scholarly journals Features of chronic complications in latent autoimmune diabetes in adults

2021 ◽  
pp. 45-51
Author(s):  
I. O. Tsaryk ◽  
N. V. Pashkovska
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Autoimmune Diabetes ◽  
Tyrosine Phosphatase ◽  
Acid Decarboxylase ◽  
Latent Autoimmune Diabetes ◽  
Patients With Diabetes ◽  
Type 1 Dm

Purpose of the work. To find out the features of the course of chronic kidney disease in patients with latent autoimmune diabetes in adults (LADA) compared with the classic types of diabetes. Materials and methods. 145 patients with diabetes mellitus (DM) were examined (70 patients with LADA, 40 with type 1 DM — T1DM, 35 with type 2 DM — T2DM. Antibodies to glutamic acid decarboxylase and to tyrosine phosphatase were determined in all patients. Features of chronic kidney disease (CKD) were studied on the basis of anamnesis, clinical examination, glomerular filtration rate, microalbuminuria and the of albumin-creatinine ratio in urine. Results and discussion. According to the anamnesis, the diagnosis of CKD in patients with LADA was established on average up to 3 years from the manifestation of diabetes (in 30 % — already in the onset of the disease), while in T1DM — after 7.2 years, in T2DM — after 1.9 years. The most common stage of CKD in LADA patients was III (in 49 % of people). At the same time, the majority of patients had a nonalbuminuric phenotype of diabetic kidney disease (NARI). In terms of the characteristics of the course of CKD, LADA occupied an intermediate position, combining the signs of both main types of diabetes. Conclusions. The diagnosis of CKD in patients with LADA was established much earlier than in T1DM which indicates the incorrect use of the same recommendations for screening this complication in these patients. There was a predominance of NARI in patients with LADA. CKD in LADA requires the development of special approaches to screening, diagnosis and treatment. 

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.

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.

Type 1 Diabetes-related Autoantibodies in Different Forms of Diabetes

2019 ◽  
Vol 15 (3) ◽  
pp. 199-204 ◽  
Author(s):  
Elin Pettersen Sørgjerd
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Autoimmune Diabetes ◽  
Acid Decarboxylase ◽  
Adult Onset ◽  
Latent Autoimmune Diabetes ◽  
Childhood Type 1 Diabetes ◽  
Childhood Type

Autoantibodies against Glutamic Acid Decarboxylase (GADA), insulinoma antigen-2 (IA- 2A), insulin (IAA) and the most recently Zinc Transporter 8 (ZnT8A) are one of the most reliable biomarkers for autoimmune diabetes in both children and adults. They are today the only biomarkers that can distinguish Latent Autoimmune Diabetes in Adults (LADA) from phenotypically type 2 diabetes. As the frequency of autoantibodies at diagnosis in childhood type 1 diabetes depends on age, GADA is by far the most common in adult onset autoimmune diabetes, especially LADA. Being multiple autoantibody positive have also shown to be more common in childhood diabetes compared to adult onset diabetes, and multiple autoantibody positivity have a high predictive value of childhood type 1 diabetes. Autoantibodies have shown inconsistent results to predict diabetes in adults. Levels of autoantibodies are reported to cause heterogeneity in LADA. Reports indicate that individuals with high levels of autoantibodies have a more type 1 diabetes like phenotype and individuals with low levels of autoantibody positivity have a more type 2 diabetes like phenotype. It is also well known that autoantibody levels can fluctuate and transient autoantibody positivity in adult onset autoimmune diabetes have been reported to affect the phenotype.

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 Chronic kidney disease in patients with diabetes mellitus

2021 ◽  
Vol 10 (5) ◽  
pp. R151-R159
Author(s):  
Espen Nordheim ◽  
Trond Geir Jenssen
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Treatment Options ◽  
Specific Treatment ◽  
Patients With Diabetes ◽  
Concomitant Condition

Chronic kidney disease is a common complication and concomitant condition of diabetes mellitus. The treatment of patients with diabetes and chronic kidney disease, including intensive control of blood sugar and blood pressure, has been very similar for type 1 and type 2 diabetes patients. New therapeutic targets have shown promising results and may lead to more specific treatment options for patients with type 1 and type 2 diabetes.

A form of Autoimmune Diabetes in Adults Named LADA – An Update on Essential Features and Controversies

2019 ◽  
Vol 15 (3) ◽  
pp. 172-173 ◽  
Author(s):  
Valdemar Grill ◽  
Bjørn O. Åsvold
Keyword(s):  
Genetic Background ◽  
Clinical Utility ◽  
Autoimmune Diabetes ◽  
Classical Type ◽  
Phenotypic Characteristics ◽  
Latent Autoimmune Diabetes ◽  
The Impact

Latent Autoimmune Diabetes in the Adult, LADA has been investigated less than “classical” type 1 and type 2 diabetes and the criteria for and the relevance of a LADA diagnosis has been challenged. Despite the absence of a genetic background that is exclusive to LADA, this form of diabetes displays phenotypic characteristics that distinguish it from other forms of diabetes. LADA is heterogeneous in terms of the impact of autoimmunity and lifestyle factors, something that poses problems as to therapy and follow-up perhaps particularly in those with marginal positivity. Yet, there appears to be clear clinical utility in classifying individuals as LADA.

scholarly journals Guidelines adherence in the prevention and management of chronic kidney disease in patients with diabetes mellitus on the background of recent European recommendations – a registry-based analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Peter Bramlage ◽  
Stefanie Lanzinger ◽  
Sascha R. Tittel ◽  
Eva Hess ◽  
Simon Fahrner ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Analysis Data ◽  
Disease Diagnosis ◽  
Diabetic Patients ◽  
European Society Of Cardiology

Abstract Background Recent European Society of Cardiology (ESC)/European Association for the Study of Diabetes (EASD) guidelines provide recommendations for detecting and treating chronic kidney disease (CKD) in diabetic patients. We compared clinical practice with guidelines to determine areas for improvement. Methods German database analysis of 675,628 patients with type 1 or type 2 diabetes, with 134,395 included in this analysis. Data were compared with ESC/EASD recommendations. Results This analysis included 17,649 and 116,747 patients with type 1 and type 2 diabetes, respectively. The analysis showed that 44.1 and 49.1 % patients with type 1 and type 2 diabetes, respectively, were annually screened for CKD. Despite anti-diabetic treatment, only 27.2 % patients with type 1 and 43.5 % patients with type 2 achieved a target HbA1c of < 7.0 %. Use of sodium-glucose transport protein 2 inhibitors (1.5 % type 1/8.7 % type 2 diabetes) and glucagon-like peptide-1 receptor agonists (0.6 % type 1/5.2 % type 2 diabetes) was limited. Hypertension was controlled according to guidelines in 41.1 and 67.7 % patients aged 18–65 years with type 1 and 2 diabetes, respectively, (62.4 vs. 68.4 % in patients > 65 years). Renin angiotensin aldosterone inhibitors were used in 24.0 and 40.9 % patients with type 1 diabetes (micro- vs. macroalbuminuria) and 39.9 and 47.7 %, respectively, in type 2 diabetes. Conclusions Data indicate there is room for improvement in caring for diabetic patients with respect to renal disease diagnosis and treatment. While specific and potentially clinically justified reasons for non-compliance exist, the data may serve well for a critical appraisal of clinical practice decisions.

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