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.

Citations

Citations to this article as recorded by  

• A Comprehensive Survey on Diabetes Type-2 (T2D) Forecast Using Machine Learning
  Satyanarayana Murthy nimmagadda, Gunnam Suryanarayana, Gangu Bharath Kumar, Ganta Anudeep, Gedela Vinay Sai
  Archives of Computational Methods in Engineering.2024;[Epub]     CrossRef
• Ensemble machine learning reveals key features for diabetes duration from electronic health records
  Gabriel Cerono, Davide Chicco
  PeerJ Computer Science.2024; 10: e1896.     CrossRef
• LADA 30th anniversary: A growing form of diabetes with persistent unresolved questions
  Ivy Lee Jia Jia, Raffaella Buzzetti, Richard David Leslie, Paolo Pozzilli
  Diabetes/Metabolism Research and Reviews.2024;[Epub]     CrossRef
• A Curious Case of New-Onset Diabetes
  Kristina Hernandez, Charity L. Tan
  The Journal for Nurse Practitioners.2023; 19(3): 104411.     CrossRef
• Comprehensive review: Frailty in pancreas transplant candidates and recipients
  Ronald F. Parsons, Ekamol Tantisattamo, Wisit Cheungpasitporn, Arpita Basu, Yee Lu, Krista L. Lentine, Kenneth J. Woodside, Neeraj Singh, Joseph Scalea, Tarek Alhamad, Ty B. Dunn, Franco H. Cabeza Rivera, Sandesh Parajuli, Martha Pavlakis, Matthew Cooper
  Clinical Transplantation.2023;[Epub]     CrossRef
• Managing latent autoimmune disease in adults
  David Morris
  Independent Nurse.2023; 2023(1): 18.     CrossRef
• Development and validation of a clinical score for identifying patients with high risk of latent autoimmune adult diabetes (LADA): The LADA primary care-protocol study
  Pilar Vich-Pérez, Juan Carlos Abánades-Herranz, Gustavo Mora-Navarro, Ángela María Carrasco-Sayalero, Miguel Ángel Salinero-Fort, Ignacio Sevilla-Machuca, Mar Sanz-Pascual, Cristina Álvarez Hernández-Cañizares, Carmen de Burgos-Lunar, Vijayaprakash Suppia
  PLOS ONE.2023; 18(2): e0281657.     CrossRef
• Diagnostic Dilemmas and Current Treatment Approaches in Latent Onset Autoimmune Diabetes in Adults: A Concise Review
  Lakshmi Chandran, Ankul Singh S., Chitra Vellapandian
  Current Diabetes Reviews.2023;[Epub]     CrossRef
• Anti-glutamic Acid Decarboxylase Antibody-Positive Gestational Diabetes Mellitus with Autoimmune Type 1 Diabetes Mellitus in the Early Postpartum Period: A Case Report and Literature Review
  Akiko Fujishima, Yohei Onodera, Hiroshi Miura, Yukihiro Terada
  The Tohoku Journal of Experimental Medicine.2023; 259(4): 327.     CrossRef
• Een 54-jarige man met onverklaard gewichtsverlies
  N. Mutebi, A. Kharagjitsing
  Tijdschrift voor Geneeskunde.2023;[Epub]     CrossRef
• Effects of Bacillus Calmette-Guérin on immunometabolism, microbiome and liver diseases
  Muhammad Umair Ijaz, Farzam Vaziri, Yu-Jui Yvonne Wan
  Liver Research.2023; 7(2): 116.     CrossRef
• The Etiological Diagnosis of Diabetes: Still a Challenge for the Clinician
  Danièle Dubois-Laforgue, José Timsit
  Endocrines.2023; 4(2): 437.     CrossRef
• Type 1 diabetes mellitus: features of differential diagnosis
  EV Gantsgorn, OV Denisenko, YaO Osipenko, DA Kalmykova, AV Ivanov, SS Gerasyuta, GA Bulguryan, MH Ivanova, DA Saakyan
  Bulletin of Russian State Medical University.2023;[Epub]     CrossRef
• A 1‐year pilot study of intralymphatic injections of GAD‐alum in individuals with latent autoimmune diabetes in adults (LADA) with signs of high immunity: No safety concerns and resemblance to juvenile type 1 diabetes
  Ingrid K. Hals, Chandima Balasuriya, Rosaura Casas, Johnny Ludvigsson, Anneli Björklund, Valdemar Grill
  Diabetes, Obesity and Metabolism.2023; 25(11): 3400.     CrossRef
