About 10-15% of individuals diagnosed with type 2 diabetes mellitus are, in fact, suffering from a form of slow evolving diabetes, called LADA, an acronym for Latent Autoimmune Diabetes in Adults.

This type of diabetes occurs after the age of 30 but recognises pathogenesis similar to type 1 diabetes (juvenile onset), i.e. determined by the destruction of pancreatic cells that produce insulin by their immune system, and to diagnose it is necessary to find the presence of autoantibodies.

LADA, however, has a slower evolution than type 1 diabetes, so that patients are directed towards insulin-based therapy even years after diagnosis.

For this reason, obtaining a correct and early diagnosis of diabetes is extremely important to develop a suitable and specific treatment; however, until now, guidelines on the therapy of LADA, unlike type 2 diabetes, did not exist.

An international panel of diabetes and metabolism experts from around the world, including Raffaella Buzzetti from the Department of Experimental Medicine of Sapienza University of Rome, met and drew up a "consensus statement" on the treatment of LADA, published on the Diabetes journal of the American Diabetes Association.

In particular, the authors of the paper proposed an algorithm based on the evaluation of the insulin reserve of the individual with autoimmune diabetes, which is obtained through a simple laboratory dosage. The data obtained will direct physicians towards the most appropriate therapy for the patient.

"There was an absolute need to provide precise indications for the treatment of this form of diabetes, as yet treated differently in different clinical contexts" − says Raffaella Buzzetti of Sapienza University, first author of the publication. "Being able to diagnose LADA in a patient previously considered a type 2 diabetes means bringing a substantial change to his/her therapy and thus achieving a significant improvement in metabolic control and proper prevention of chronic complications."

As a matter of fact, at the moment, diabetologists have many classes of medicines at their disposal for the treatment of diabetes, but only with a precise diagnosis can they prescribe a personalised therapy to the patient.

"In the case of LADA − concludes Buzzetti −  if the function of the cells has already been compromised, using hypoglycemic drugs capable of preserving the function of the cells that produce insulin is certainly a priority, as is the use of insulin therapy as early as possible. This in order to prevent the most serious consequences, such as heart attack, stroke, renal failure and retinopathy, especially in advanced stages of the disease."

References:

Management of Latent Autoimmune Diabetes in Adults: A Consensus Statement From an International Expert Panel − Raffaella Buzzetti, Tiinamaija Tuomi, Didac Mauricio, Massimo Pietropaolo, Zhiguang Zhou, Paolo Pozzilli, and Richard David Leslie −Diabetes 2020. DOI https://doi.org/10.2337/dbi20-0017

Further Information

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