Latent Autoimmune Diabetes in Adults: A Case Series and Clinical Insights

Diabetes mellitus (DM) is a disease spectrum ranging from classic insulin deficiency of type 1 diabetes (T1DM) to insulin-resistant type 2 diabetes (T2DM). Latent autoimmune diabetes in adults (LADA) is a type of DM with clinical characteristics of both T1DM and T2DM. Despite its clinical significance, LADA remains underdiagnosed and mismanaged due to overlapping characteristics with other diabetes types.  Methods: It is a case series describing clinical, immunological, and metabolic characteristics of ten patients diagnosed with LADA based on three criteria identified by the Immunology of Diabetes Society.

We found that these patients had uncontrolled diabetes not controlled with oral hypoglycemic drugs, were mostly males aged above 30 years with a mean body mass index of 22.6 kg/m², and everyone had positive anti-glutamic acid decarboxylase (GAD) antibody. At the presentation, one patient had combined moderate non-proliferative diabetic retinopathy and peripheral neuropathy. Four patients had mild non-proliferative diabetic retinopathy, and two had peripheral neuropathy as complications of uncontrolled diabetes.

LADA remains a diagnostic challenge, as its phenotypic picture resembles T2DM, while immunologically it resembles T1DM. A high index of suspicion, early diagnosis, and correct treatment can prevent further damage to the beta islet cells and help prevent short-term and long-term complications of DM.