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Src: Desai(2008)DiabMed: Autoimmune diabetes in adults: lessons from the UKPDS [pdf]
  • Latent autoimmune diabetes in adults=LADA: relatively mild diabetes onset; AAb positivity; eventual requirement for insulin;
  • 12% of newly diagnosed UKPDS patients were positive for AAb to GAD65 (GAD[A]=glutamic acid decarboxylase [antibodies]:GADA) and/or insulinoma-associated antigen-2A (IA-2A);
  • during UKPDS: LADA patients required insulin earlier; dcr in islet fx was similar for insulin- and OHA-agent treated patients;
  • GADA levels did not predict disease progression
  • slowly progressing insulitis and pancreatic beta cell loss
  • HLA and INS gene pattern similar to T1DM patients
  • autoimmune DM (hyperglyc a/w serolog markers of pancreatic beta cell autoimmunity) in adults: relatively slower onset, usu diagnosed and treated as T2DM
  • most pts retain adeq beta cell fx to prevent DKA and need for insulin for a number of years;
  • usually only distinguished by testing for AAb against beta cell proteins;
  • called LADA (or: slowly progressive IDDM; latent T1DM; T1DM masquerading as T2DM; T1.5DM)
  • Recent proposal for diagnostic criteria for LADA: (1) age>30y at clin presentation; (2) not requiring insulin for >6mths post-diagnosis;
  • ~10[2-22]% of patients diagnosed as T2DM;
  • NB: GADA persist in LADA for several years post-diagnosis [unlike T1DM];