LADA (Latent Autoimmune Diabetes in Adults) is a form of autoimmune diabetes that shares features with both type 1 and type 2 diabetes.
- Key Characteristics:
- Autoimmune Basis: Presence of islet autoantibodies (e.g., GADA, IA-2A), similar to T1D.
- Adult Onset: Typically diagnosed after age 30, often misdiagnosed as T2D initially.
- Slower β-Cell Decline: Progressive β-cell failure, but slower than classic T1D.
- Insulin Deficiency: Requires insulin therapy, often within 6–12 months of diagnosis.
- Clinical Implications:
- Higher CV Risk: Like T1D/T2D, LADA patients have increased cardiovascular risk due to hyperglycemia, dyslipidemia, and inflammation.
- Diagnostic Challenge: Often diagnosed as T2D initially due to lack of ketoacidosis and older age at onset.
- Therapeutic Approach: Early insulin initiation is crucial to preserve β-cell function.
- From the Study:
- LADA patients were older with higher age at diagnosis compared to T1D, suggesting a slower disease progression.
- AAb-IFN-α status may further stratify LADA phenotypes, but data is preliminary.
Rationale: LADA’s unique features (autoimmunity + adult onset) necessitate distinct management, including early insulin therapy and aggressive CV risk factor control.