Abstract

ALVES, Daniela et al. LADA in a Diabetes Unit. Medicina Interna [online]. 2016, vol.23, n.4, pp.22-25. ISSN 0872-671X.

Introduction: Latent autoimmune diabetes in adults (LADA) is an autoimmune disease, with insulin deficiency due to progressive destruction of pancreatic islets. Around 2-12% of the patients classified with diabetes mellitus type 2 have LADA. The diagnosis is based on the 2006 Fourlanos criteria: age of onset < 50 years, acute symptoms, BMI < 25 kg/m2, personal or family history of autoimmune disease. The presence of at least two of these clinical features justifies testing for GAD antibodies (GADA). In these patients, anti-insulin antibodies (IAA) are rare while GADA are usually present although they may disappear over time. Material and Methods: A retrospective study of the medical records, collected in the period between January 1st, 2013 and December 31st, 2015, in the Diabetes Unit was performed. Results: Fifteen patients with positive antibodies to LADA were identified. Eight were male and seven were female. The mean age at diagnosis was 43 years. The average body mass index was 23.8 kg/m2. All patients had titles of GADA> 1U/mL (maximum 84, 34 U/L). 87% started treatment with insulin after the diagnosis. The average time between diagnosis and insulin treatment was 2 years. In 11 of these patients other autoimmune diseases were diagnosed, the most frequent one was thyroiditis (seven of 15 patients). Conclusion: LADA occurs in adults with type 2 diabetes phenotype. The diagnosis is vital so that insulin therapy can be started early and other autoimmune diseases associated with LADA can be diagnosed.

Keywords : Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Autoimmune Diseases; Age of Onset.

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