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Editorial
. 2018 Oct-Dec;14(4):520-524.
doi: 10.4183/aeb.2018.520.

A COMMENTARY ON CLASSIFICATION OF DIABETES: LATENT AUTOIMMUNE DIABETES IN ADULTS (LADA) OR INTERMEDIARY DIABETES MELLITUS (IDM)?

C Ionescu-Tirgoviste  1 , P Gagniuc  1 , C Guja  1
Affiliations
Editorial

A COMMENTARY ON CLASSIFICATION OF DIABETES: LATENT AUTOIMMUNE DIABETES IN ADULTS (LADA) OR INTERMEDIARY DIABETES MELLITUS (IDM)?

C Ionescu-Tirgoviste et al. Acta Endocrinol (Buchar). 2018 Oct-Dec.

Abstract

Diabetes Mellitus is a huge syndrome which can be detected from the first day of life until the last year of life of a centenarian. In the current classification of diabetes among the so-called "idiopathic phenotypes", apart Type 1 Diabetes (T1D) and Type 2 Diabetes (T2D) has been included provisionally term "Latent Autoimmune Diabetes in Adults" (LADA). This has unclear characterization regarding the age at onset, the presence of anti-β-cell antibodies and the level of insulin secretory function, in conformity with C-peptide levels. According to several recent publications, there are no specific biochemical or genetic markers for Latent Autoimmune Diabetes in Adults (LADA), but only a gradual transition from T1D to T2D. In addition, the word "latent" in the construction of "LADA" term is inaccurate because in this phenotype nothing is latent: both the autoimmunity and diabetes are present and are even parts of the diagnosis. So that, the best term should be what in reality this sub-phenotype is: an Intermediary Diabetes Mellitus (IDM). Some recent genetic data strongly support this designation.

Keywords: Classification of diabetes; IDM; LADA; primary insulin dependence; secondary insulin dependence.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1.
Figure 1.
The contribution of diabetogenic and protective HLA haplotypes: continuous blue line - diabetogenic HLA; dashed red line - contribution of the protective HLA in various phenotypes of diabetes vs. control (Redrawn after Pettersen et al. (39).
Figure 2.
Figure 2.
Relationship between various genes associated with the three phenotypes of diabetes A-type 1 diabetes, B-type 2 diabetes and C-Intermediary Diabetes Mellitus (from 40).
Figure 3.
Figure 3.
The clear position of Intermediary Diabetes Mellitus (IDM) between type 1 diabetes and type 2 diabetes (from 40).
See this image and copyright information in PMC

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