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      KCI등재 SCOPUS SCIE

      Latent Autoimmune Diabetes in Adults: A Review on Clinical Implications and Management

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      https://www.riss.kr/link?id=A105950061

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      다국어 초록 (Multilingual Abstract)

      Latent autoimmune diabetes in adults (LADA) is a heterogeneous disease characterized by a less intensive autoimmune process and a broad clinical phenotype compared to classical type 1 diabetes mellitus (T1DM), sharing features with both type 2 diabete...

      Latent autoimmune diabetes in adults (LADA) is a heterogeneous disease characterized by a less intensive autoimmune process and a broad clinical phenotype compared to classical type 1 diabetes mellitus (T1DM), sharing features with both type 2 diabetes mellitus (T2DM) and T1DM. Since patients affected by LADA are initially insulin independent and recognizable only by testing for islet-cell autoantibodies, it could be difficult to identify LADA in clinical setting and a high misdiagnosis rate still remains among patients with T2DM. Ideally, islet-cell autoantibodies screening should be performed in subjects with newly diagnosed T2DM, ensuring a closer monitoring of those resulted positive and avoiding treatment of hyperglycaemia which might increase the rate of β-cells loss. Thus, since the autoimmune process in LADA seems to be slower than in classical T1DM, there is a wider window for new therapeutic interventions that may slow down β-cell failure. This review summarizes the current understanding of LADA, by evaluating data from most recent studies, the actual gaps in diagnosis and management. Finally, we critically highlight and discuss novel findings and future perspectives on the therapeutic approach in LADA.

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      참고문헌 (Reference)

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      2 Lampasona V, "Zinc transporter 8 antibodies complement GAD and IA-2 antibodies in the identification and characterization of adult-onset autoimmune diabetes: Non Insulin Requiring Autoimmune Diabetes (NIRAD) 4" 33 : 104-108, 2010

      3 Grant SF, "Variant of transcription factor 7-like 2 (TCF7L2) gene confers risk of type 2 diabetes" 38 : 320-323, 2006

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      6 D’Alessio DA, "Treatment with the dipeptidyl peptidase-4 inhibitor vildagliptin improves fasting islet-cell function in subjects with type 2 diabetes" 94 : 81-88, 2009

      7 Bell DS, "The role of C-peptide levels in screening for latent autoimmune diabetes in adults" 11 : 308-311, 2004

      8 Roh MO, "The prevalence and characteristics of latent autoimmune diabetes in adults (LADA) and its relation with chronic complications in a clinical department of a university hospital in Korea" 50 : 129-134, 2013

      9 Rawshani A, "The incidence of diabetes among 0-34 year olds in Sweden: new data and better methods" 57 : 1375-1381, 2014

      10 Kobayashi T, "Small doses of subcutaneous insulin as a strategy for preventing slowly progressive beta-cell failure in islet cell antibody-positive patients with clinical features of NIDDM" 45 : 622-626, 1996

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      2 Lampasona V, "Zinc transporter 8 antibodies complement GAD and IA-2 antibodies in the identification and characterization of adult-onset autoimmune diabetes: Non Insulin Requiring Autoimmune Diabetes (NIRAD) 4" 33 : 104-108, 2010

      3 Grant SF, "Variant of transcription factor 7-like 2 (TCF7L2) gene confers risk of type 2 diabetes" 38 : 320-323, 2006

      4 Turner R, "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" 350 : 1288-1293, 1997

      5 Buzzetti R, "Tyrosine phosphatase-related islet antigen 2(256-760) autoantibodies, the only marker of islet autoimmunity that increases by increasing the degree of BMI in obese subjects with type 2 diabetes" 38 : 513-520, 2015

      6 D’Alessio DA, "Treatment with the dipeptidyl peptidase-4 inhibitor vildagliptin improves fasting islet-cell function in subjects with type 2 diabetes" 94 : 81-88, 2009

      7 Bell DS, "The role of C-peptide levels in screening for latent autoimmune diabetes in adults" 11 : 308-311, 2004

      8 Roh MO, "The prevalence and characteristics of latent autoimmune diabetes in adults (LADA) and its relation with chronic complications in a clinical department of a university hospital in Korea" 50 : 129-134, 2013

      9 Rawshani A, "The incidence of diabetes among 0-34 year olds in Sweden: new data and better methods" 57 : 1375-1381, 2014

