical and metabolic characteristics has been identified in this group of patients, namely persistent islet cell antibodies, high frequency of thyroid and gastric autoimmunity, DR3 and DR4 human leukocyte antigen haplotypes, progressive loss of beta cells, adult disease onset, normal weight, defective glycaemic control, and without tendency to ketoacidosis. Although anthropomorphic measurements are useful as a first line screening, the detection of C-peptide levels and the presence of glutamic acid decarboxylase (GAD) autoantibodies is undoubtedly the sine qua non condition for a confirmatory LADA diagnosis. In point of fact, GAD autoantibodies are far from being solely a biomarker and the specific role of these autoantibodies in disease pathogenesis is still to be thoroughly studied. Nevertheless, the lack of diagnostic criteria and guidelines still puzzle the physicians, who struggle between early diagnosis and correct timing for insulin treatment.

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Section: Characteristicsmentioning

confidence: 99%

Distinct clinical and laboratory characteristics of latent autoimmune diabetes in adults in relation to type 1 and type 2 diabetes mellitus

Pipi

Marketou

Tsirogianni

2014

WJD

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“…Los últimos 3 puntos serían producto de un mejor balance genético protección/riesgo en comparación con diabéticos tipo 1 1,13 .…”

Section: Factores Ambientalesunclassified

Diabetes autoinmune (latente) del adulto

2012

Rev. méd. Chile

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“…The true diagnosis may be more obvious only over time. There is growing evidence that emphasize the existence of a significant overlap between diabetes type 1 and 2 [2][3][4][5][6][7][8][9][10][11][12] . Despite the increasing incidence of the disease and the efforts made to establish diagnostic guidelines some patients do not qualify strictly into the given definitions.…”

Section: Introductionmentioning

confidence: 99%

HLA alleles may serve as a tool to discriminate atypical type 2 diabetic patients

Fernández

Fabregat

Javiel

et al. 2014

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AIM:To investigate whether the presence of human leukocyte antigen (HLA) marker could add new information to discriminated atypical diabetic type 2 patients. METHODS:We analyzed 199 patients initially diagnosed as type 2 diabetes who are treated in special care diabetes clinics (3 rd level). This population was classified in "atypical" (sample A) and "classic" (sample B) according to HLA typing. We consider "classic patient" when has absence of type 1 diabetes associated HLA alleles and no difficulties in their diagnosis and treatments. By the other hand, we considered "atypical patient" when show type 1 diabetes associated HLA alleles and difficulties in their diagnosis and treatments. The standard protocol Asociacion Latinoamericana de Diabetes 2006 was used for patients follow up. To analyze differences between both populations in paraclinical parameters we used unpaired t tests and contingence tables. Bivariate and multivariate analyses were carried out using the SPSS software program. In all studies we assume differences statistically significant, with a P -value < 0.05 corrected and 95%CI. RESULTS:The typing HLA in the "atypical" populations show that 92.47% patients presented at list one type 1 diabetes associated HLA alleles (DQB1*0201-0302 and DR 3-4) and 7.53% had two of its. The results showed for categorical variables (family history, presence or absence of hypertension and/or dyslipidemia, reason for initial consultation) the only difference found was at dyslipidemia (OR = 0.45, 0.243 < OD < 0.822 (P < 0.001). In relation to continuous variables we found significant differences between atypical vs classic only in cholesterol (5.07 ± 1.1 vs 5.56 ± 1.5, P < 0.05), high density lipoproteins (1.23 ± 0.3 vs 1.33 ± 0.3, P < 0.05) and low density lipoproteins (2.86 ± 0.9 vs 3.38 ± 1.7, P < 0.01). None of the variables had discriminating power when logistic regression was done. CONCLUSION:We propose an algorithm including HLA genotyping as a tool to discriminate atypical patients, complementing international treatment guidelines for complex patients. Key words: Atypical diabetes; Clinical algorithm; Immunity molecular marker Core tip: There are evidences that exists a lot of patients who were diagnosed as type 2 diabetics but present difficult management, don't have good responses to treatment and don't achieve the metabolic goals. We include the study of human leukocyte antigen markers typically associated whit type 1 diabetes to characterize these patients. This paper provides information about the possibility of incorporate a standardized molecular

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Latent Autoimmune Diabetes in Adults

Cited by 202 publications

References 101 publications

Distinct clinical and laboratory characteristics of latent autoimmune diabetes in adults in relation to type 1 and type 2 diabetes mellitus

Distinct clinical and laboratory characteristics of latent autoimmune diabetes in adults in relation to type 1 and type 2 diabetes mellitus

Diabetes autoinmune (latente) del adulto

HLA alleles may serve as a tool to discriminate atypical type 2 diabetic patients

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