Latent autoimmune diabetes in adults

Latent autoimmune diabetes in adults
Other namesLADA, late-onset autoimmune diabetes of adulthood,[1] adult-onset autoimmune diabetes
Universal blue circle symbol for diabetes[2]
Pronunciation
SpecialtyEndocrinology

Slowly evolving immune-mediated diabetes, or latent autoimmune diabetes in adults (LADA), is a form of diabetes that exhibits clinical features similar to both type 1 diabetes (T1D) and type 2 diabetes (T2D),[3][4] and is sometimes referred to as type 1.5 diabetes.[5] It is an autoimmune form of diabetes, similar to T1D, but patients with LADA often show insulin resistance, similar to T2D, and share some risk factors for the disease with T2D.[3] Studies have shown that LADA patients have certain types of antibodies against the insulin-producing cells, and that these cells stop producing insulin more slowly than in T1D patients.[3][6] Since many people develop the disease later in life, it is often misdiagnosed as type 2 diabetes.[7]

LADA appears to share genetic risk factors with both T1D and T2D but is genetically distinct from both.[8][9][10][11][4] Within the LADA patient group, a genetic and phenotypic heterogeneity has been observed with varying degrees of insulin resistance and autoimmunity.[6][12] With the knowledge we have today, LADA can thus be described as a hybrid form of T1D and T2D, showing phenotypic and genotypic similarities with both, as well as variation within LADA regarding the degree of autoimmunity and insulin resistance.

The concept of LADA was first introduced in 1993,[13] though the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus does not recognize the term, instead including it under the standard definition of diabetes mellitus type 1.[14]

  1. ^ Williams, Wilkins & Munden 2006, p. 20.
  2. ^ "Diabetes Blue Circle Symbol". International Diabetes Federation. 17 March 2006. Archived from the original on 5 August 2007.
  3. ^ a b c Carlsson, Sofia (2019). "Etiology and Pathogenesis of Latent Autoimmune Diabetes in Adults (LADA) Compared to Type 2 Diabetes". Frontiers in Physiology. 10: 320. doi:10.3389/fphys.2019.00320. ISSN 1664-042X. PMC 6444059. PMID 30971952.
  4. ^ a b Mishra, Rajashree; Hodge, Kenyaita M.; Cousminer, Diana L.; Leslie, Richard D.; Grant, Struan F. A. (2018-09-01). "A Global Perspective of Latent Autoimmune Diabetes in Adults". Trends in Endocrinology & Metabolism. 29 (9): 638–650. doi:10.1016/j.tem.2018.07.001. ISSN 1043-2760. PMID 30041834. S2CID 51715011.
  5. ^ "Latent autoimmune diabetes in adults (LADA): What is it?". Mayo Clinic. Retrieved December 26, 2022.
  6. ^ a b Buzzetti, Raffaella; Zampetti, Simona; Maddaloni, Ernesto (November 2017). "Adult-onset autoimmune diabetes: current knowledge and implications for management". Nature Reviews Endocrinology. 13 (11): 674–686. doi:10.1038/nrendo.2017.99. ISSN 1759-5037. PMID 28885622. S2CID 3339346.
  7. ^ "Latent autoimmune diabetes in adults (LADA): What is it?". Mayo Clinic. Retrieved 2023-12-12.
  8. ^ Andersen, Mette K.; Lundgren, Virve; Turunen, Joni A.; Forsblom, Carol; Isomaa, Bo; Groop, Per-Henrik; Groop, Leif; Tuomi, Tiinamaija (2010-09-01). "Latent Autoimmune Diabetes in Adults Differs Genetically From Classical Type 1 Diabetes Diagnosed After the Age of 35 Years". Diabetes Care. 33 (9): 2062–2064. doi:10.2337/dc09-2188. ISSN 0149-5992. PMC 2928363. PMID 20805278.
  9. ^ Andersen, Mette K.; Sterner, Maria; Forsén, Tom; Käräjämäki, Annemari; Rolandsson, Olov; Forsblom, Carol; Groop, Per-Henrik; Lahti, Kaj; Nilsson, Peter M.; Groop, Leif; Tuomi, Tiinamaija (2014-09-01). "Type 2 diabetes susceptibility gene variants predispose to adult-onset autoimmune diabetes". Diabetologia. 57 (9): 1859–1868. doi:10.1007/s00125-014-3287-8. ISSN 1432-0428. PMID 24906951. S2CID 10477815.
  10. ^ Cervin, Camilla; Lyssenko, Valeriya; Bakhtadze, Ekaterine; Lindholm, Eero; Nilsson, Peter; Tuomi, Tiinamaija; Cilio, Corrado M.; Groop, Leif (2008-05-01). "Genetic Similarities Between Latent Autoimmune Diabetes in Adults, Type 1 Diabetes, and Type 2 Diabetes". Diabetes. 57 (5): 1433–1437. doi:10.2337/db07-0299. ISSN 0012-1797. PMID 18310307.
  11. ^ Cousminer, Diana L.; Ahlqvist, Emma; Mishra, Rajashree; Andersen, Mette K.; Chesi, Alessandra; Hawa, Mohammad I.; Davis, Asa; Hodge, Kenyaita M.; Bradfield, Jonathan P.; Zhou, Kaixin; Guy, Vanessa C. (2018-11-01). "First Genome-Wide Association Study of Latent Autoimmune Diabetes in Adults Reveals Novel Insights Linking Immune and Metabolic Diabetes". Diabetes Care. 41 (11): 2396–2403. doi:10.2337/dc18-1032. ISSN 0149-5992. PMC 6196829. PMID 30254083.
  12. ^ Pettersen, Elin; Skorpen, Frank; Kvaløy, Kirsti; Midthjell, Kristian; Grill, Valdemar (2010-01-01). "Genetic Heterogeneity in Latent Autoimmune Diabetes Is Linked to Various Degrees of Autoimmune Activity: Results From the Nord-Trøndelag Health Study". Diabetes. 59 (1): 302–310. doi:10.2337/db09-0923. ISSN 0012-1797. PMC 2797937. PMID 19833889.
  13. ^ Vandewalle C.L.; Decraene, T.; Schuit, F.C.; De Leeuw, I.H.; Pipeleers, D.G.; F.K. Gorus (November 1993). "Insulin autoantibodies and high titre islet cell antibodies are preferentially associated with the HLA DQA1*0301-DQB1*0302 haplotype at clinical type 1 (insulin-dependent) diabetes mellitus before age 10 years, but not at onset between age 10 and 40 years". Diabetologia. 36 (11): 1155–62. doi:10.1007/bf00401060. PMID 8270130. S2CID 20735601.
  14. ^ American Diabetes, Association (January 2007). "Diagnosis and classification of diabetes mellitus". Diabetes Care. 30 (Suppl 1): S42–7. doi:10.2337/dc07-S042. PMID 17192378.