• The relationship between red blood cell distribution width and islet β-cell function indexes in patients with latent autoimmune diabetes in adults
  Xiuli Fu, Qin Tan, Wei Wei, Sheng Ding, Zhongjing Wang
  BMC Endocrine Disorders.2023;[Epub]     CrossRef
• A Review on Latent Autoimmune Diabetes in Adults
  Vijay Ravikumar, Ariba Ahmed, Ashish Anjankar
  Cureus.2023;[Epub]     CrossRef
• Neutrophils and their role in the aetiopathogenesis of type 1 and type 2 diabetes
  Anna Giovenzana, Debora Carnovale, Brett Phillips, Alessandra Petrelli, Nick Giannoukakis
  Diabetes/Metabolism Research and Reviews.2022;[Epub]     CrossRef
• Prevalence of Latent Autoimmune Diabetes in Adult Based on the Presence of GAD 65 Antibodies in North-Eastern Uttar Pradesh, India
  Himalina Sangma, Anshul Singh, Anubha Srivastava, Vatsala Misra
  Annals of the National Academy of Medical Sciences (India).2022; 58(01): 017.     CrossRef
• Serum Bile Acid Profiles in Latent Autoimmune Diabetes in Adults and Type 2 Diabetes Patients
  Yu Zhou, Deli Ye, Xiaofen Yuan, Yonglie Zhou, Jun Xia, Giuseppe Pugliese
  Journal of Diabetes Research.2022; 2022: 1.     CrossRef
• Early life Bacillus Calmette-Guerin vaccination and incidence of type 1, type 2, and latent autoimmune diabetes in adulthood
  Philippe Corsenac, Marie-Élise Parent, Hélène Mansaray, Andrea Benedetti, Hugues Richard, Simona Stäger, Marie-Claude Rousseau
  Diabetes & Metabolism.2022; 48(3): 101337.     CrossRef
• Atypical Diabetes and Management Considerations
  Shivajirao Prakash Patil
  Primary Care: Clinics in Office Practice.2022; 49(2): 225.     CrossRef
• Efficacy and safety of sitagliptin and insulin for latent autoimmune diabetes in adults: A systematic review and meta‐analysis
  Tong Lin, Yinhe Cai, Liting Tang, Youwei Lian, Min Liu, Chaonan Liu
  Journal of Diabetes Investigation.2022; 13(9): 1506.     CrossRef
• Latent autoimmune diabetes in youth shows greater autoimmunity than latent autoimmune diabetes in adults: Evidence from a nationwide, multicenter, cross‐sectional study
  Jin Cheng, Xiaohan Tang, Xiang Yan, Gan Huang, Shuoming Luo, Zhiguang Zhou, Xia Li
  Pediatric Diabetes.2022; 23(5): 578.     CrossRef
• Latent Autoimmune Diabetes in Adults and Metabolic Syndrome—A Mini Review
  Niansi Pan, Shimei Yang, Xiaohong Niu
  Frontiers in Endocrinology.2022;[Epub]     CrossRef
• Lifestyle or Environmental Influences and Their Interaction With Genetic Susceptibility on the Risk of LADA
  Sofia Carlsson
  Frontiers in Endocrinology.2022;[Epub]     CrossRef
• Antigen-specific immunotherapies in type 1 diabetes
  Xuejiao Zhang, Ying Dong, Dianyuan Liu, Liu Yang, Jiayi Xu, Qing Wang
  Journal of Trace Elements in Medicine and Biology.2022; 73: 127040.     CrossRef
• Latent autoimmune diabetes in adults: a focus on β-cell protection and therapy
  Wenfeng Yin, Shuoming Luo, Zilin Xiao, Ziwei Zhang, Bingwen Liu, Zhiguang Zhou
  Frontiers in Endocrinology.2022;[Epub]     CrossRef
• Diagnostic camouflage: A case report on Latent autoimmune diabetics of adulthood
  Sandhya kiran Neupane, Prakash Paudel Jaishi, Divyaa Koirala, Arjun Kandel, Prabhat Kiran Neupane
  Annals of Medicine & Surgery.2022;[Epub]     CrossRef
• Clinical characteristics and cardiovascular risk profile in children and adolescents with latent autoimmune diabetes: Results from the German/Austrian prospective diabetes follow‐up registry
  Alena Welters, Sascha R. Tittel, Thomas Reinehr, Daniel Weghuber, Susanna Wiegand, Wolfram Karges, Clemens Freiberg, Thomas Meissner, Nanette C. Schloot, Reinhard W. Holl
  Pediatric Diabetes.2022; 23(8): 1602.     CrossRef
• The utility of assessing C-peptide in patients with insulin-treated type 2 diabetes: a cross-sectional study
