Latent Autoimmune Diabetes in Adults
Abstract
Context Autoantibodies that are reactive to islet antigens are present at the time of diagnosis in most patients with type 1 diabetes. Additionally, approximately 10% of phenotypic type 2 diabetic patients are positive for at least one of the islet autoantibodies, and this group is often referred to as "latent autoimmune diabetes in adults (LADA)." These patients share many genetic and immunological similarities with type 1 diabetes, suggesting that LADA, like type 1 diabetes, is an autoimmune disease. However, there are differences in autoantibody clustering, T cell reactivity, and genetic susceptibility and protection between type 1 diabetes and LADA, implying important differences in the underlying disease processes. Evidence acquisition and synthesis In this clinical review, we will summarize the current understanding of LADA based on the MEDLINE search of all peer-reviewed publications (original articles and reviews) on this topic between 1974 and 2009. Conclusions In LADA, diabetes occurs earlier in the beta-cell-destructive process because of the greater insulin resistance. Complexities arise also because of variable definitions of LADA and type 1 diabetes in adults. As immunomodulatory therapies that slow or halt the type 1 diabetes disease process are discovered, testing these therapies in LADA will be essential.
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Islet cell antibodies are common in LADA.
“Islet cell antibodies are also common in LADA, whereas both islet antigen (IA2) antibodies and insulin autoantibodies are much less common in LADA than in T1DM87.”
From The epidemiology of type 1 diabetes mellitus in older adults (2025) · cites this paper as [87]
Insulin autoantibodies are much less common in LADA than in T1DM.
“Islet cell antibodies are also common in LADA, whereas both islet antigen (IA2) antibodies and insulin autoantibodies are much less common in LADA than in T1DM87.”
From The epidemiology of type 1 diabetes mellitus in older adults (2025) · cites this paper as [87]
Islet antigen (IA2) antibodies are much less common in LADA than in T1DM.
“Islet cell antibodies are also common in LADA, whereas both islet antigen (IA2) antibodies and insulin autoantibodies are much less common in LADA than in T1DM87.”
From The epidemiology of type 1 diabetes mellitus in older adults (2025) · cites this paper as [87]
Attempts to distinguish adult cases of type 1 diabetes from type 2 disease have resulted in the proposal of new disease classifications, including latent autoimmune disease of adults (LADA) and ketosis-prone diabetes.
“Attempts to distinguish adult cases of type 1 diabetes from those with type 2 disease have resulted in the proposal of new disease classifications, including latent autoimmune disease of adults (LADA) and ketosis-prone diabetes.38,39”
From Type 1 diabetes (2014) · cites this paper as [39]
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- Authors
- Naik, R. G., Brooks-Worrell, B. M., & Palmer, J. P.
- Affiliations
- Charles River Clinical Services Northwest (R.G.N.), Tacoma, Washington 98418
- Department of Medicine (B.M.B.-W., J.P.P.), Division of Endocrinology, Metabolism, and Nutrition, Department of Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, Washington 98108
- University of Washington (US)
- Corresponding author
- Palmer, Jerry P.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2009-12-01
- Volume
- 94
- Issue
- 12
- Pages
- 4635-4644
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2130880816
- Cited by
- 249
- References
- 10
- Citations by year
- 2026: 10 · 2025: 11 · 2024: 5 · 2023: 5 · 2022: 8 · 2021: 17 · 2020: 6 · 2019: 15 · 2018: 15 · 2017: 17 · 2016: 13 · 2015: 21 · 2014: 28 · 2013: 21 · 2012: 30
- FWCI
- 1.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- UCLA - Biblioteca de Ciencias de la Salud (submittedVersion)
- Funders
- U.S. Department of Veterans Affairs
- University of Washington
- 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
- latent autoimmune diabetes in adults, islet autoantibodies, type 1 diabetes, type 2 diabetes, islet autoimmunity, insulin resistance, T cell response, genetic susceptibility, immunomodulatory therapy, disease classification
- MeSH terms
- Adult, Autoimmune Diseases, Diabetes Mellitus, Humans, Insulin Resistance, Pancreatitis, T-Lymphocytes, Genetic Predisposition to Disease, Insulin-Secreting Cells, Immunity, Humoral
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