Vol 6, No 3 (2005): Practical Diabetology
Research paper
Published online: 2005-05-16
LADA: pathophysiological and clinical aspects
Diabetologia Praktyczna 2005;6(3):121-125.
Abstract
LADA is a specific form of type 1 diabetes that develops
in adulthood and that is characterized by slow
development of clinical symptoms. The presence of
chronic immune-mediated mechanism leads to the destruction of the insulin-secreting beta-cells of the islets
of Langerhans. Typical features of LADA are age
at diagnosis usually over 30 years, circulating type 1 diabetes related antibodies, low C-peptide level, lack
of obesity, initially good response to diet and oral
medications and fast progression to clinical insulin
dependency. LADA patients are often diagnosed initially with type 2 diabetes. It is very important to make
a right diagnosis because early intervention with insulin
may protect beta-cells, maintain their residual function
over longer period of time and result in better
metabolic control. The diagnosis of autoimmune diabetes
is based on the presence of type 1 diabetes
related antibodies, particularly glutamic acid decarboxylase
antibodies (GADA). There were several studies
performed on genetic background of LADA. In general the role of HLA in LADA, similarly to typical
type 1 diabetes, has been confirmed. The role of other
genes such as for example insulin, cytotoxic T-Lymphocyte
Antigen-4 (CTLA-4) and protein tyrosine phosphatase
type 22 (PTPN22) has not been defined.
Keywords: LADA form of diabetesautoantibodiesgenetics