China
Africa
Explore chapters and articles related to this topic
The endocrine system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Latent autoimmune diabetes in adults (LADA) is a form of type 1 diabetes that occurs in adulthood but is characterized by a slower onset. Patients with this condition may be misdiagnosed as having type 2 diabetes. Patients will eventually require insulin and will not respond to weight loss regimes.
Lifestyle Therapies for the Management of Diabetes
Published in James M. Rippe, Lifestyle Medicine, 2019
Type 1 diabetes accounts for approximately 5% of diagnosed diabetes and is due to cellular-mediated autoimmune destruction of the pancreatic beta-cells, usually leading to absolute insulin deficiency.1 The rate of beta-cell destruction is quite variable, being rapid in some individuals (mainly infants and children) and slow in others (mainly adults). Immune-mediated diabetes commonly occurs in childhood and adolescence, but it can occur at any age, even in the eighth and ninth decades of life.8 Children and adolescents may present with ketoacidosis as the first symptom of the disease. Adults may retain sufficient beta-cell function to prevent ketoacidosis for many years; however, such individuals eventually become dependent on insulin for survival and are at risk for ketoacidosis. This later-onset type 1 diabetes picture is referred to as Latent Autoimmune Diabetes of Adults (LADA).
Traditional and Nontraditional Treatments for Diabetes
Published in Mary J. Marian, Gerard E. Mullin, Integrating Nutrition Into Practice, 2017
Patricia G. Davidson, Dwight L. Davidson
Diabetes is classified into two predominant types: type 1 (T1DM) and type 2 (T2DM). A comparison between the characteristics of T1DM and T2DM is illustrated in Table 12.1. T1DM results from the immune system attacking healthy insulin producing beta (β) cells of the pancreas and is a disease of the autoimmune system. This destruction of β cells results in a complete deficiency in insulin production. A virus, such as shingles, or autoimmune diseases, such as hypo/hyperthyroidism, can trigger T1DM. There is also a genetic tendency for T1DM that typically occurs in children. It is increasing in the adult population and is known as latent autoimmune diabetes in adults (LADA), a slow evolving variant of T1DM. Some form of T2DM is found in the majority of older adults. In contrast to T1DM, the etiology of T2DM is hereditary, though triggered by environmental and/or lifestyle factors. Decreased insulin production, insulin resistance, and ultimately insulin deficiency result from a progressive decline in β cell function. Theories of the cause of T2DM include, but are not limited to normal aging body composition changes, increase in visceral adiposity, vitamin D deficiency, and inflammation [3,4].
Prediction, diagnosis, prevention and treatment: genetic-led care of patients with diabetes
Published in Expert Review of Precision Medicine and Drug Development, 2021
Watip Tangjittipokin, Nutsakol Borrisut, Patcharapong Rujirawan
Latent autoimmune diabetes of adults (LADA) is one of autoimmune diabetes spectrum that shared clinical manifestation and metabolic profile from both T1DM and T2DM. Although, patients with LADA have common characteristics that provide the clue for diagnoses such as age <50, family or personal history of autoimmunity, low BMI, or acute symptom onset; however; current key for LADA diagnosis still need the presence of diabetes-associated autoantibodies (90% of subjects autoantibodies are GADA positive [8]) along with adult-onset (age > 30) and absence of insulin requirement for at least 6 months after diagnosis [9]. LADA patients tend to have a similar or higher frequency of metabolic syndromes than adult-onset T1DM but have lower metabolic syndromes such as lower insulin resistance, blood pressure, and diabetic dyslipidemia than T2DM [10]. LADA patients also have lower major cardiovascular risk both clinical and metabolic parameters after adjustment for traditional cardiovascular risk factors and lower risk of microvascular complication compare to T2DM patients [11,12].
Auto-reactivity against gut bacterial peptides in patients with late-onset diabetes
Published in Autoimmunity, 2020
Mohammad Sajid, Krishna Biswas, Harpreet Singh, Sapna Negi
Diabetes mellitus is a non-communicable disease causing a burden for global human health. In 2017, worldwide there were approximately 451 million individuals who had diabetes mellitus (DM) and with the current trend, it is expected to reach 693 million by 2045 [1]. Approximately 90–95% of DM belongs to type 2 diabetes (T2D). It is essential to predict DM and prevent it in time, for which we need to understand the disease completely. The main triggers of this disease are an unhealthy lifestyle, obesity, and advanced age. The mounting inflammatory response in T2D is assigned through autoimmunity [2]. Further, another adult-onset autoimmune diabetic condition is known as Latent autoimmune diabetes in adults (LADA) and this phenotype mainly does not need insulin therapy [3]. Most of the T2D is mainly due to insulin resistance [4]. T2D is known to be a metabolic disorder. In this study, we hypothesize that sera binding of some metabolic peptides might cause a spectrum of diseases including T2D.
Phenotypic characteristics and risk factors in a multi-ethnic cohort of young adults with type 2 diabetes
Published in Current Medical Research and Opinion, 2019
Nadia Lascar, Quratul-Ain Altaf, Neil T. Raymond, James E. P. Brown, Helen Pattison, Anthony Barnett, Clifford J. Bailey, Srikanth Bellary
The city of Birmingham, UK has a multi-ethnic population with an estimated diabetes prevalence of around 10%11. South Asians (people of Indian, Pakistani and Bangladeshi ethnicity) comprise the largest ethnic group after white Europeans and account for 19.5% of its population12. We recruited a multi-ethnic cohort of young adults diagnosed with T2DM below the age of 40 years to this observational study. Ethnicity classification was based on the UK 2011 census analysis13. The following ethnic groups were considered: white, Asian/Asian British (Pakistani, Indian, Bangladeshi and other Asian), Black/British (Caribbean, African and other black). Patients were included in the study if they were: aged 18 years and above, had a diagnosis of T2DM before the age of 40 years and able to provide informed consent. Key exclusion criteria were: a known diagnosis of type 1 diabetes; latent autoimmune diabetes in adults (LADA, defined as: (1) age usually ≥30 years; (2) positive titre for at least one of the four autoantibodies; and (3) has not been treated with insulin within the first 6 months after diagnosis)14; monogenic diabetes or secondary diabetes; diabetes duration >14 years; ongoing pregnancy; developmental disorders; other significant illness or condition including severe mental health condition. Key inclusion and exclusion criteria are summarized in Table 1. The West Midlands National Research Ethics Service approved the study.