The islet autoantibody titres: their clinical relevance in latent autoimmune diabetes in adults (LADA) and the classification of diabetes mellitus

Abstract

Latent autoimmune diabetes in the adult (LADA) is a slowly progressive form of autoimmune diabetes, characterized by diabetes-associated autoantibody positivity. A recent hypothesis proposes that LADA consists of a heterogeneous population, wherein several subgroups can be identified based on their autoimmune status. A systematic review of the literature was carried out to appraise whether the clinical characteristics of LADA patients correlate with the titre and numbers of diabetes-associated autoantibodies. We found that the simultaneous presence of multiple autoantibodies and/or a high-titre anti-glutamic acid decarboxylase (GAD)--compared with single and low-titre autoantibody--is associated with an early age of onset, low fasting C-peptide values as a marker of reduced pancreatic B-cell function, a high predictive value for future insulin requirement, the presence of other autoimmune disorders, a low prevalence of markers of the metabolic syndrome including high body mass index, hypertension and dyslipidaemia, and a high prevalence of the genotype known to increase the risk of Type 1 diabetes. We propose a more continuous classification of diabetes mellitus, based on the finding that the clinical characteristics gradually change from classic Type 1 diabetes to LADA and finally to Type 2 diabetes. Future studies should focus on determining optimal cut-off points of anti-GAD for differentiating clinically relevant diabetes mellitus subgroups.

Latent autoimmune diabetes in adults in a population-based cohort of Polish patients with newly diagnosed diabetes mellitus

“…These observations are concordant with other studies regarding LADA [16][17][18]. Patients with newly diagnosed LADA presented with similar fasting glucose and HbA 1c compared to patients with type 2 diabetes, suggesting rather slow progression and relatively asymptomatic clinical onset [17].…”

Type 2 diabetes susceptibility gene variants predispose to adult-onset autoimmune diabetes

“…The level of autoantibodies, particularly GADA, has a clear influence on the phenotype of LADA. A high GADA level is associated with a phenotype more like type 1 diabetes, including reduced beta cell function, increased need for insulin treatment, lower BMI and lower prevalence of dyslipidaemia (reviewed by [5,6]). …”

Andosan?-An Anti-Allergic and Anti-Inflammatory Ingredient Prepared from Agaricus blazei Mushroom

“…However, most of the literature supports the anti-inflammatory and anti-allergic findings done with the AbM-based Andosan ingredient. In line with this and the autoimmune aspect of diabetes [75] is also the observations that AbM ameliorates diabetic disorders in murine models [76,77], as well as in a clinical study on insulin resistance type 2 diabetes [21].…”