nach oben

Diabetologia

Erschienen in:

01.07.2010 | Commentary

Latent autoimmune diabetes in adults (LADA) is dead: long live autoimmune diabetes!

verfasst von: O. Rolandsson, J. P. Palmer

Erschienen in: Diabetologia | Ausgabe 7/2010

Einloggen, um Zugang zu erhalten

Excerpt

Latent autoimmune diabetes in adults (LADA) prevails as a name in diabetes research although it was ranked as the second silliest name some years ago [1]. LADA describes a subgroup of patients who develop phenotypic type 2 diabetes but with markers of autoimmunity [2, 3]. In 2005, we tried to describe the background to LADA and establish a definition based on adult age at onset, presence of autoantibodies and lack of requirement for insulin at least 6 months after diagnosis [4]. Both the age and the insulin criteria were soon questioned [1, 5], but they also gained some support [6]. The question of how to define LADA has resulted in numerous articles and debates discussing whether LADA is a disease on its own or just a variant of type 1 diabetes [7‐9]. Thus, it could be questioned whether the introduction of the term LADA has been an asset or an obstacle to our understanding of diabetes. …

Gale EA (2005) Latent autoimmune diabetes in adults: a guide for the perplexed. Diabetologia 48:2195–2199CrossRefPubMed

Tuomi T, Groop LC, Zimmet PZ, Rowley MJ, Knowles W, Mackay IR (1993) Antibodies to glutamic acid decarboxylase reveal latent autoimmune diabetes mellitus in adults with a non-insulin-dependent onset of disease. Diabetes 42:359–362CrossRefPubMed

Groop LC, Bottazzo GF, Doniach D (1986) Islet cell antibodies identify latent type I diabetes in patients aged 35–75 years at diagnosis. Diabetes 35:237–241CrossRefPubMed

Fourlanos S, Dotta F, Greenbaum CJ et al (2005) Latent autoimmune diabetes in adults (LADA) should be less latent. Diabetologia 48:2206–2212CrossRefPubMed

Clark A, Desai M (2006) Comment on: Gale EAM (2005) Latent autoimmune diabetes in adults: a guide for the perplexed: Diabetologia 48:2195–2199. Diabetologia 49:2222–2224

Groop L, Tuomi T, Rowley M, Zimmet P, Mackay IR (2006) Latent autoimmune diabetes in adults (LADA)—more than a name. Diabetologia 49:1996–1998CrossRefPubMed

Pozzilli P, Di Mario U (2001) Autoimmune diabetes not requiring insulin at diagnosis (latent autoimmune diabetes of the adult): definition, characterization, and potential prevention. Diabetes Care 24:1460–1467CrossRefPubMed

Palmer JP, Hirsch IB (2003) What’s in a name: latent autoimmune diabetes of adults, type 1.5, adult-onset, and type 1 diabetes. Diabetes Care 26:536–538CrossRefPubMed

Palmer JP, Hampe CS, Chiu H, Goel A, Brooks-Worrell BM (2005) Is latent autoimmune diabetes in adults distinct from type 1 diabetes or just type 1 diabetes at an older age? Diabetes 54(Suppl 2):S62–S67CrossRefPubMed

10.

Alberti KG, Zimmet PZ (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 15:539–553CrossRefPubMed

11.

Thunander M, Petersson C, Jonzon K et al (2008) Incidence of type 1 and type 2 diabetes in adults and children in Kronoberg, Sweden. Diabetes Res Clin Pract 82:247–255CrossRefPubMed

12.

Brooks-Worrell BM, Juneja R, Minokadeh A, Greenbaum CJ, Palmer JP (1999) Cellular immune responses to human islet proteins in antibody-positive type 2 diabetic patients. Diabetes 48:983–988CrossRefPubMed

13.

Hampe CS, Kockum I, Landin-Olsson M et al (2002) GAD65 antibody epitope patterns of type 1.5 diabetic patients are consistent with slow-onset autoimmune diabetes. Diabetes Care 25:1481–1482CrossRefPubMed

14.

Padoa CJ, Crowther NJ, Thomas JW et al (2005) Epitope analysis of insulin autoantibodies using recombinant Fab. Clin Exp Immunol 140:564–571CrossRefPubMed

15.

