I requested the article from O. Rolandsson and Jerry Palmer, “Latent Autoimmune Diabetes in Adults (LADA) is Dead: Long Live Autoimmune Diabetes!” from Dr. Rolandsson, and he kindly sent me the PDF. Very interesting! I have attached the article.
6459-Commentary_LADA.pdf (110 KB)
What did you take from the article, Melitta? I got bored pretty quickly. Are we now AD’s as opposed to LADA’s?
The bottom line is that autoimmunity is present in diabetes.
The presence of autoimmunity is in non-diabetics as well as in diabetics.
Classification of subsets is useful in research pathway determination: for science.
Subset classification may not be as useful in therapy determination.
Elaine: I got multiple things from this article, most of which I knew already but it was good to see summarized in one place, and also I am glad to see that superb researchers “get” some of the things we face (we who were diagnosed with Type 1 as adults). First, they clearly state that new-onset autoimmune diabetes is more common in adults than children. Then, they make the case for eliminating the term LADA, which I think is a good idea. Even though the term LADA was useful to draw attention to this large population of people with autoimmune diabetes who were almost always misdiagnosed as having Type 2 diabetes (a different disease altogether), the term LADA also allowed diabetes organizations, researchers, and MDs to marginalize adult-onset autoimmune diabetes as “rare” (“rare” but way more common than childhood-onset autoimmune diabetes) and not give it the attention I believe it deserves. For example, there is substantial evidence that putting ALL people with new onset autoimmune diabetes on intensive insulin therapy as soon as feasible greatly reduces the risk of complications. But many doctors insist on initially treating LADAs with Type 2 treatments, which hastens the destruction of remaining beta cells and leads to poorer outcomes for the person with diabetes.
I recall reading that the thinking had changed on initially prescribing T2 treatment as a “cover all bases” adjuct for newly diagnosed adult patients, for the reason you state, shortly after I was treated that way at diagnoses 6 years ago. I have been surprised at the number of new Tu members still witnesssing that protocol.
Thanks for posting the article, Melitta.