scholarly journals Slowly evolving, immune-mediated diabetes in 14-year-old patient: a case report

2021 ◽  
Vol 24 (1) ◽  
pp. 70-73
Author(s):  
M. R. Ragimov ◽  
D. D. Omelchuk ◽  
L. I. Ibragimova ◽  
O. S. Derevyanko ◽  
T. V. Nikonova
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Insulin Therapy ◽  
Type 1 Diabetes Mellitus ◽  
Autoimmune Diabetes ◽  
Tyrosine Phosphatase ◽  
Acid Decarboxylase ◽  
Latent Autoimmune Diabetes ◽  
Immune Mediated

Slowly developing immune-mediated diabetes, often called latent autoimmune diabetes in adults, is characterized by the presence of autoantibodies (ATs) to glutamic acid decarboxylase (GADA), the patient's age at the onset over 35 years, and the absence of the need for insulin therapy for 6-12 months to 6 years from the moment of diagnosis, according to the WHO classification of 2019, refers to hybrid forms of diabetes mellitus (DM). In this article, we present a case history of slowly developing immune-mediated diabetes in a 14-year-old boy who was transferred from metformin monotherapy and a diet with restriction of digestible carbohydrates to the intensified insulin therapy only 4 years after the onset of diabetes mellitus with a glycated hemoglobin (HbA1c) level of less than 6.5% throughout the disease. As a result of the studies, the patient was found to have a homozygous genotype highly predisposing to the development of Type 1 Diabetes Mellitus (T1DM), as well as increased levels of ATs to GADA and tyrosine phosphatase (IA-2A). The initially preserved level of basal C-peptide and the clinical course of the disease in this patient do not allow us to classify this case as a classic variant of the course of Type 1 Diabetes Mellitus.

scholarly journals The role of “latent autoimmune diabetes in adults” in the structure of diabetes mellitus in young people

2022 ◽  
pp. 150-155
Author(s):  
A. K. Ovsyannikova ◽  
R. B. Galenok ◽  
O. B. Rymar
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Young People ◽  
Insulin Therapy ◽  
Type 1 Diabetes Mellitus ◽  
Autoimmune Diabetes ◽  
Correct Diagnosis ◽  
Practical Importance ◽  
Latent Autoimmune Diabetes

In the clinical practice of an endocrinologist, verification of the type of diabetes mellitus (DM) in young people is of high clinical significance, since the prescription of treatment depends on this: from the correction of carbohydrate metabolism by a balanced diet to the prescription of oral hypoglycemic drugs and insulin therapy. In rare forms of diabetes mellitus, which include «latent autoimmune diabetes in adults» (LADA), it is not always possible to make a correct diagnosis. This form of diabetes mellitus occupies an intermediate position between type 1 diabetes mellitus and type 2 diabetes mellitus (DM 1 and DM 2) and is often not detected. In this regard, the study of the LADA flow is of great practical importance. Verification of the LADA diagnosis is based on three clinical criteria: adult onset of diabetes; the presence of circulating islet autoantibodies, which distinguishes LADA from T2DM; the absence of an absolute need for insulin when making a diagnosis, which distinguishes LADA from the classic type 1 diabetes mellitus. The main treatment tactics for patients with LADA should be aimed at preserving their own insulin secretion. This requires the timely appointment of insulin therapy. The question of the possibility of using drugs of peripheral action – biguanides and glitazones, which do not cause depletion of β-cells, is discussed, but their effectiveness has not yet been established. The appointment of any secretogens, including sulfonylurea preparations, is contraindicated Quite often, LADA is difficult to diagnose, and the wrong treatment tactics are prescribed. At the moment, there is little data on the effectiveness of different classes of drugs, which leads to further detailed study of this type of diabetes. Currently, there are no special algorithms for LADA treatment

Differences in the genetic background of latent autoimmune diabetes in adults (LADA) and type 1 diabetes mellitus

