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Cited by 413Diabetes and associated disordersDiabetes Management and ResearchPancreatic function and diabetes

Latent Autoimmune Diabetes Mellitus in Adults (LADA): the Role of Antibodies to Glutamic Acid Decarboxylase in Diagnosis and Prediction of Insulin Dependency

Zimmet, P., Tuomi, T., Mackay, I.R., Rowley, M.J., Knowles, W., Cohen, M., Lang, D.A.·1994·Diabetic Medicine
DOI 10.1111/j.1464-5491.1994.tb00275.x
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Abstract

Type 1 diabetes mellitus in adults may present in a manner similar to that of Type 2 diabetes but with a late development of insulin dependency. We studied 65 patients who presented with ‘adult‐onset’ diabetes after the age of 30 years. Of these patients, 19 required insulin therapy. The insulin‐treated patients were significantly younger, their onset of diabetes was at an earlier age, and their postprandial serum C‐peptide levels were lower than those of the non‐insulin‐treated group. Moreover, the insulin‐treated subjects had a higher mean concentration of antibodies to glutamic acid decarboxylase (GAD) (66.8 ± 10.2 units) than the patients who did not require insulin (9.9 ± 1.9 units) (p < 0.001) and their frequency of anti‐GAD positivity was 73.7% versus 4.3% (p < 0.001). Thus, among patients attending a diabetes clinic, the majority (73.7%) of subjects who presented with diabetes after 30 years of age and who subsequently required therapy with insulin, actually have the islet cell lesion of Type 1 diabetes which progresses at a slower tempo than in children. We conclude that testing for anti‐GAD in adult‐onset non‐obese diabetic patients should be a routine procedure in order to detect latent insulin‐dependency at the earliest possible stage, since this assay can assist in the correct classification of diabetes, and more appropriate therapy.

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  • GADA-positive individuals with LADA were found to have a much greater requirement for insulin (87.5%) than GADA-negative people diagnosed with diabetes mellitus at a similar age (10.2%).

    “GADA-positive individuals with LADA were found to have a much greater requirement for insulin (87.5%) than GADA-negative people diagnosed with diabetes mellitus at a similar age (10.2%)85.”

    From The epidemiology of type 1 diabetes mellitus in older adults (2025) · cites this paper as [85]

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Authors
Zimmet, P., Tuomi, T., Mackay, I. R., Rowley, M. J., Knowles, W., Cohen, M., & Lang, D. A.
Affiliations
  • The University of Melbourne (AU)
  • Monash University (AU)
Corresponding author
Zimmet, P.
ORCID
Zimmet, P.
Venue
Diabetic Medicine
Publisher
Wiley
Published
1994-04
Volume
11
Issue
3
Pages
299-303
ISSN
  • 0742-3071 (ISSN-L)
  • 1464-5491
DOI
10.1111/j.1464-5491.1994.tb00275.x
OpenAlex
W2084215480
Cited by
413
References
0
Citations by year
2026: 2 · 2025: 1 · 2024: 9 · 2023: 5 · 2022: 7 · 2021: 3 · 2020: 8 · 2019: 11 · 2018: 6 · 2017: 13 · 2016: 13 · 2015: 11 · 2014: 10 · 2013: 16 · 2012: 12
FWCI
3.99
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 5599 d)
Locations
  • Diabetic Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
World Health Organization
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 › Surgery › Pancreatic function and diabetes
Keywords
latent autoimmune diabetes in adults, type 2 diabetes, glutamic acid decarboxylase antibodies, glutamic acid decarboxylase, islet autoimmunity, C-peptide, diabetes classification, early diagnosis, type 1 diabetes
MeSH terms
Adult, Aged, Autoantibodies, Autoimmune Diseases, C-Peptide, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diet, Diabetic, Female, Glutamate Decarboxylase, Humans, Hypoglycemic Agents, Insulin, Male, Middle Aged, Predictive Value of Tests, Age of Onset

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