MISDIAGNOSED PATIENT WITH LATENT AUTOIMMUNE DIABETES IN ADULTS (CASE REPORT).

Latent Autoimmune Diabetes in Adults (LADA) is often misdiagnosed because it lacks both awareness and standardized diagnostic criteria. A 30-year-old patient with high blood glucose, HbA1c level 10.1% and positive GAD antibodies was diagnosed with type 1 diabetes but LADA was not ruled out. Patient refused to receive insulin therapy. He chose to follow the dietary restrictions and therapy with sulfonylurea, initiated by another physician. Following 7 months the patient's HbA1c values decreased, but never achieved the goal. Furthermore, after the first year of diagnosis his glycemic values rapidly worsened. The similarities between type 1 diabetes, type 2 diabetes, and LADA can make diagnosis difficult. The Immunology of Diabetes Society (IDS) has proposed three criteria to standardize the definition of LADA. 1) age usually ≥25 years 2) positive titer for at least one of the four antibodies, and 3) no treatment with insulin was needed in the first 6 months after diagnosis. The patient in this case closely fits the proposed IDS criteria for diagnosing LADA. Making the right diagnosis at the right time is crucial for patients with diabetes. Patients with LADA are often misdiagnosed due to the use of arbitrary screening criteria such as age. Health care providers must learn to recognize the characteristics of LADA, in order to improve the treatment options, glycemic control and potentially decrease the risk of long-term complications.