  Tuccinardi Dario, Giorgino Riccardo, Pieralice Silvia, Watanabe Mikiko, Maggi Daria, Palermo Andrea, Defeudis Giuseppe, Fioriti Elvira, Pozzilli Paolo, Manfrini Silvia
  Acta Diabetologica.2021; 58(4): 411.     CrossRef
• Cross-reactive peptide epitopes of Enterovirus Coxsackie B4 and human glutamic acid decarboxylase detecting antibodies in latent autoimmune diabetes in adults versus type 1 diabetes
  Feliciana Real-Fernández, Alessandra Gallo, Francesca Nuti, Lorenzo Altamore, Gloria Giovanna Del Vescovo, Pietro Traldi, Eugenio Ragazzi, Paolo Rovero, Annunziata Lapolla, Anna Maria Papini
  Clinica Chimica Acta.2021; 515: 73.     CrossRef
• Treating latent autoimmune diabetes in adults in the era of cardiovascular outcomes trials: Old dog should learn new tricks
  Theocharis Koufakis, Prashanth Vas, Kalliopi Kotsa
  Diabetic Medicine.2021;[Epub]     CrossRef
• Defining and Classifying New Subgroups of Diabetes
  Ashok Balasubramanyam
  Annual Review of Medicine.2021; 72(1): 63.     CrossRef
• Slowly evolving, immune-mediated diabetes in 14-year-old patient: a case report
  M. R. Ragimov, D. D. Omelchuk, L. I. Ibragimova, O. S. Derevyanko, T. V. Nikonova
  Diabetes mellitus.2021; 24(1): 70.     CrossRef
• The role of autoimmunity in the pathophysiology of type 2 diabetes: Looking at the other side of the moon
  Theocharis Koufakis, George Dimitriadis, Symeon Metallidis, Pantelis Zebekakis, Kalliopi Kotsa
  Obesity Reviews.2021;[Epub]     CrossRef
• Dapagliflozin as an Adjunct Therapy to Insulin in Patients with Type 1 Diabetes Mellitus: Efficacy and Safety of this Combination
  Johan H Jendle, Francisco J Ampudia-Blasco, Martin Füchtenbusch, Paolo Pozzilli
  European Endocrinology.2021; 1(1): 12.     CrossRef
• Dapagliflozin as an Adjunct Therapy to Insulin in Patients with Type 1 Diabetes Mellitus: Efficacy and Safety of this Combination
  Johan H Jendle, Francisco J Ampudia-Blasco, Martin Füchtenbusch, Paolo Pozzilli
  touchREVIEWS in Endocrinology.2021; 17(1): 12.     CrossRef
• Toward an Improved Classification of Type 2 Diabetes: Lessons From Research into the Heterogeneity of a Complex Disease
  Maria J Redondo, Ashok Balasubramanyam
  The Journal of Clinical Endocrinology & Metabolism.2021; 106(12): e4822.     CrossRef
• Bacillus Calmette-Guerin 's beneficial impact on glucose metabolism: Evidence for broad based applications
  Gabriella F. Shpilsky, Hiroyuki Takahashi, Anna Aristarkhova, Michele Weil, Nathan Ng, Kacie J. Nelson, Amanda Lee, Hui Zheng, Willem M. Kühtreiber, Denise L. Faustman
  iScience.2021; 24(10): 103150.     CrossRef
• Masqueraders: how to identify atypical diabetes in primary care
  Sumera Ahmed, Sana Saeed, Jay H. Shubrook
  Journal of Osteopathic Medicine.2021; 121(12): 899.     CrossRef
• Lada or Type 2 Diabetes Mellitus - A Challenging Diagnosis in Clinical Approach
  Lucia Mihaela Custură, Oana Deteşan, Raluca Maria Tilinca, Reka Annamaria Schmiedt, Brigitta Irén Bacso, Mariana Cornelia Tilinca
  Acta Medica Transilvanica.2021; 26(3): 55.     CrossRef
• Antioxidant, Anti-Inflammatory, and Immunomodulatory Properties of Tea—The Positive Impact of Tea Consumption on Patients with Autoimmune Diabetes
  Anna Winiarska-Mieczan, Ewa Tomaszewska, Karolina Jachimowicz
  Nutrients.2021; 13(11): 3972.     CrossRef
• A Review of Statistical and Machine Learning Techniques for Microvascular Complications in Type 2 Diabetes
  Nitigya Sambyal, Poonam Saini, Rupali Syal
  Current Diabetes Reviews.2021; 17(2): 143.     CrossRef
• Bariatric Surgery Outcomes in Patients with Latent Autoimmune Diabetes of the Adult
  Marta Guimarães, Sofia S. Pereira, Mário Nora, Mariana P. Monteiro
