Pozzilli and Di Mario describe a number of features of latent autoimmune diabetes of the adult (LADA). The authors are from Universita Campus Biomedico and Universita La Sapienza in Rome.
(1) onset of diabetes in an adult
(2) insulin not required at the time of diagnosis
(3) several markers of autoimmune diabetes including any combination of:
(3a) HLA-DR3 or HLA-DR4
(3b) antibodies to islet cells
(3c) antibodies to glutamic acid decarboxylase (GAD)
(4) variable progression to insulin dependence
(5) other endocrine autoantibodies (anti-thyroid, anti-adrenal, etc)
(6) family history of Type I diabetes or autoimmune endocrinopathy
The patient typically has a low body mass index (BMI).
A patient with antibodies to islet cells or GAD are more likely to develop insulin dependence.
A patient with latent autoimmune diabetes may show a defect in maximally stimulated beta-cell capacity. These patients produce enough insulin for usual requirements but do not have much reserve capacity. One test is to measure C-peptide response following administration of glucagon.
(1) pancreatic destruction in a patient with non-insulin dependent diabetes
To read more or access our algorithms and calculators, please log in or register.
Specialty: Endocrinology, Clinical Laboratory