Past, present and future of latent autoimmune diabetes in adults
Abstract
Summary: Latent autoimmune diabetes in adults (LADA) is the most common form of autoimmune diabetes diagnosed in adults. Similar to type 1 diabetes, the prevalence of LADA is impacted by ethnicity and geography. LADA is characterized by β cell loss due to autoimmunity and insulin resistance and has highly heterogeneous clinical features, autoimmunity, and genetics in a glutamic acid decarboxylase antibody (GADA) titre‐dependent manner, suggesting LADA is part of a continuum spectrum between type 1 and type 2 diabetes. Although LADA is the most frequent form of autoimmune diabetes diagnosed in adults, clinical trials involving LADA are scarce. Here we review the recent advancements in LADA epidemiology, clinical features, pathogenesis, and interventions. We also highlight the environmental factors that are thought to play an important role in addition to genetics in the pathogenesis of LADA. In the future, high‐throughput molecular profiles might shed light on the nature of LADA among the wide spectrum of diabetes and offer new opportunities to identify novel LADA‐specific biomarkers.
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Diabetes is linked to impaired insulin secretion, impaired insulin action, or both.
“In the case of diabetes, it may be linked to impaired insulin secretion (insulin deficiency), impaired insulin action (insulin resistance), or both (71).”
From Diabetes and Sarcopenic Obesity: Pathogenesis, Diagnosis, and Treatments (2020) · cites this paper as [71]
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Self-citationFatty fish consumption and risk of latent autoimmune diabetes in adults
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Self-citationJin, P., Xiang, B., Huang, G., & Zhou, Z. (2014) · Journal of Endocrinological Investigation · doi:10.1007/s40618-014-0162-x · Cited by 22 · see citing works
Self-citationLow prevalence of latent autoimmune diabetes in adults in northern India
Sachan, A., Zaidi, G., Sahu, R. P., Agrawal, S., Colman, P. G., & Bhatia, E. (2014) · Diabetic Medicine · doi:10.1111/dme.12644 · Cited by 22 · see citing works
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Olsson, L., Ahlbom, A., Grill, V., Midthjell, K., & Carlsson, S. (2012) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2012.09.011 · Cited by 22 · see citing works
Metabolite Profiling of LADA Challenges the View of a Metabolically Distinct Subtype
Al‐Majdoub, M., Ali, A., Storm, P., Rosengren, A. H., Groop, L., & Spégel, P. (2016) · Diabetes · doi:10.2337/db16-0779 · Cited by 22 · see citing works
Metabolic Syndrome in Adult-Onset Latent Autoimmune Diabetes
Li, X., Zhou, Z., Huang, G., Su, H., Yan, X., & Yang, L. (2005) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2005.3.174 · Cited by 20 · see citing works
Self-citationTLR2 and TLR4 expression on CD14++ and CD14+ monocyte subtypes in adult-onset autoimmune diabetes
Čejková, P., Němečková, I., Brož, J., & Černá, M. (2015) · Biomedical Papers · doi:10.5507/bp.2015.016 · Cited by 18 · see citing works
Latent Autoimmune Diabetes in Adults in a South Asian Population of the U.K.
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Rasouli, B., Andersson, T., Carlsson, P. ‐., Grill, V., Groop, L., Martinell, M., Midthjell, K., Storm, P., Tuomi, T., & Carlsson, S. (2017) · Diabetic Medicine · doi:10.1111/dme.13179 · Cited by 18 · see citing works
Rasouli, B. S., Ahlqvist, E., Alfredsson, L. S., Andersson, T., Carlsson, P., Groop, L., Löfvenborg, J. E., Martinell, M., Rosengren, A. H., Tuomilehto, J., et al. (2018) · Diabetes & Metabolism · doi:10.1016/j.diabet.2018.05.002 · Cited by 18 · see citing works
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Cruz, J. C. S., Rode, E. C., Gómez, L. S., Cabrera, J. A. G., Ortega, A. H., Molina, G., Amador, P. A. P., Puig, M. E. L., Alonso, E. D., & Díaz-Horta, O. (2007) · Autoimmunity · doi:10.1080/08916930601118825 · Cited by 17 · see citing works
Stable GAD65 Autoantibody Epitope Patterns in Type 1 Diabetes Children Five Years after Onset
Hampe, C. S., Hammerle, L. P., Bekris, L. M., Örtqvist, E., Persson, B., & Lernmark, Å. (2002) · Journal of Autoimmunity · doi:10.1006/jaut.2001.0564 · Cited by 17 · see citing works
DiaPep277® and immune intervention for treatment of type 1 diabetes
Schloot, N. C., & Cohen, I. R. (2013) · Clinical Immunology · doi:10.1016/j.clim.2013.09.001 · Cited by 16 · see citing works
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4 of the 220 references couldn’t be matched to a known paper.