  Obesity Facts.2021; 14(4): 425.     CrossRef
• Особливості перебігу діабетичної хвороби нирок у хворих на латентний автоімунний діабет дорослих
  I.O. Tsaryk, N.V. Pashkovska
  INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine).2021; 17(2): 116.     CrossRef
• Latenter Autoimmundiabetes im Erwachsenen- und Kindesalter
  Alena Welters, Nanette C. Schloot
  Der Diabetologe.2020; 16(1): 27.     CrossRef
• A treatment-based algorithm for identification of diabetes type in the National Health and Nutrition Examination Survey
  Mitra Mosslemi, Hannah L. Park, Christine E. McLaren, Nathan D. Wong
  Cardiovascular Endocrinology & Metabolism.2020; 9(1): 9.     CrossRef
• Case 6-2020: A 34-Year-Old Woman with Hyperglycemia
  Richard C. Cabot, Eric S. Rosenberg, Virginia M. Pierce, David M. Dudzinski, Meridale V. Baggett, Dennis C. Sgroi, Jo-Anne O. Shepard, Kathy M. Tran, Emily K. McDonald, Tara Corpuz, Miriam S. Udler, Camille E. Powe, Christina A. Austin-Tse
  New England Journal of Medicine.2020; 382(8): 745.     CrossRef
• Therapeutic approaches for latent autoimmune diabetes in adults: One size does not fit all
  Theocharis Koufakis, Niki Katsiki, Pantelis Zebekakis, George Dimitriadis, Kalliopi Kotsa
  Journal of Diabetes.2020; 12(2): 110.     CrossRef
• Grenzformen zwischen Typ-1- und Typ-2-Diabetes
  Michael Hummel
  MMW - Fortschritte der Medizin.2020; 162(11): 60.     CrossRef
• The Differential Expression of Long Noncoding RNAs in Type 2 Diabetes Mellitus and Latent Autoimmune Diabetes in Adults
  Zhang Pengyu, Yan Yan, Fu Xiying, Yang Maoguang, Li Mo, Cheng Yan, Shen Hong, Wang Lijuan, Zhang Xiujuan, Cai Hanqing
  International Journal of Endocrinology.2020; 2020: 1.     CrossRef
• A convenient diagnostic tool for discriminating adult-onset glutamic acid decarboxylase antibody-positive autoimmune diabetes from type 2 diabetes: a retrospective study
  Hon-Ke Sia, Shih-Te Tu, Pei-Yung Liao, Kuan-Han Lin, Chew-Teng Kor, Ling-Ling Yeh
  PeerJ.2020; 8: e8610.     CrossRef
• Correct Diabetes Diagnosis and Treatment Allows Sailor to Remain on Active Duty
  Andrea R Frazier
  Military Medicine.2020; 185(9-10): e1843.     CrossRef
• Hombre de 28 años con presentación de diabetes
  M. Ricci, J. Sanz Cánovas, V. Buonaluto, R. Gómez Huelgas
  Medicine - Programa de Formación Médica Continuada Acreditado.2020; 13(16): 942.e1.     CrossRef
• Uncommon Presentations of Diabetes: Zebras in the Herd
  Karen L. Shidler, Lisa R. Letourneau, Lucia M. Novak
  Clinical Diabetes.2020; 38(1): 78.     CrossRef
• Ketogenic Diet as a Trigger for Diabetic Ketoacidosis in a Misdiagnosis of Diabetes: A Case Report
  Alexander J. White-Cotsmire, Amber M. Healy
  Clinical Diabetes.2020; 38(3): 318.     CrossRef
• Subphänotypen des Diabetes
  Oana Patricia Zaharia, Julia Szendrödi
  Der Diabetologe.2019; 15(4): 288.     CrossRef
• Autoimmunity in latent autoimmune diabetes in adults
  Alessandro P. Delitala
  AIMS Medical Science.2019; 6(2): 132.     CrossRef
• Risk of diabetes-associated diseases in subgroups of patients with recent-onset diabetes: a 5-year follow-up study
  Oana P Zaharia, Klaus Strassburger, Alexander Strom, Gidon J Bönhof, Yanislava Karusheva, Sofia Antoniou, Kálmán Bódis, Daniel F Markgraf, Volker Burkart, Karsten Müssig, Jong-Hee Hwang, Olof Asplund, Leif Groop, Emma Ahlqvist, Jochen Seissler, Peter Nawr
  The Lancet Diabetes & Endocrinology.2019; 7(9): 684.     CrossRef
• The Influence of Type 2 Diabetes–Associated Factors on Type 1 Diabetes
  Maria J. Redondo, Carmella Evans-Molina, Andrea K. Steck, Mark A. Atkinson, Jay Sosenko
  Diabetes Care.2019; 42(8): 1357.     CrossRef