Abstract
LADA or Latent Autoimmune Diabetes in Adults is characterized by age at the onset of the disease over 30 years, by positivity of at least one diabetes-associated autoantibody (most common is isolated positivity of antibodies against GAD65 - glutamic acid decarboxylase) and by the fact that insulin therapy is not required at least for six months after diagnosis. LADA represents a significant part of adult-onset diabetes.
Autoimmune insulitis in LADA patients has slightly different immunological characteristics and its progression is less rapid than in type 1 diabetes mellitus (DM) patients. Two LADA subtypes can be distinguished, where LADA 1 is more reminiscent of DM1, and LADA 2 is closer in its characteristics to type 2 DM.
According to the expert consensus from 2020, the value of C-peptide in the manifestation of the disease is decisive for the choice of the right treatment strategy. It is recommended to monitor C-peptide every six months.
It is not recommended to use an insulin secretagogue to treat these patients. On the contrary, drugs targeting the GLP-1 axis as well as insulin therapy itself are suitable because they protect the remaining beta cells of the pancreas.