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Diabetes Type 1.5 (Latent Autoimmune Diabetes of Adults)

Mette Wod, Reimar W Thomsen, Lars Pedersen, Knud B Yderstraede, Henning Beck-Nielsen, Kurt Højlund
BACKGROUND: Latent Autoimmune Diabetes in Adults (LADA) is the second most common form of diabetes, but data on its clinical course and prognosis are scarce. We compared long-term risk of mortality and cardiovascular outcomes in patients with LADA, type 2 diabetes mellitus (T2D), and insulin deficient diabetes (IDD). METHODS: We conducted a cohort study of 4,368 adults with diabetes referred to the Department of Endocrinology, Odense University Hospital, Denmark, between 1997 and 2012...
March 5, 2018: Diabetes Research and Clinical Practice
Paolo Pozzilli, Richard D Leslie, Anne L Peters, Raffaella Buzzetti, Sudha S Shankar, Zvonko Milicevic, Imre Pavo, Jeremie Lebrec, Sherry Martin, Nanette C Schloot
AIMS: Patients with a type-2-diabetes (T2D) phenotype positive for glutamic acid decarboxylase antibodies (GADA) represent the majority of latent autoimmune diabetes of the adult (LADA). The GLP-1 receptor agonist dulaglutide, recently introduced for treatment of T2D, has yet to be evaluated in LADA patients. Our primary objective was to evaluate the effect of dulaglutide on glycemic control (HbA1c ) in GADA-positive LADA vs. GADA-negative T2D patients. METHODS: A post-hoc analysis was performed using data from three randomized phase 3 trials (AWARD-2,-4,-5; patients with GADA assessment) which were part of the dulaglutide clinical development program in T2D...
January 27, 2018: Diabetes, Obesity & Metabolism
Oana P Zaharia, Pavel Bobrov, Klaus Strassburger, Kálmán Bódis, Yanislava Karusheva, Michaela Scholz, Daniel F Markgraf, Volker Burkart, Nanette C Schloot, Karsten Müssig, Julia Szendroedi, Michael Roden
Context and Objective: Among patients diagnosed with type 2 diabetes, autoimmune diabetes often remains undetected. Metabolic features of these patients are insufficiently characterized at present. Design, Setting, and Patients: This study compared age- and sex-matched adult (aged 41 to 62 years) humans with recent-onset diabetes: patients positive for antibodies against glutamic acid decarboxylase (GAD) and/or cytoplasmic islet-cell antigen with an insulin-free period of >6 months [antibody positive/insulin negative (ab+/ins-); previously termed latent autoimmune diabetes of adults], type 1 diabetes [antibody positive/insulin positive (ab+/ins+)], and type 2 diabetes [antibody negative/insulin negative (ab-/ins-)], as well as glucose-tolerant humans (controls) of the German Diabetes Study (n = 41/group)...
February 1, 2018: Journal of Clinical Endocrinology and Metabolism
Emanuela Zaharieva, Zdravko Kamenov, Tsvetelina Velikova, Adelina Tsakova, Yosif El-Darawish, Haruki Okamura
BACKGROUND: Interleukin-18 (IL-18) is an inflammatory cytokine found to be elevated in obesity, metabolic syndrome and type 2 diabetes (T2D) as a part of the chronic low-grade inflammatory process in these states. The aim of the study was to evaluate the interleukin level in patients with latent autoimmune diabetes of the adults (LADA) in comparison to that in T2D subjects. MATERIALS AND METHODS: IL-18 was analyzed through enzyme-linked immunosorbent assay in 76 participants with T2D and 24 with LADA and 14 control subjects...
January 2018: Endocrine Connections
Cristen P Page, Brian Fitzgerald, Emily M Hawes
Background: Primary care clinicians will see a higher incidence of type 2 diabetes in adult patients, and the diagnosis and management of an initial presentation of type 1 diabetes can pose challenges to clinicians who see it less frequently. Symptoms of hyperglycemia and risk of ketoacidosis may be missed. Further, endocrine autoimmune disease can run together in patients and families. Case presentation: A 49-year-old Caucasian female with history of pituitary adenoma and Graves' disease with history of thyroid ablation presented in the outpatient setting due to hand tingling of her right middle finger that was worse in the mornings and improved throughout the day...
