Latent Autoimmune Diabetes in Adults

Latent autoimmune diabetes in adults (LADA) is a genetically linked, autoimmune form of type 1 diabetes mellitus that is commonly seen after age 30 in patients who often have a normal body mass index without overt signs of metabolic syndrome. They have positive circulating antibodies reflecting the autoimmune nature of beta cell destruction, and they frequently are poorly controlled on oral anti-diabetic agents. Because they are older when first symptomatic, they are often diagnosed with type 2 diabetes. However, it is important to recognize patients with LADA because they often progress quickly to insulin dependence. The characteristics of LADA, pathogenesis, diagnostic work-up, complications, and evidence-based management of the disease will be reviewed. Implications for practice will be included.