Latent autoimmune diabetes of adulthood (LADA) is a slowly progressing type of autoimmune diabetes usually manifesting in individuals more than 30 years old. Often unacknowledged and wrongly diagnosed as type 2 diabetes, this disease does not manifest microvascular complications (kidney and eye complications) since diagnosis, resulting in a delay both in its correct identification among different types of diabetes and in delivering appropriate treatments.

Prompt identification of this disease  may be essential to prevent more serious consequences, especially in its advanced stages. This research carried out by the  Department of Experimental Medicine of Sapienza University of Rome and the Oxford Centre for Diabetes, Endocrinology, and Metabolism of University of Oxford has been recently published on The Lancet Diabetes & Endocrinology journal.

By analysing the results of the “Prospective Diabetes Study,” a randomised, multi-centre clinical trial that has monitored more than 5000 diabetic patients in 30 years, the Italy-UK researchers have shown how retina and kidney-related risks are different for patients affected by LADA compared with those with type 2 diabetes. It is unlikely that during the first decade since the onset, patients with LADA develop diabetic retinopathy and nephropathy; however, the risk of such complications drastically increases after this time span and a lack of proper therapies makes the consequences even more serious, considerably affecting the patient's life expectancy and quality.

“The main cause – says Raffaella Buzzetti, Sapienza team's coordinator – is that patients with LADA are often not treated in the appropriate way and present a worse glycaemic control than patients with type 2 diabetes.”

This study suggests how a prompt diagnosis of LADA is necessary in order to take advantage of the early therapeutic window for implementing a strict glycaemic control, and the prevention of a greater risk of microvascular complications.

References:

Time-varying Risk of Microvascular Complications in Latent Autoimmune Diabetes in Adults Compared with Type 2 Diabetes: UKPDS 30-year follow-up data (UKPDS 86) - Ernesto Maddaloni, MD, Ruth L. Coleman, MSc, Olorunsola Agbaje, MSc, Raffaella Buzzetti, MD, Rury R. Holman, FRCP - Lancet Diabetes Endocrinol. 2020 Feb 4. Doi: 10.1016/S2213-8587(20)30003-6

Further Information

Raffaella Buzzetti
Department of Experimental Medicine
raffaella.buzzetti@uniroma1.it