      10 Kobayashi T, "Small doses of subcutaneous insulin as a strategy for preventing slowly progressive beta-cell failure in islet cell antibody-positive patients with clinical features of NIDDM" 45 : 622-626, 1996

      11 Buzzetti R, "Saxagliptin improves glycaemic control and C-peptide secretion in latent autoimmune diabetes in adults (LADA)" 32 : 289-296, 2016

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      20 Maioli M, "Number of autoantibodies and HLA genotype, more than high titers of glutamic acid decarboxylase autoantibodies, predict insulin dependence in latent autoimmune diabetes of adults" 163 : 541-549, 2010

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      31 Barinas-Mitchell E, "Islet cell autoimmunity in a triethnic adult population of the Third National Health and Nutrition Examination Survey" 53 : 1293-1302, 2004

      32 Brophy S, "Interventions for latent autoimmune diabetes (LADA) in adults" 9 : 2011

      33 Tiittanen M, "Insulin treatment in patients with type 1 diabetes induces upregulation of regulatory T-cell markers in peripheral blood mononuclear cells stimulated with insulin in vitro" 55 : 3446-3454, 2006

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      35 Hernandez M, "Insulin secretion in patients with latent autoimmune diabetes (LADA): half way between type 1 and type 2 diabetes: action LADA 9" 15 : 1-, 2015

      36 Maruyama T, "Insulin intervention in slowly progressive insulin-dependent (type 1) diabetes mellitus" 93 : 2115-2121, 2008

      37 Haller K, "Insulin gene VNTR, CTLA-4 +49A/G and HLA-DQB1 alleles distinguish latent autoimmune diabetes in adults from type 1 diabetes and from type 2 diabetes group" 69 : 121-127, 2007

      38 Bruno G, "Incidence of type 1 and type 2 diabetes in adults aged 30-49 years: the population-based registry in the province of Turin, Italy" 28 : 2613-2619, 2005

      39 Lee SH, "Identifying latent autoimmune diabetes in adults in Korea: the role of C-peptide and metabolic syndrome" 83 : e62-e65, 2009

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      41 Buzzetti R, "High titer of autoantibodies to GAD identifies a specific phenotype of adult-onset autoimmune diabetes" 30 : 932-938, 2007

      42 Zampetti S, "High GADA titer increases the risk of insulin requirement in LADA patients: a 7-year follow-up (NIRAD study 7)" 171 : 697-704, 2014

      43 Radtke MA, "Heterogeneity of patients with latent autoimmune diabetes in adults: linkage to autoimmunity is apparent only in those with perceived need for insulin treatment: results from the Nord-Trondelag Health (HUNT) study" 32 : 245-250, 2009

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      49 Desai M, "GAD autoantibodies and epitope reactivities persist after diagnosis in latent autoimmune diabetes in adults but do not predict disease progression: UKPDS 77" 50 : 2052-2060, 2007

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      54 Pozzilli P, "Dulaglutide treatment results in effective glycaemic control in latent autoimmune diabetes in adults (LADA): a post-hoc analysis of the AWARD-2, -4 and -5 trials" 20 : 1490-1498, 2018

      55 Pipi E, "Distinct clinical and laboratory characteristics of latent autoimmune diabetes in adults in relation to type 1 and type 2 diabetes mellitus" 5 : 505-510, 2014

      56 Zhao Y, "Dipeptidyl peptidase 4 inhibitor sitagliptin maintains β-cell function in patients with recent-onset latent autoimmune diabetes in adults: one year prospective study" 99 : E876-E880, 2014

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      72 Desai M, "An association analysis of the HLA gene region in latent autoimmune diabetes in adults" 50 : 68-73, 2007

      73 Barker A, "Age-dependent decline of β-cell function in type 1 diabetes after diagnosis: a multi-centre longitudinal study" 16 : 262-267, 2014

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      76 Mishra R, "A global perspective of latent autoimmune diabetes in adults" 29 : 638-650, 2018

      77 Monge L, "A clinically orientated approach increases the efficiency of screening for latent autoimmune diabetes in adults (LADA) in a large clinic-based cohort of patients with diabetes onset over 50 years" 21 : 456-459, 2004

      78 Fourlanos S, "A clinical screening tool identifies autoimmune diabetes in adults" 29 : 970-975, 2006

      79 American Diabetes Association, "(2) Classification and diagnosis of diabetes" 38 (38): S8-S16, 2015

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