Endocrine Abstracts

Latent autoimmune diabetes of adulthood (LADA) is the most common form of autoimmune Diabetes diagnosed in Adults. Approximately 5–12%of cases in Europeans with apparent type2Diabetes are in facts misdiagnosed LADA. This is a heterogeneous condition that presents with clinical and laboratory manifestations common to type1diabetes and type2 diabetes. Its main feature is the presence of diabetes-associated autoantibodies (mostly autoantibody against glutamicaciddecarboxylase), which leads to progressive destruction of the Langerhans’islets. The Immunology of Diabetes Society (IDS) has established three main criteria, including (1) adult age of onset (>30 years) (2) presence of at least one islet-cell autoantibody (3) absence of insulin requirement for at least six months after diagnosis, to Diagnose LADA.

Introduction: We report two cases of a57-Yo woman and a 40-YO man, initially diagnosed with D.M.T2.

Case 1: The woman was poorly controlled for2Years with oral antidiabetic therapy, and worsening in the third year. She had a negative family history of type 2 diabetes and no autoimmune disease. Her body mass index was 23 kg/m² and glycated hemoglobin was 15.8%. The laboratory tests were normal. Screening for diabetic retinopathy revealed Non Proliferative Diabetic Retinopathy Laboratory workup revealed positive glutamic acid decarboxylase (anti Gad) and anti Tyrosine Phosphatase (anti IA2) antibodies, and LADA diagnosis was confirmed. A therapeutic regimen with Insulin was Initiated, and at follow-up3 mo later HBA1c improved to 8.4%. HerC-peptide was not measured. The second case, had a negative family history of type 2 diabetes and autoimmune disease. Body mass index 22 kg/m2 and glycated hemoglobin 9.8%. His physical examination and general lab test were unremarcable. Only positive anti Gad was found. He was keept on Diet and physical activity. After a 8 mo His HBa1c 6.9%, C-peptide was normal.

Conclusions: These cases highlights*The importance of being aware of Lada and implemention of screening diagnostictest

*An early diagnosis are crucial for better glycemic control, to delaying disease progression and complications.

*Immunologic markers hint to autoimmune involvement and is also a key factor for diagnosis.

*The titer and number of autoantibodies may indicate progression of LADA and Complications

*Identifying LADA patients early and initiating insulin therapy helps preserve beta cell function.

*Measure of C-peptide helps in LADA management