Type 1 Diabetes and Latent Autoimmune Diabetes in Adults: One End of the Rainbow
Abstract
Context The aim of this review was to explore the pathogenic and clinical spectrum of type 1 diabetes, which includes a form of adult onset autoimmune diabetes usually referred to as latent autoimmune diabetes in adults (LADA). We looked at this entire range of forms of autoimmune diabetes as a spectrum of genetic and nongenetic environmental influences, diabetes-associated immune responses, and metabolic changes. Evidence acquisition We assessed epidemiological, genetic, immunological, and clinical data from major articles on autoimmune diabetes, including LADA and type 1 diabetes, published since 1992. Evidence synthesis Data analysis of autoimmune diabetes indi-cates that type 1 diabetes and LADA occupy different poles of the same spectrum. Conclusion Evidence is presented that LADA represents one end of a rainbow encompassing type 1 diabetes. The clinical nature and management of autoimmune diabetes poses important therapeutic questions regarding conventional therapy for hyperglycemia as well as therapy aiming to protect residual beta-cell function. Limiting loss of endogenous insulin secretion using immunomodulation could be valuable, not only for LADA but also for type 1 diabetes.
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The number of older adults being diagnosed with type 1 diabetes mellitus is growing.
“Although type 1 diabetes mellitus (T1DM) is traditionally viewed as a youth-onset disorder, the number of older adults being diagnosed with this disease is growing.”
From The epidemiology of type 1 diabetes mellitus in older adults (2025) · cites this paper as [6]
Cites
Redondo, M. J., Yu, L., Hawa, M., Mackenzie, T., Pyke, D. A., Eisenbarth, G. S., & Leslie, R. D. G. (2001) · Diabetologia · doi:10.1007/s001250051626 · Cited by 322 · see citing works
Self-citationClinical evidence for the safety of GAD65 immunomodulation in adult-onset autoimmune diabetes
Agardh, C.-D., Cilio, C. M., Lethagen, Å., Lynch, K., Leslie, R. D. G., Palmér, M., Harris, R. A., Robertson, J. A., & Lernmark, Å. (2005) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2004.12.003 · Cited by 226 · see citing works
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Epidemiology of type 1 diabetes
Maahs, D. M., West, N. A., Lawrence, J. M., & Mayer-Davis, E. J. (2010) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2010.05.011 · Cited by 1,092 · see citing works
Adult-Onset Autoimmune Diabetes in Europe Is Prevalent With a Broad Clinical Phenotype
Hawa, M. I., Kolb, H., Schloot, N., Beyan, H., Paschou, S. A., Buzzetti, R., Mauricio, D., De Leiva, A., Yderstraede, K., Beck-Neilsen, H., et al. (2013) · Diabetes Care · doi:10.2337/dc12-0931 · Cited by 339 · see citing works
Self-citationMaddaloni, E., Lessan, N., Al Tikriti, A., Buzzetti, R., Pozzilli, P., & Barakat, M. T. (2015) · PLOS ONE · doi:10.1371/journal.pone.0131837 · Cited by 93 · see citing works
Self-citationThe epidemiology of type 1 diabetes mellitus in older adults
Tomic, D., Harding, J. L., Jenkins, A. J., Shaw, J. E., & Magliano, D. J. (2025) · Nature Reviews Endocrinology · doi:10.1038/s41574-024-01046-z · Cited by 58 · see citing works
Past, present and future of latent autoimmune diabetes in adults
Liu, B., Xiang, Y., Liu, Z., & Zhou, Z. (2020) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3205 · Cited by 50 · see citing works
- Authors
- Leslie, R. D. G., Williams, R., & Pozzilli, P.
- Affiliations
- University of London (GB)
- University of Wales (GB)
- Corresponding author
- Leslie, R. David G.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2006-05
- Volume
- 91
- Issue
- 5
- Pages
- 1654-1659
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2124631480
- Cited by
- 142
- References
- 2
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 7 · 2023: 5 · 2022: 6 · 2021: 3 · 2020: 3 · 2019: 1 · 2018: 8 · 2017: 9 · 2016: 6 · 2015: 8 · 2014: 6 · 2013: 11 · 2012: 14
- FWCI
- 7.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
- Keywords
- type 1 diabetes, latent autoimmune diabetes in adults, autoimmune diabetes, disease spectrum, islet autoimmunity, residual beta-cell function, immunomodulation, insulin secretion, genetic and environmental risk factors
- MeSH terms
- Autoimmune Diseases, Diabetes Mellitus, Type 1, Humans
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