Diabetes Current Topics in Diabetes

New Tool Diagnoses Rare Diabetes in Adults

Researchers have devised a way of detecting a hard-to-diagnose form of diabetes called latent autoimmune diabetes of adulthood (LADA).

The American Diabetes Association describes LADA as a variation of type 1 diabetes that occurs in adults. Like standard type 1, LADA is an autoimmune disorder in which the immune system mistakenly destroys the insulin-producing cells of the pancreas. One difference in adults, however, is that the need for insulin therapy develops more slowly in patients with LADA. Because it tends to develop after age 30 and does not initially require insulin administration, LADA is often misdiagnosed as type 2 diabetes, a disorder of metabolism that often involves obesity and usually develops in middle age.

Australian researchers sought to establish a screening tool to identify patients who may have LADA and would benefit from autoantibody testing. These blood tests reveal autoantibodies, the misguided proteins that damage the pancreas in people with autoimmune forms of diabetes.

To confirm what signs and symptoms could distinguish LADA from type 2 diabetes, the researchers interviewed 102 adults diagnosed with LADA and 111 adults with type 2. Five characteristics set LADA apart: onset before age 50, acute symptoms, normal weight and a personal or family history of autoimmune diseases, such as rheumatoid arthritis and multiple sclerosis.

The researchers then tried this "LADA clinical risk score" on 130 adults newly diagnosed with diabetes. They found that patients with least two of the five traits had a 90 percent probability of having LADA. They concluded that their clinical tool could help identify LADA in diabetic adults.

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