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Diabetes and Sarcopenic Obesity: Pathogenesis, Diagnosis, and Treatments
Wang, M., Tan, Y., Shi, Y., Wang, X., Liao, Z., & Wei, P. (2020) · Frontiers in Endocrinology · doi:10.3389/fendo.2020.00568 · Cited by 231 · see citing works
The Incidence of Adult-Onset Type 1 Diabetes: A Systematic Review From 32 Countries and Regions
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Self-citationLatent Autoimmune Diabetes in Adults (LADA): From Immunopathogenesis to Immunotherapy
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Adult-onset autoimmune diabetes in 2020: An update
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Latent autoimmune diabetes in adults: a focus on β-cell protection and therapy
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Self-citationLi, X., Chen, Y., Xie, Y., Xiang, Y., Yan, X., Huang, G., & Zhou, Z. (2020) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaa205 · Cited by 32 · see citing works
Self-citationAntigen-specific immunotherapies in type 1 diabetes
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The role of incretins and incretin-based drugs in autoimmune diseases
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Maheshwari, R. A., Parmar, G. R., Hinsu, D., Seth, A. K., & Balaraman, R. (2020) · Life Sciences · doi:10.1016/j.lfs.2020.118155 · Cited by 16 · see citing works
Carlsson, S. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.917850 · Cited by 16 · see citing works
GAD65 Antibody Epitopes and Genetic Background in Latent Autoimmune Diabetes in Youth (LADY)
Peng, Y., Li, X., Xiang, Y., Yan, X., Zhou, H., Tang, X., Cheng, J., Niu, X., Liu, J., Ji, Q., et al. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.836952 · Cited by 11 · see citing works
Self-citationPang, H., Luo, S., Huang, G., Li, X., Xie, Z., & Zhou, Z. (2021) · Biochemical Genetics · doi:10.1007/s10528-021-10152-w · Cited by 10 · see citing works
Self-citationCai, M., Cui, R., Yang, P., Gao, J., Cheng, X., Sheng, C., Li, H., Sheng, H., Qu, S., & Zhang, M. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.675525 · Cited by 10 · see citing works
Zhang, M., Sheng, C., You, H., Cai, M., Gao, J., Cheng, X., Sheng, H., & Qu, S. (2021) · Journal of Endocrinological Investigation · doi:10.1007/s40618-020-01472-6 · Cited by 9 · see citing works
Distinct secretion pattern of serum proinsulin in different types of diabetes
Tong, Y. A., Yang, L., Shao, F., Yan, X., Li, X., Huang, G., Xiao, Y., & Zhou, Z. (2020) · Annals of Translational Medicine · doi:10.21037/atm.2020.03.189 · Cited by 6 · see citing works
Self-citationA long and winding road to understand latent autoimmune diabetes in adults
Luo, S., Liu, B.-W., Yin, W., Li, X., & Zhou, Z. (2021) · Chinese Medical Journal · doi:10.1097/cm9.0000000000001321 · Cited by 5 · see citing works
Self-citationA Case of Late Diagnosis of Latent Autoimmune Diabetes in Adults
da Costa, J. C., Mestre, A., Miranda, M. F. D. L., Ferreira, F. H., & Abuowda, Y. (2022) · Cureus · doi:10.7759/cureus.21826 · Cited by 5 · see citing works
LADA: The Evolving Landscape of Adult-Onset Autoimmune Diabetes
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The Role of Gene Therapy in the Treatments of Type 1 Diabetes Mellitus: a review
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Qi, Y., Chen, S., Chen, H., Chen, Y., Shi, Y., Yao, Q., Zhang, M., Yang, T., & Gu, Y. (2022) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgac720 · Cited by 2 · see citing works
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Lada or Type 2 Diabetes Mellitus - A Challenging Diagnosis in Clinical Approach
Custură, L. M., Deteșan, O., Tilinca, R. M., Schmiedt, R. A., Bacso, B. I., & Tilinca, M. C. (2021) · Acta Medica Transilvanica · doi:10.2478/amtsb-2021-0052 · Cited by 1 · see citing works
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An Ensemble Neural Model for Classification of LADA Diabetes Case, Control and Variable Importance
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Diabetes Mellitus: Review of the Common, Rare, and Uncommon (Conceptual and Metaphorical) Types
Pliszka, M., & Szablewski, L. (2026) · International Journal of Molecular Sciences · doi:10.3390/ijms27219611
- Authors
- Liu, B., Xiang, Y., Liu, Z., & Zhou, Z.
- Affiliations
- Ministry of Education of the People's Republic of China (CN)
- University of Virginia Health System (US)
- Corresponding author
- Zhou, Zhiguang
- Venue
- Diabetes/Metabolism Research and Reviews
- Publisher
- Wiley
- Published
- 2019-07-31
- Volume
- 36
- Issue
- 1
- Pages
- e3205-e3205
- ISSN
- 1520-7552 (ISSN-L)
- 1520-7560
- OpenAlex
- W2961279790
- Cited by
- 50
- References
- 220
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 5 · 2023: 4 · 2022: 13 · 2021: 8 · 2020: 7 · 2019: 1
- FWCI
- 0.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes/Metabolism Research and Reviews (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Innovative Research Group Project of the National Natural Science Foundation of China (81461168031)
- National Science and Technology Infrastructure Program (2015BAI12B13)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- latent autoimmune diabetes in adults, autoimmune diabetes, islet autoimmunity, glutamic acid decarboxylase antibodies, type 1 diabetes, type 2 diabetes, insulin resistance, environmental risk factors
- MeSH terms
- Adult, Autoantibodies, Diabetes Mellitus, Type 1, Humans, Autoimmunity, Age of Onset
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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