PDF(Pubmed)
Abstract：
Latent autoimmune diabetes of adults (LADA) is a type of autoimmune diabetes that begins in adulthood (usually after the age of 35 years); its main feature is the presence of diabetes-associated autoantibodies (most often autoantibody against glutamic acid decarboxylase), which leads to progressive destruction of the islets of Langerhans. This is a heterogeneous condition that presents with clinical and laboratory manifestations common to type 1 diabetes and type 2 diabetes. We report a case of a 71-year-old man diagnosed with type 2 diabetes two years ago, poorly controlled with oral antidiabetic therapy, and worsening in the third year. He had a positive family history of type 2 diabetes in two second-degree relatives (nephews). No pathologic findings at the physical examination were found. His body mass index was 23 kg/m2 and glycated hemoglobin was 10.6%. Laboratory workup revealed low basal C-peptide (<0.1 ng/mL) and positive glutamic acid decarboxylase antibodies, and the LADA diagnosis was confirmed. This case highlights the importance of being aware of this disease, especially in patients previously diagnosed with type 2 diabetes who remain uncontrolled with diet and oral hypoglycemic agents. LADA is often confused with type 2 diabetes, and therefore, the management is frequently inadequate. An early diagnosis and treatment are crucial to delaying disease progression.
摘要：
成人隐匿性自身免疫性糖尿病（LADA）是一种始于成年期（通常在35岁之后）的自身免疫性糖尿病；其主要特征是存在与糖尿病相关的自身抗体（最常见的是抗谷氨酸脱羧酶的自身抗体），导致朗格汉斯岛的逐渐破坏。这是一种异质性疾病，具有1型糖尿病和2型糖尿病常见的临床和实验室表现。我们报道了一个71岁的男性，两年前被诊断患有2型糖尿病，口服抗糖尿病治疗控制不佳，并在第三年恶化。他在两个二级亲属（侄子）中有2型糖尿病家族史。在体格检查中未发现病理结果。他的体重指数为23kg/m2，糖化血红蛋白为10.6％。实验室检查显示低基础C肽（<0.1ng/mL）和谷氨酸脱羧酶抗体阳性，LADA的诊断得到了证实。这个案例突出了意识到这种疾病的重要性，尤其是在先前诊断为2型糖尿病的患者中，这些患者仍然不受饮食和口服降糖药的控制。LADA经常与2型糖尿病混淆，因此,管理往往不足。早期诊断和治疗对于延缓疾病进展至关重要。
