Latent Autoimmune Diabetes in Adults

Definition, Prevalence, β-Cell Function, and Treatment

  1. Gunnar Stenström1,
  2. Anders Gottsäter2,
  3. Ekaterine Bakhtadze3,
  4. Bo Berger3 and
  5. Göran Sundkvist3
  1. 1Department of Medicine, Kungsbacka Hospital, Kungsbacka, Göteborg University, Göteborg, Sweden
  2. 2Division of Vascular Diseases, Department of Clinical Sciences Malmö, Lund University, Malmö University Hospital, Malmö, Sweden
  3. 3Division of Diabetes Epidemiology and Neuropathy, Department of Clinical Sciences Malmö, Lund University, Malmö University Hospital, Malmö, Sweden
  1. Address correspondence and reprint requests to Professor Göran Sundkvist, MD, PhD, Department of Endocrinology, Malmö University Hospital, SE 20 501, Malmö, Sweden. E-mail: goran.sundkvist{at}med.lu.se

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 β-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 β-cell function show that LADA patients with multiple islet antibodies develop β-cell failure within 5 years, whereas those with only GAD antibodies (GADAs) or only islet cell antibodies (ICAs) mostly develop β-cell failure after 5 years. Even though it may take up to 12 years until β-cell failure occurs in some patients, impairments in the β-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 β-cell failure might be a more adequate concept. In agreement with proved impaired β-cell function at diagnosis of diabetes, insulin is the treatment of choice.

Footnotes

  • This article is based on a presentation at a symposium. The symposium and the publication of this article were made possible by an unrestricted educational grant from Servier.

    • Accepted May 23, 2005.
    • Received March 1, 2005.
No Related Web Pages
| Table of Contents