2017: Clinical Diabetes and Endocrinology
Stoyan Popkirov, Seena Sebastian, Fatme Seval Ismail, Jörg Wellmer
Antibodies against glutamic acid decarboxylase (GAD) are a hallmark of type 1 diabetes and its late-onset variant, latent autoimmune diabetes of the adult (LADA).(1) While cerebrovascular disease and dementia are common causes of cognitive dysfunction and neurological deficits in diabetic patients,(2,3) rare autoimmune disorders of the central nervous system such as stiff-person syndrom or limbic encephalits can also occur on the basis of shared GAD autoimmunity.(4,5).
November 20, 2017: Journal of Diabetes
Takuya Awata, Akira Shimada, Taro Maruyama, Yoichi Oikawa, Nobuyuki Yasukawa, Susumu Kurihara, Yumi Miyashita, Masako Hatano, Yuichi Ikegami, Masafumi Matsuda, Masataka Niwa, Youichiro Kazama, Shoichiro Tanaka, Tetsuro Kobayashi
INTRODUCTION: We tested the hypothesis that dipeptidyl peptidase-4 (DPP-4) inhibitors are effective in preserving the β-cell function for long-term periods in patients with slowly progressive type 1 diabetes (SPIDDM) or latent autoimmune diabetes in adults (LADA). METHODS: In the present open-label, randomized, controlled trial, 14 non-insulin-requiring diabetic patients with glutamic acid decarboxylase autoantibodies (GADAb) were randomly assigned to receive either sitagliptin (S group) or pioglitazone (P group)...
October 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Marta Hernández, Carolina López, Jordi Real, Joan Valls, Emilio Ortega-Martinez de Victoria, Federico Vázquez, Esther Rubinat, Minerva Granado-Casas, Nuria Alonso, Teresa Molí, Angels Betriu, Albert Lecube, Elvira Fernández, Richard David Leslie, Dídac Mauricio
BACKGROUND: LADA is probably the most prevalent form of autoimmune diabetes. Nevertheless, there are few data about cardiovascular disease in this group of patients. The aim of this study was to investigate the frequency of carotid atherosclerotic plaques in patients with LADA as compared with patients with classic type 1 diabetes and type 2 diabetes. METHODS: Patients with LADA were matched for age and gender in different proportions to patients with type 2 diabetes, and classic type 1 diabetes...
July 28, 2017: Cardiovascular Diabetology
R Hjort, L Alfredsson, T Andersson, P-O Carlsson, V Grill, L Groop, M Martinell, B Rasouli, P Storm, T Tuomi, S Carlsson
BACKGROUND: A family history of diabetes (FHD) is a strong predictor of diabetes risk, yet has rarely been investigated in latent autoimmune diabetes in adults (LADA). This study therefore investigated the risk of LADA and type 2 diabetes (T2D) in relation to FHD, taking into account the type of diabetes in relatives. METHODS: Data from a population-based study were used, including incident cases of LADA [glutamic acid decarboxylase antibody (GADA)-positive, n=378] and T2D (GADA-negative, n=1199), and their matched controls (n=1484)...
June 29, 2017: Diabetes & Metabolism
B Rasouli, T Andersson, P-O Carlsson, R Hjort, J E Löfvenborg, M Martinell, L Groop, T Tuomi, S Carlsson
AIM: It has been suggested that experiencing serious life events may promote Type 1 diabetes in children. Studies in adults are lacking, as are studies on the interaction of life events with genetic factors. We aimed to investigate life events and the risk of latent autoimmune diabetes in adults (LADA) and Type 2 diabetes while taking into account HLA genotype. METHODS: Analysis was based on 425 incident cases of LADA, 1417 incident cases of Type 2 diabetes and 1702 population-based controls recruited in Sweden between 2010 and 2016...
