Latent Autoimmune Diabetes of the Adult (LADA): a case report of a misunderstood form of diabetes

Abstract

Latent autoimmune diabetes in adults (LADA), an increasingly recognized form of type 1 diabetes mellitus (DM1), often initially presents in middle-aged adults and is often misdiagnosed as type 2 diabetes mellitus (DM2). However, like DM1, patients often have autoantibodies directed against pancreatic islet-cells, and although ultimately they will require insulin, the progression to insulin dependence is much slower. Studies indicate that 10% of patients who present with DM2 have a positive serum glutamic acid decarboxlase (GAD) antibody titer. GAD antibody titers should be ordered for patients who do not fit the classic presentation of DM2. This is especially true in nonobese adult patients who have no family history of DM2. Studies have shown that identifying LADA patients early and initiating insulin therapy helps preserve beta cell function. The following case report will demonstrate the progression of a person who was initially identified as having DM2, but eventually was correctly diagnosed with LADA.