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J Clin Endocrinol Metab. 2006 May;91(5):1654-9. Epub 2006 Feb 14.

Clinical review: Type 1 diabetes and latent autoimmune diabetes in adults: one end of the rainbow.

Author information

1
Institute of Cell and Molecular Science, Queen Mary College, University of London, London E1 4NS, United Kingdom. r.d.g.leslie@qmul.ac.uk

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.

PMID:
16478821
DOI:
10.1210/jc.2005-1623
[Indexed for MEDLINE]

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