September 2017: Diabetic Medicine: a Journal of the British Diabetic Association
Ryotaro Bouchi, Tatsuya Fukuda, Takato Takeuchi, Yujiro Nakano, Masanori Murakami, Isao Minami, Hajime Izumiyama, Koshi Hashimoto, Takanobu Yoshimoto, Yoshihiro Ogawa
BACKGROUND: To investigate the association of both latent autoimmune diabetes in adults (LADA) and type 2 diabetes (T2DM) with muscle mass and function (sarcopenia). METHODS: Japanese patients with LADA (N=20), T2DM (N=208), and control subjects (N=41) were included in this cross-sectional study. The definition of LADA was based on age of onset (≥30), positive glutamic acid decarboxylase autoantibodies, and insulin requirement within the first 6months after diagnosis...
June 2017: Journal of Diabetes and its Complications
N N Yin, S M Luo, J Lin, Z G Xie, G Huang, X Li, P L Zheng, J P Wang, Z G Zhou
Objective: To identify human leukocyte antigen (HLA)-DRB1, DQA1 and DQB1 susceptible alleles and genotypes in latent autoimmune diabetes in adults (LADA) patients of Chinese Han nationality. Methods: All subjects including 652 LADA patients and 1 181 healthy controls from 1999 to 2015 in Han nationality region of Hunan province were genotyped with high resolution at HLA-DRB1, DQA1 and DQB1 locus by PCR-sequence based typing (PCR-SBT). Frequencies of genotypes between patients and controls were compared by chi square test...
February 28, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Josefin E Löfvenborg, Tomas Andersson, Per-Ola Carlsson, Mozhgan Dorkhan, Leif Groop, Mats Martinell, Tiinamaija Tuomi, Alicja Wolk, Sofia Carlsson
OBJECTIVE: Sweetened beverage intake is associated with increased risk of type 2 diabetes, but its association with autoimmune diabetes is unclear. We aimed to investigate sweetened beverage intake and risk of latent autoimmune diabetes in adults (LADA); autoimmune diabetes with features of type 2 diabetes. DESIGN/METHODS: Data from a Swedish population-based study was used, including incident cases of LADA (n = 357) and type 2 diabetes (n = 1136) and randomly selected controls (n = 1371)...
December 2016: European Journal of Endocrinology
Yu V Silko, T V Nikonova, O N Ivanova, S M Stepanova, M V Shestakova, I I Dedov
AIM: To investigate the prevalence of autoantibodies (autoAbs) associated with the development of type 1 diabetes mellitus (T1DM) in latent autoimmune diabetes of adults (LADA) in the Russian Federation. SUBJECTS AND METHODS: A total of 96 patients (46 women and 50 men) with LADA were examined. All the patients underwent an immunological examination including the determination of autoAbs, such as glutamic acid decarboxylase autoAbs (GADA), islet antigen-2 auto-Abs (IA-2A), islet cell cytoplasmic auto-Abs (ICA), zinc transporter 8 auto-Abs (ZnT8A), and insulin auto-Abs (IAA)...
2016: Terapevticheskiĭ Arkhiv
Christoffer Polcwiartek, Torkel Vang, Christina Hedegård Bruhn, Nasseh Hashemi, Mary Rosenzweig, Jimmi Nielsen
RATIONALE: Patients exposed to second-generation antipsychotics (SGAs) have approximately 10 times increased risk of diabetic ketoacidosis (DKA) compared with the general population. However, as DKA is a rare complication of type 2 diabetes mellitus, and susceptible patients exposed to antipsychotics may rapidly develop DKA independently of treatment duration and weight gain, this is rather suggestive of type 1 diabetes mellitus (T1DM) or latent autoimmune diabetes in adults. OBJECTIVES: We performed a systematic review of current studies regarding antipsychotic-associated DKA with type 1 etiology and analyzed Danish adverse drug event (ADE) reports (previously unpublished cases)...
