scholarly journals Masqueraders: how to identify atypical diabetes in primary care

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Sumera Ahmed ◽  
Sana Saeed ◽  
Jay H. Shubrook
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Autoimmune Diabetes ◽  
Healthcare Providers ◽  
Diabetes Type 2 ◽  
Secondary Diabetes ◽  
Atypical Form ◽  
Latent Autoimmune Diabetes ◽  
Atypical Diabetes

Abstract Diabetes mellitus is a complex set of conditions that impacts 34 million Americans. While type 1 diabetes, type 2 diabetes, and gestational diabetes are most frequently encountered, there are many other types of diabetes with which healthcare providers are less familiar. These atypical forms of diabetes make up nearly 10% of diabetes cases and can masquerade as type 1 or 2 diabetes mellitus (T1DM or T2DM), and the treatment may not be optimized if the diagnosis is not accurate. Atypical forms include monogenic diabetes (formally known as maturity-onset diabetes of the young [MODY]), latent autoimmune diabetes of the adult (LADA), ketosis-prone diabetes, and secondary diabetes. This paper will detail the defining characteristics of each atypical form and demonstrate how they can masquerade as type 1 or 2 diabetes mellitus. Gestational diabetes mellitus will not be discussed in this article.

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 Prevalence of risk factors of cardiometabolic complications in latent autoimmune diabetes in adults

2021 ◽  
Vol 25 (2(98)) ◽  
pp. 125-129
Author(s):  
I. Tsaryk ◽  
N. Pashkovska ◽  
O. Ilashchuk
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Metabolic Syndrome ◽  
Clinical Laboratory ◽  
Autoimmune Diabetes ◽  
Acid Decarboxylase ◽  
Latent Autoimmune Diabetes ◽  
Patients With Diabetes

The aim of the study. To determine the prevalence of risk factors for cardiometabolic complications in latent autoimmune diabetes in adults compared to other types of diabetes depending on the phenotype of the disease.Materials and methods. A comprehensive examination of 106 patients with diabetes mellitus: 45 (main group) with latent autoimmune diabetes in adults (LADA), 26 - with type 1 diabetes mellitus (T1DM), 35 - with type 2 diabetes mellitus (T2DM). Complaints, anamnesis data, objective examination, results of general clinical, laboratory researches, indicators of carbohydrate metabolism, titers of antibodies to glutamic acid decarboxylase were evaluated.Results. The prevalence of metabolic syndrome (MS) in LADA was 51% and was significantly higher than in T1DM (19%), but was lower compared with T2DM (94%). The highest incidence of MS was found in patients with the LADA2 phenotype (87%). Of particular note is the fact that this figure was close to that in T2DM. At the same time in LADA1 the incidence of MS was lower (36%), but twice as high as in T1DM. In addition to hyperglycemia, abdominal obesity (62% of patients), hypertension (78%) and dyslipidemia (56%) were commonly reported in LADA.Conclusions. The prevalence of metabolic syndrome as a complex of cardiometabolic risk factors in LADA differs from that in classical types of diabetes, which requires a differential approach to their management.

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

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.

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