A long and winding road to understand latent autoimmune diabetes in adults

Abstract

Latent autoimmune diabetes in adults (LADA) describes a ing autoimmune diabetes”, “type 1.5 diabetes”, “adultsubgroup of patients who develop phenotypic type 2 diabetes (T2D) but with markers of islet autoimmunity. It is under debate whether LADA is a subtype of type 1 diabetes (T1D) or a unique disease. LADA comprises about 1.5% to 14.2% in phenotypic T2D depending on ethnicity. It is the most common form of autoimmune diabetes diagnosed in adults, with 3.3to 12.2-fold higher prevalence than that of adult-onset T1D. LADA has similar pathogenesis as classic insulin-dependent diabetes mellitus, which is contributed to simultaneously by environmental factors and genetic susceptibility. It is characterized by autoimmune and slow progressive damage in islet b cells. As an important subtype of diabetes, LADA should be recognized, understood, and managed appropriately in clinical practice. Up to now, an increasing number of researches worldwide have depicted and updated the naming, diagnostic criteria, clinical features, pathogenesis, and treatment of LADA. There is a long and winding road to understand LADA. Here, we will discuss the expanding understanding of LADA and update the latest evidence on LADA.