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LADA

  • Simona Zampetti
  • Raffaella Buzzetti
Living reference work entry
Part of the Endocrinology book series (ENDOCR)

Abstract

The term latent autoimmune diabetes of the adult (LADA) has been introduced to define the subgroup of adult type 2 diabetes (T2DM) patients who are initially noninsulin requiring but with immune markers of type 1 diabetes (T1DM).

The prevalence of LADA has been estimated in a number of multicenter studies of both European and non-European populations. Around 4–14% of patients classified with T2DM have diabetes associated autoantibodies. Among these autoantibodies, glutamic acid decarboxylase (GAD) has become the main islet autoantibody for LADA screening and the most sensitive autoimmune marker for LADA diagnosis.

It remains to be clarified whether LADA exists as a distinct disease entity or it just represents the end of a wide spectrum of the heterogeneous immune-mediated diabetes. Uncertainties concern almost all aspects of this disease, including the nomenclature, diagnostic criteria, epidemiology, natural history, and pathogenesis with genetic, metabolic, and immunological aspects.

A number of attractive therapeutic interventions may be envisaged for prevention of beta-cell loss in LADA, including hypoglycemic and immunomodulatory agents. Since the autoimmune process in LADA seems to be slower than in T1DM, there is a wider window of opportunities for intervention.

Keywords

LADA NIRAD Islet autoantibodies GADA GADA titer T1DM T2DM Insulin Immunotherapy 

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Experimental Medicine“Sapienza” University of RomeRomeItaly

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