Desai M, Cull CA, Horton VA et al (2007) GAD autoantibodies and epitope reactivities persist after diagnosis in latent autoimmune diabetes in adults but do not predict disease progression: UKPDS 77. Diabetologia 50:2052–2060CrossRefPubMed

16.

Carlsson A, Sundkvist G, Groop L, Tuomi T (2000) Insulin and glucagon secretion in patients with slowly progressing autoimmune diabetes (LADA). J Clin Endocrinol Metab 85:76–80CrossRefPubMed

17.

Chiu HK, Tsai EC, Juneja R et al (2007) Equivalent insulin resistance in latent autoimmune diabetes in adults (LADA) and type 2 diabetic patients. Diabetes Res Clin Pract 77:237–244CrossRefPubMed

18.

Cervin C, Lyssenko V, Bakhtadze E et al (2008) Genetic similarities between latent autoimmune diabetes in adults, type 1 diabetes, and type 2 diabetes. Diabetes 57:1433–1437CrossRefPubMed

19.

Brophy S, Brunt H, Davies H, Mannan S, Williams R (2007) Interventions for latent autoimmune diabetes (LADA) in adults. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD006165. doi:10.1002/14651858.CD006165.pub2.

20.

Lohmann T, Kellner K, Verlohren HJ et al (2001) Titre and combination of ICA and autoantibodies to glutamic acid decarboxylase discriminate two clinically distinct types of latent autoimmune diabetes in adults (LADA). Diabetologia 44:1005–1010CrossRefPubMed

21.

Buzzetti R, Di Pietro S, Giaccari A et al (2007) High titer of autoantibodies to GAD identifies a specific phenotype of adult-onset autoimmune diabetes. Diabetes Care 30:932–938CrossRefPubMed

22.

Brooks-Worrell BM, Greenbaum CJ, Palmer JP, Pihoker C (2004) Autoimmunity to islet proteins in children diagnosed with new-onset diabetes. J Clin Endocrinol Metab 89:2222–2227CrossRefPubMed

23.

Tfayli H, Bacha F, Gungor N, Arslanian S (2009) Phenotypic type 2 diabetes in obese youth: insulin sensitivity and secretion in islet cell antibody-negative vs -positive patients. Diabetes 58:738–744CrossRefPubMed

24.

Yki-Jarvinen H, Ryysy L, Nikkila K, Tulokas T, Vanamo R, Heikkila M (1999) Comparison of bedtime insulin regimens in patients with type 2 diabetes mellitus. A randomized, controlled trial. Ann Intern Med 130:389–396PubMed

25.

Tuomi T, Carlsson A, Li H et al (1999) Clinical and genetic characteristics of type 2 diabetes with and without GAD antibodies. Diabetes 48:150–157CrossRefPubMed

26.

Desai M, Clark A (2008) Autoimmune diabetes in adults: lessons from the UKPDS. Diabet Med 25(Suppl 2):30–34CrossRefPubMed

27.

Goel A, Chiu H, Felton J, Palmer JP, Brooks-Worrell B (2007) T cell responses to islet antigens improves detection of autoimmune diabetes and identifies patients with more severe beta-cell lesions in phenotypic type 2 diabetes. Diabetes 56:2110–2115CrossRefPubMed

28.

Brooks-Worrell B, Warsen A, Palmer JP (2009) Improved T cell assay for identification of type 1 diabetes patients. J Immunol Methods 344:9–83CrossRef

29.

Torn C, Mueller PW, Schlosser M, Bonifacio E, Bingley PJ (2008) Diabetes Antibody Standardization Program: evaluation of assays for autoantibodies to glutamic acid decarboxylase and islet antigen-2. Diabetologia 51:846–852CrossRefPubMed

30.

Daka B, Svensson MK, Lernmark Å, Mincheva-Nilsson L, Hallmans G, Rolandsson O (2009) Low agreement between radio binding assays in analyzing glutamic acid decarboxylase (GAD65Ab) autoantibodies in patients classified with type 2 diabetes. Autoimmunity 42:1–8CrossRef

31.

