Generic placeholder image

Current Diabetes Reviews


ISSN (Print): 1573-3998
ISSN (Online): 1875-6417

Review Article

LADA: A Type of Diabetes in its Own Right?

Author(s): Valdemar Grill *

Volume 15, Issue 3, 2019

Page: [174 - 177] Pages: 4

DOI: 10.2174/1573399814666180716150905

Price: $65


Latent Autoimmune Diabetes in the Adult, LADA has been investigated less than “classical” type 1 and type 2 diabetes and the criteria for and the relevance of a LADA diagnosis have been challenged. Despite the absence of a genetic background that is exclusive for LADA this form of diabetes displays phenotypic characteristics that distinguish it from other forms of diabetes. LADA is heterogeneous in terms of the impact of autoimmunity and lifestyle factors, something that poses problems to therapy and follow-up, perhaps particularly in those with marginal positivity. Yet, there appears to be clear clinical utility in classifying individuals as LADA.

Keywords: Autoimmunity, GADA, C-peptide, islet reactive T-cells, type 1 diabetes, type 2 diabetes.

Jones AG, McDonald TJ, Shields BM. Markers of β-cell failure predict poor glycemic response to glp-1 receptor agonist therapy in type 2 diabetes. Diabetes Care 2016; 39: 250-7.
American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2018. Diabetes Care 2018; 41(Suppl. 1): S13-27.
Tuomi T, Santoro N, Caprio S, Cai M, Weng J, Groop L. The many faces of diabetes: A disease with increasing heterogeneity. Lance 2014; 383(9922): 1084-94.
Gale EA. Latent autoimmune diabetes in adults: A guide for the perplexed. Diabetologia 2005; 48: 2195-9.
Bloomgarden Z. Is insulin the preferred treatment for HbA1c >9%? J Diabetes 2017; 9: 814-6.
Brophy S, Yderstraede K, Mauricio D, et al. Time to insulin initiation cannot be used in defining latent autoimmune diabetes in adults. Diabetes Care 2008; 31: 439-41.
Wod M, Yderstræde KB, Halekoh U, Beck-Nielsen H, Højlund K. Metabolic risk profiles in diabetes stratified according to age at onset, islet autoimmunity and fasting C-peptide. Diabetes Res Clin Pract 2017; 134: 62-71.
Rolandsson O, Palmer JP. Latent autoimmune diabetes in adults (LADA) is dead: long live autoimmune diabetes! Diabetologia 2010; 53: 1250-3.
Lohmann T, Nietzschmann U, Kiess W. “Lady-like”: is there a latent autoimmune diabetes in the young? Diabetes Care 2000; 23: 1707-8.
Thunander M, Petersson C, Jonzon K, Fornander J, Ossiansson B, Torn C. Incidence of type 1 and type 2 diabetes in adults and children in Kronoberg, Sweden. Diabetes Res Clin Pract 2008; 82: 247-55.
Sørgjerd EP, Skorpen F, Kvaløy K, Midthjell K, Grill V. Time dynamics of autoantibodies are coupled to phenotypes and add to the heterogeneity of autoimmune diabetes in adults: the HUNT study, Norway. Diabetologia 2012; 55: 1310-8.
Brooks-Worrell BM, Juneja R, Minokadeh A, Greenbaum CJ, Palmer JP. Cellular immune responses to human islet proteins in antibody-positive type 2 diabetic patients. Diabetes 1999; 48: 983-8.
Radenkovic M, Silver C, Arvastsson J, et al. Altered regulatory T cell phenotype in latent autoimmune diabetes of the adults (LADA). Clin Exp Immunol 2016; 186: 46-56.
Brooks-Worrell BM, Reichow JL, Goel A, Ismail H. Palmer Identification of autoantibody-negative autoimmune type 2 diabetic patients. Diabetes Care 2011; 34: 168-73.
Al-Majdoub M, Ali A, Storm P, Rosengren AH, Groop L, Spégel P. Metabolite Profiling of LADA Challenges the View of a Metabolically Distinct Subtype. Diabetes 2017; 66: 806-14.
