Emotional exhaustion-induced latent autoimmune diabetes in adults in a young lady

Abstract

Rationale:Latent autoimmune diabetes in adults (LADA) refers to an autoimmune disorder characterized with detectable islets antibodies in the early diagnosis and increased autoimmune beta-cell failure progression. Notably, this kind of diabetes seems to be confused with other phenotypic diabetes.Patient concerns:A young woman suffered an emotional exhaustion-induced LADA, showing asthenia, polydipsia, polyuria, and visible weight loss. The patient emotionally ended a 14-year romantic relationship, leading to the emotional flooding.Diagnoses:The data from physical examination and laboratory tests exhibited as follows: glutamic acid decarboxylase antibody (GADA) = 63.83 U/mL, the fasting blood glucose (FBG) = 13.3 mmol/L, and glycated haemoglobin (HbA1c) = 10.9%. According to levels of GADA, the patient was diagnosed as LADA.Interventions:The patient was clinically treated with insulin for 3-month. Then, running, diet-control, and emotional treatment were combined, such as the patient started a new relationship.Outcomes:An emotional recovery initiated from a new romantic relationship and a baby, showing normal levels of GAD65 (27.007 IU/mL) and FBG (5.46) mmol/L.Lessons:The emotional exhaustion might play a significant role in induction of LADA. It is important that individuals should maintain optimism, cheer, and a positive attitude.

Diabetic ketoacidosis as first presentation of latent autoimmune diabetes in adults in a patient with hashitoxicosis as first presentation of Hashimoto’s thyroiditis: a case report

“…Moreover, stressful situations, characterized by increased levels of cortisol, promote α-adrenergic signaling and decrease insulin secretion [ 46 ], subsequently leading to hyperglycemia. In addition, correlation of emotional stress with LADA has also been proposed [ 47 ]. HLA-DR4, among others, is found both in patients with HD and in those with stress-induced Graves’ disease, which indicates an indirect connection of HD and hashitoxicosis with stress [ 48 ].…”

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“…Existe consenso general acerca de que la existencia de múltiples autoanticuerpos se asocia con riesgo alto de diabetes, mientras que la existencia de un solo autoanticuerpo y en bajo título tiene escaso valor predictivo. 28 Al considerar que la diabetes mellitus tipo 1 es una enfermedad autoinmunitaria, su diagnóstico es difícil y la mayor parte de herramientas tenidas en cuenta son las características epidemiológicas y clínicas; es importante saber que existen pruebas especializadas que pueden utilizarse, como el estudio de anticuerpos específicos, que puede ayudar a establecer un diagnóstico de tipo inmunológico, entre éstos tenemos: péptido C, anticuerpos antiislote, anticuerpos antiácido glutámico descarboxilasa, anticuerpos antiinsulínicos y anticuerpos asociados con el insulinoma 2. Sin embargo, en el 100% de la población estudiada no se solicitaron estas determinaciones para poder establecer desde el punto de vista inmunológico alguna relación diagnóstica, por tanto, se sugiere implementar estas clases de técnicas analíticas como herramienta clave para una mejor orientación diagnóstica inicial y certeza.…”

Latent autoimmune diabetes in adults

“…Этиология болезни в настоящее время точно не изучена, но известны некоторые факторы риска развития данной патологии: женский пол, определенная наследственность [11], низкая масса тела при рождении и последующая полнота во взрослом возрасте, ожирение [12,13], курение, усиливающее инсулинорезистентность [14,15], избыточное употребление сладких и искусственно подслащенных напитков (соки, нектары, шипучие газированные напитки по типу колы и т.п.) [16], перенесенные вирусные инфекции, психоэмоциональный стресс [17,18], низкая физическая активность и злоупотребление кофе [10,19]. Данные факторы риска характерны для множества патологий, но в контексте LADA имеются свои особенности.…”