Turner R, Stratton I, Horton V et al (1997) UKPDS 25: autoantibodies to islet-cell cytoplasm and glutamic acid decarboxylase for prediction of insulin requirement in type 2 diabetes. UK Prospective Diabetes Study Group. Lancet 350:1288–1293. Erratum in Lancet 1998 351:376CrossRefPubMed

32.

Ruige JB, Batstra MR, Aanstoot HJ et al (1997) Low prevalence of antibodies to GAD65 in a 50- to 74-year-old general Dutch population. The Hoorn Study. Diabetes Care 20:1108–1110CrossRefPubMed

33.

Rolandsson O, Hagg E, Hampe C et al (1999) Glutamate decarboxylase (GAD65) and tyrosine phosphatase-like protein (IA-2) autoantibodies index in a regional population is related to glucose intolerance and body mass index. Diabetologia 42:555–559CrossRefPubMed

34.

Bingley PJ, Bonifacio E, Williams AJ, Genovese S, Bottazzo GF, Gale EA (1997) Prediction of IDDM in the general population: strategies based on combinations of autoantibody markers. Diabetes 46:1701–1710CrossRefPubMed

35.

Hampe CS, Hall TR, Agren A, Rolandsson O (2007) Longitudinal changes in epitope recognition of autoantibodies against glutamate decarboxylase 65 (GAD65Ab) in prediabetic adults developing diabetes. Clin Exp Immunol 148:72–78PubMedCrossRef

36.

Kimpimaki T, Kulmala P, Savola K et al (2002) Natural history of beta-cell autoimmunity in young children with increased genetic susceptibility to type 1 diabetes recruited from the general population. J Clin Endocrinol Metab 87:4572–4579CrossRefPubMed

37.

Sabbah E, Savola K, Kulmala P et al (1999) Diabetes-associated autoantibodies in relation to clinical characteristics and natural course in children with newly diagnosed type 1 diabetes. The Childhood Diabetes In Finland Study Group. J Clin Endocrinol Metab 84:1534–1539CrossRefPubMed

38.

Schranz DB, Bekris L, Landin-Olsson M et al (2000) Newly diagnosed latent autoimmune diabetes in adults (LADA) is associated with low level glutamate decarboxylase (GAD65) and IA-2 autoantibodies. Diabetes Incidence Study in Sweden (DISS). Horm Metab Res 32:133–138CrossRefPubMed

39.

Franca AP, Bezerra DL, Franco LJ, Dib SA (2000) GAD65 autoantibodies, beta-cell function, and insulin resistance in Japanese-Brazilian adults. Centro de Estudos da Comunidade Nipo Brasileira de Bauru. Diabetes Care 23:1437–1439CrossRefPubMed

40.

Brophy S, Yderstraede K, Mauricio D et al (2008) Time to insulin initiation cannot be used in defining latent autoimmune diabetes in adults. Diabetes Care 31:439–441CrossRefPubMed

41.

Katulanda P, Shine B, Katulanda GW et al (2008) Diabetes mellitus among young adults in Sri Lanka—role of GAD antibodies in classification and treatment: the Sri Lanka Young Diabetes study. Diabetologia 51:1368–1374CrossRefPubMed

42.

Maruyama T, Oak S, Shimada A, Hampe CS (2008) GAD65 autoantibody responses in Japanese latent autoimmune diabetes in adult patients. Diabetes Care 31:1602–1607CrossRefPubMed

Titel: Latent autoimmune diabetes in adults (LADA) is dead: long live autoimmune diabetes!
verfasst von: O. Rolandsson
J. P. Palmer
Publikationsdatum: 01.07.2010
Verlag: Springer-Verlag
Erschienen in: Diabetologia / Ausgabe 7/2010
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-010-1713-0

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren.

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Excerpt

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 7/2010

Variants in ACAD10 are associated with type 2 diabetes, insulin resistance and lipid oxidation in Pima Indians

Getting beta all the time: discovery of reliable markers of beta cell mass

Consensus guidelines, algorithms and care of the individual patient with type 2 diabetes

Serum uric acid does not predict cardiovascular or all-cause mortality in type 2 diabetes: the Fremantle Diabetes Study

External validation and optimisation of a model for predicting foot ulcers in patients with diabetes