Persistence of glutamic acid decarboxylase antibody (GADA) is associated with clinical characteristics of latent autoimmune diabetes in adults: a prospective study with 3-year follow-up

2016 ◽  
Vol 32 (6) ◽  
pp. 615-622 ◽  
Author(s):  
Gan Huang ◽  
Min Yin ◽  
Yufei Xiang ◽  
Xia Li ◽  
Wei Shen ◽  
...  
Keyword(s):  
Prospective Study ◽  
Glutamic Acid ◽  
Glutamic Acid Decarboxylase ◽  
Clinical Characteristics ◽  
Autoimmune Diabetes ◽  
Acid Decarboxylase ◽  
Glutamic Acid Decarboxylase Antibody ◽  
Latent Autoimmune Diabetes ◽  
A Prospective Study

scholarly journals Combined treatment with sitagliptin and vitamin D in a patient with latent autoimmune diabetes in adults

2016 ◽  
Vol 2016 ◽  
Author(s):  
E Rapti ◽  
S Karras ◽  
M Grammatiki ◽  
A Mousiolis ◽  
X Tsekmekidou ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Glutamic Acid ◽  
Glutamic Acid Decarboxylase ◽  
Autoimmune Diabetes ◽  
Combined Treatment ◽  
Acid Decarboxylase ◽  
Latent Autoimmune Diabetes ◽  
Glutamic Acid Decarboxylase Antibodies

Summary Latent autoimmune diabetes in adults (LADA) is a relatively new type of diabetes with a clinical phenotype of type 2 diabetes (T2D) and an immunological milieu characterized by high titers of islet autoantibodies, resembling the immunological profile of type 1 diabetes (T1D). Herein, we report a case of a young male, diagnosed with LADA based on both clinical presentation and positive anti-glutamic acid decarboxylase antibodies (GAD-abs), which were normalized after combined treatment with a dipeptidyl peptidase-4 inhibitor (DPP-4) (sitagliptin) and cholecalciferol. Learning points Anti-glutamic acid decarboxylase antibodies (GAD-abs) titers in young patients being previously diagnosed as type 2 diabetes (T2D) may help establish the diagnosis of latent autoimmune diabetes in adults (LADA). Sitagliptin administration in patients with LADA might prolong the insulin-free period. Vitamin D administration in patients with LADA might have a protective effect on the progression of the disease.

scholarly journals Number of autoantibodies and HLA genotype, more than high titers of glutamic acid decarboxylase autoantibodies, predict insulin dependence in latent autoimmune diabetes of adults

2010 ◽  
Vol 163 (4) ◽  
pp. 541-549 ◽  
Author(s):  
M Maioli ◽  
G M Pes ◽  
G Delitala ◽  
L Puddu ◽  
A Falorni ◽  
...  
Keyword(s):  
Glutamic Acid ◽  
Disease Progression ◽  
Glutamic Acid Decarboxylase ◽  
Autoimmune Diabetes ◽  
Tyrosine Phosphatase ◽  
Female Gender ◽  
Acid Decarboxylase ◽  
Latent Autoimmune Diabetes ◽  
Insulin Dependence ◽  
Glutamic Acid Decarboxylase Autoantibodies

ObjectiveIn latent autoimmune diabetes of adults (LADA), the progression into insulin-dependent diabetes is usually faster than in type 2 diabetes (T2D) but the factors influencing this progression are not completely known. In this study, we searched for sensitive markers associated with early development of insulin dependence.DesignThe screening of 5568 T2D patients for glutamic acid decarboxylase autoantibodies (GAD65Ab) identified 276 LADA patients (M=131; F=145) and in 251 of them, tyrosine phosphatase-2 (IA-2Ab) and thyroperoxidase autoantibodies (TPOAbs), some clinical features and genotype variation of the main type 1 diabetes (T1D) disease susceptibility loci (HLA-DRB1 and HLA-DQB1) were analyzed.ResultsFour years after the diagnosis of diabetes, high GAD65Ab titer was not significantly associated with faster progression toward insulin deficiency (P=0.104). Patients with GAD65Ab and TPOAb or IA-2Ab or triple positivity for both islet and TPOAbs (GAD65Ab/IA-2Ab/TPOAb) showed a significantly faster disease progression (P=0.002). Among 104 TPOAb-positive LADA patients, 10 received replacement therapy (l-thyroxine), 43 showed high TSH levels (62.7% developed insulin dependence), and 3 had hyperthyroidism treated with methimazole. Multivariate analysis revealed a significant effect on disease progression only for TPOAb (P=0.022), female gender (P=0.036), low body mass index (BMI; P=0.001), and T1D high/intermediate risk HLA-DRB1/DQB1 genotypes grouped (P=0.020).ConclusionsHigh GAD65Ab titers per se are not a major risk factor for disease progression in LADA, while the number of positive autoantibodies and HLA DRB1-DQB1 genotypes at high risk for T1D are significant predictors. Moreover, clinical characteristics such as low BMI and female gender are more likely to identify patients who will require insulin therapy within 4 years of diagnosis.

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