October 2016: Psychopharmacology
Bahareh Rasouli, Tomas Andersson, Per-Ola Carlsson, Valdemar Grill, Leif Groop, Mats Martinell, Petter Storm, Tiinamaija Tuomi, Sofia Carlsson
OBJECTIVE: Smoking is an established risk factor for type 2 diabetes. In contrast, it has been proposed that smoking may reduce the risk of latent autoimmune diabetes in adults (LADA), but studies are scarce. We aimed to study the impact of smoking on LADA and type 2 diabetes risks. RESEARCH DESIGN AND METHODS: We used data from a Swedish case-control study including incident case patients with LADA (GAD antibody [GADA] positive, n = 377) and type 2 diabetes (GADA negative, n = 1,188) and control subjects randomly selected from the population (n = 1,472)...
May 2016: Diabetes Care
Yehuda Handelsman, Robert R Henry, Zachary T Bloomgarden, Sam Dagogo-Jack, Ralph A DeFronzo, Daniel Einhorn, Ele Ferrannini, Vivian A Fonseca, Alan J Garber, George Grunberger, Derek LeRoith, Guillermo E Umpierrez, Matthew R Weir
AACE = American Association of Clinical Endocrinologists ACE = American College of Endocrinology DKA = diabetic ketoacidosis EMA = European Medicines Agency FDA = U.S. Food and Drug Administration SGLT-2 = sodium glucosecotransporter 2 T1D = type 1 diabetes T2D = type 2 diabetes.
June 2016: Endocrine Practice
Barbara Szepietowska, Natalia Wawrusiewicz-Kurylonek, Adam Krętowski, Maria Górska, Małgorzata Szelachowska
INTRODUCTION: Latent autoimmune diabetes in adults (LADA) is a slow-developing form of autoimmune diabetes, characterised by the presence of type 1 diabetes-associated autoantibody and presentation at diagnosis similar to patients with type 2 diabetes. The aim of this study was to determine the prevalence of auto-antibodies related to endocrine autoimmune diseases in patients with LADA and to assess their association with HLA genotype. MATERIAL AND METHODS: We evaluated the presence of anti-thyroglobulin (ATG), anti-thyroid peroxidase (ATPO), anti-tissue transglutaminase IgA (ATTA), and anti 21 hydroxylase (A21H) in 70 patients with LADA, 69 with Type 2 diabetes, and in 50 healthy controls HLA genotype was assed in subpopulation of sluclied subjects...
2016: Endokrynologia Polska
J M Brix, E C Krzizek, C Hoebaus, B Ludvik, G Schernthaner, G H Schernthaner
Recently, SFRP4 was identified as a molecular link between islet inflammation and defective insulin secretion. Gene co-expression analysis detected a molecule associated with type 2 diabetes mellitus (T2D), elevated HbA1c, and reduced insulin secretion in mice as well as in a pilot sample of humans. To our knowledge SFRP4 has never been investigated in patients with different types of diabetes. We included 179 patients: 46 with type 1 diabetes (T1D), 30 age matched healthy controls for patients with T1D (CO-T1D), 55 with T2D, 37 with latent autoimmune diabetes of the adult (LADA) and 30 healthy controls (CO) for patients with T2D and LADA...
May 2016: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
Gan Huang, Guizhong Sun, Lin Yang, Xia Li, Yufei Xiang, Zhiguang Zhou
OBJECTIVE: To observe the changes of islet function in ZnT8A positive and IA-2A positive patients so as to provide rationales for early intervention of LADA patients. METHODS: A total of 69 outpatients and inpatients with newly diagnosed LADA testing for GADA, IA-2A and ZnT8A by radioligand binding assay (RBA) were enrolled from 2005 to 2010, including 13 with double positive for GADA and ZnT8A (GADA+ZnT8A double positive group), 14 with double positive for GADA and IA-2A (GADA+IA-2A double positive group) and 42 with positive for GADA alone (GADA positive group), 40 type 2 diabetes mellitus (T2DM) patients negative for the above three autoantibodies were selected as control subjects (T2DM group)...
May 26, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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