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Diagnosis and treatment of Latent Autoimmune Diabetes in Adults in everyday clinical practice


Authors: J. Brož 1;  K. Melicharová 1;  L. Koberová 1;  L. Brunerová 2;  J. Urbanová 2
Authors‘ workplace: Interní klinika 2. LF UK a FN Motol, Praha, Přednosta: prof. MUDr. Milan Kvapil, CSc., MBA 1;  Centrum pro výzkum diabetu, metabolismu a výživy, II. interní klinika 3. LF UK a FNKV, Praha, Přednosta: prof. MUDr. Ivan Rychlík, CSc., FASN, FERA 2
Published in: Prakt. Lék. 2020; 100(3): 140-142
Category: Of different specialties

Overview

Latent Autoimmune Diabetes in Adults is a heterogeneous disease that is characterized by a less intensive autoimmune process and a mild metabolic decompensation at onset compared with young-onset type 1 diabetes mellitus (T1DM). The majority of patients with adult-onset autoimmune diabetes usually do not require insulin treatment for at least 6 months after diagnosis. Thus, they may be falsely classified as having type 2 diabetes. The onset of LADA is usually in non-obese patients older than 30 years, without prominent features of metabolic syndrome and sings of insulin resistance. LADA is treated with insulin and combined with metformin in patients with a higher level of insulin resistance. Other oral antidiabetics as gliptins, glinitazones are under investigation as they might preserve beta-cells.

Keywords:

diabetes mellitus – LADA – C-peptid – anti-GAD


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Labels
General practitioner for children and adolescents General practitioner for adults
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