2002 ◽  
Vol 84 (2) ◽  
pp. 109-115 ◽  
Author(s):  
Ágnes Vatay ◽  
Katalin Rajczy ◽  
Éva Pozsonyi ◽  
Nóra Hosszúfalusi ◽  
Zoltán Prohászka ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Genetic Background ◽  
Autoimmune Diabetes ◽  
Latent Autoimmune Diabetes

scholarly journals IMMUNOLOGICAL AND METABOLIC FACTORS INTERACTION IN THE DEVELOPMENT AND PROGRESSION OF MICROVASCULAR COMPLICATIONS IN LATENT AUTOIMMUNE DIABETES OF ADULTS (LADA)

2014 ◽  
Vol 13 (1) ◽  
pp. 73-78
Author(s):  
T. V. Saprina ◽  
T. S. Prokhorenko ◽  
F. E. Lazarenko ◽  
I. N. Vorozhtsova ◽  
N. V. Ryazantseva
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Autoimmune Diabetes ◽  
Microvascular Complications ◽  
Mononuclear Leukocytes ◽  
Latent Autoimmune Diabetes ◽  
Immunological Factors

Some researchers found that the development of microvascular complications (nephropathy, retinopathy) with latent autoimmune diabetes adults (LADA) occurs much earlier than in type 1 diabetes mellitus. The research devoted to the study of the spectrum and the time of development of microangiopathy in patients with latent autoimmune diabetes of adults, compared to patients with type 1 and 2 diabetes mellitus. Also studied immunological factors (cytokine secretion of mononuclear leukocytes) as one of the possible mechanisms of diabetic angiopathy progression. It has been shown that in LADA, as in patients with type 2 diabetes mellitus, the development of microvascular complications (nephropathy, retinopathy) occurs much earlier than in type 1 diabetes mellitus (after a 4-year course of the disease) due to a sharp decline in the serum concentration of C peptide. Thus in patients with LADA, having microvascular complications in the supernatants of cell cultures of mononuclear leukocytes determined a significant increase in the concentrations of cytokines IL-2, IL-4, TNFα.

scholarly journals Late-onset type 1 diabetes mellitus or latent autoimmune diabetes in adults: a teachable moment

2020 ◽  
Author(s):  
Isabel Borges ◽  
Roberto Añez ◽  
Mervin Chavez-Castillo ◽  
Juan Salazar
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Late Onset ◽  
Autoimmune Diabetes ◽  
Wide Spectrum ◽  
Clinical Form ◽  
Latent Autoimmune Diabetes

Adult-onset autoimmune diabetes (AOAD) is clinical form of diabetes with a wide spectrum of genotypical and phenotypical manifestations, which has risen in prominence in recent decades, probably due to greater interest in its pathogenic mechanisms, and increased identification of autoimmune markers. The clinical presentation may vary from type 1 diabetes mellitus to latent autoimmune diabetes in adults, which although clearly distinct from a theoretical viewpoint, may pose various clinical pitfalls in practice. We present the case of a patient with AOAD which featured several diagnostic challenges during follow-up.

Autoimmune diagnostics in diabetes mellitus

2006 ◽  
Vol 44 (2) ◽  
Author(s):  
Jochen Seissler ◽  
Werner A. Scherbaum
Keyword(s):  
Type 1 Diabetes ◽  
Islet Cell ◽  
Autoimmune Diabetes ◽  
Tyrosine Phosphatase ◽  
Islet Cell Antibodies ◽  
Acid Decarboxylase ◽  
Latent Autoimmune Diabetes ◽  
Islet Cell Antigens

AbstractType 1 diabetes results from a specific destruction of the insulin-producing β-cells of the pancreas. The disease is characterized by the appearance of specific autoantibodies against islet cell antigens. Autoantibodies to insulin, glutamic acid decarboxylase, tyrosine phosphatase IA-2 and cytoplasmic islet cell antibodies are useful markers for the differential diagnosis of type 1 diabetes when clinical and metabolic criteria alone do not allow definite classification. Autoimmune diagnostics is of particular importance in adults to discriminate between type 1 and type 2 diabetes and to assess the diagnosis of latent autoimmune diabetes in adults.

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