Turner R, Stratton I, Horton V, et al. UKPDS 25: autoantibodies to islet-cell cytoplasm and glutamic acid decarboxylase for prediction of insulin requirement in type 2 diabetes. UK Prospective Diabetes Study Group. Lancet 1997; 350(9087): 1288-93.
Desai M, Cull CA, Horton VA, et al. GAD autoantibodies and epitope reactivities persist after diagnosis in latent autoimmune diabetes in adults but do not predict disease progression: UKPDS 77. Diabetologia 2007; 50: 2052-60.
Hillman M, Törn C, Landin-Olsson M. DISS study group The glutamic acid decarboxylase 65 immunoglobulin G subclass profile differs between adult-onset type 1 diabetes and latent autoimmune diabetes in adults (LADA) up to 3 years after clinical onset. Clin Exp Immunol 2009; 157: 255-60.
Gale EA, Gillespie KM. Diabetes and gender. Diabetologia 2001; 44: 3-15.
Lindholm E, Hallengren B, Agardh CD. Gender differences in GAD antibody-positive diabetes mellitus in relation to age at onset, C-peptide and other endocrine autoimmune diseases. Diabetes Metab Res Rev 2004; 20: 158-64.
Hawa MI, Kolb H, Schloot N, et al. Action LADA consortium Adult-onset autoimmune diabetes in Europe is prevalent with a broad clinical phenotype: Action LADA 7. Diabetes Care 2013; 36: 908-13.
Kumar A, de Leiva A. Latent autoimmune diabetes in adults (LADA) in Asian and European populations. Diabetes Metab Res Rev 2017; 33(5)
Buzzetti R, Zampetti S, Maddaloni E. Adult-onset autoimmune diabetes: Current knowledge and implications for management. Nat Rev Endocrinol 2017; 13: 674-86.
Krischer JP, Lynch KF, Schatz DA, et al. The 6 year incidence of diabetes-associated autoantibodies in genetically at-risk children: the TEDDY study. Diabetologia 2015; 58: 980-7.
Butler AE, Janson J, Bonner-Weir S, Ritzel R, Rizza RA, Butler PC. Beta-cell deficit and increased beta-cell apoptosis in humans with type 2 diabetes. Diabetes 2003; 52: 102-10.
Brooks-Worrell BM, Palmer JP. Attenuation of islet-specific T cell responses is associated with C-peptide improvement in autoimmune type 2 diabetes patients. Clin Exp Immunol 2013; 171: 164-70.
Thomas NJ, Jones SE, Weedon MN, Shields BM, Oram RA, Hattersley AT. Frequency and phenotype of type 1 diabetes in the first six decades of life: A cross-sectional, genetically stratified survival analysis from UK Biobank. Lancet Diabetes Endocrinol 2018; 6(2): 122-9.
Buzzetti R, Di Pietro S, Giaccari A, et al. Non Insulin Requiring Autoimmune Diabetes Study Group High titer of autoantibodies to GAD identifies a specific phenotype of adult-onset autoimmune diabetes. Diabetes Care 2007; 30: 932-8.
Radtke MA, Midthjell K, Nilsen TI, Grill V. Heterogeneity of patients with latent autoimmune diabetes in adults: linkage to autoimmunity is apparent only in those with perceived need for insulin treatment: Results from the Nord-Trøndelag Health (HUNT) study. Diabetes Care 2009; 32: 245-50.
Carlsson S, Midthjell K, Tesfamarian MY, Grill V. Age, overweight and physical inactivity increase the risk of latent autoimmune diabetes in adults: results from the Nord-Trøndelag health study. Diabetologia 2007; 50: 55-8.
Wilkin TJ. Is autoimmunity or insulin resistance the primary driver of type 1 diabetes? Curr Diab Rep 2013; 13: 651-6.

Rights & Permissions Print Export Cite as
© 2022 Bentham Science Publishers | Privacy Policy