Ricerc@Sapienza

A substantial proportion of patients with adult-onset diabetes share features of both type 1 diabetes (T1D) and type 2 diabetes (T2D). These individuals, at diagnosis, clinically resemble T2D patients by not requiring insulin treatment, yet they have immunogenetic markers associated with T1D. Such a slowly evolving form of autoimmune diabetes, described as latent autoimmune diabetes of adults (LADA), accounts for 2-12% of all patients with adult-onset diabetes, though they show considerable variability according to their demographics and mode of ascertainment.

To the Editor
The paper by Jones et al. in which they studied the response of a
cohort of 19 patients with adult-onset diabetes who were glutamic
acid decarboxylase autoantibodies (GADA) positive, most with very
low levels of C peptide and multiple autoantibodies, is consistent with
published results studying GLP-1 agonists in patients with established
type 1 diabetes who show little by way of a beneficial response.1,2
Importantly, they note that those with GADA, who were not on insulin

An increasing number of new cases of autoimmune diabetes occur during adulthood. Most are cases of latent autoimmune diabetes in adults (LADA), a form of autoimmune diabetes with older mean age at onset, slower rate of beta-cell loss and longer period of insulin independence after onset when compared with type 1 diabetes. Unfortunately, patients with LADA are often misdiagnosed as having type 2 diabetes, the most frequent form of adult-onset diabetes, and show a sustained poor glycemic control over time.