Latent autoimmune diabetes in adults: definition, prevalence, beta-cell function, and treatment.

Abstract

Latent autoimmune diabetes in adults (LADA) is a disorder in which, despite the presence of islet antibodies at diagnosis of diabetes, the progression of autoimmune beta-cell failure is slow. LADA patients are therefore not insulin requiring, at least during the first 6 months after diagnosis of diabetes. Among patients with phenotypic type 2 diabetes, LADA occurs in 10% of individuals older than 35 years and in 25% below that age. Prospective studies of beta-cell function show that LADA patients with multiple islet antibodies develop beta-cell failure within 5 years, whereas those with only GAD antibodies (GADAs) or only islet cell antibodies (ICAs) mostly develop beta-cell failure after 5 years. Even though it may take up to 12 years until beta-cell failure occurs in some patients, impairments in the beta-cell response to intravenous glucose and glucagon can be detected at diagnosis of diabetes. Consequently, LADA is not a latent disease; therefore, autoimmune diabetes in adults with slowly progressive beta-cell failure might be a more adequate concept. In agreement with proved impaired beta-cell function at diagnosis of diabetes, insulin is the treatment of choice.

• Authors: Gunnar Stenström, Anders Gottsäter, Ekaterine Bakhtadze, Bo Berger, Göran Sundkvist
• Journal: Diabetes (Diabetes) Vol. 54 Suppl 2 Pg. S68-72 (Dec 2005) ISSN: 0012-1797 [Print] United States
• PMID: 16306343 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• C-Peptide
• Insulin
• Glucose

Topics

• Adult
• Age of Onset
• Biomarkers
• C-Peptide (blood)
• Diabetes Mellitus, Type 1 (epidemiology, immunology)
• Diabetes Mellitus, Type 2 (epidemiology, immunology)
• Disease Progression
• Glucose (pharmacology)
• Humans
• Insulin (blood)
• Islets of Langerhans (metabolism)
• Prospective Studies
• Time Factors