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Lad A
Lad A
diabetes: A pathogenic role for maternal antibodies? Matthias von Herrath1 & JeanFrancois Bach2 Nature Medicine 8, 331 - 333 (2002)
What is LADA
Latent Autoimmune Diabetes of Adults (LADA) is a slow developing form of autoimmune diabetes found in people over 35 years old which is often misdiagnosed as Type 2. The reason for this misdiagnosis is that by age 35 many people in the general population are slightly overweight or may have developed some insulin resistance or other signs of the metabolic syndrome which doctors associate with Type 2 diabetes. In addition, evidence is emerging that suggests that LADA, though it is an autoimmune disease, is not quite the same as Type 1 diabetes, and, in fact, has a genetic profile that includes genes also found in people who develop Type 2 diabetes. This was made clear in a study published in February of 2008 that reports that people diagnosed with LADA had variations in the HLA autoimmunity genes similar to those found in people with Type 1 diabetes but that many of them also had variations of the TCF7L2 gene that has been associated with Type 2 diabetes. Genetic Similarities Between LADA, Type 1 and Type 2 Diabetes Camilla Cervin et al, Diabetes DOI: 10.2337/db07-0299 This led the researchers to conclude that LADA shares genetic features with both type 1 (HLA, INS VNTR, and PTPN22) and type 2 (TCF7L2) diabetes, which justifies considering LADA as an admixture of the two major types of diabetes. This finding was confirmed by a second study published in November of 2008 which found that young people with Diabetes who were negative for
GAD Antibodies had higher levels of a common Type 2 gene than their peers who were positive for these antibodies, but that in older people diagnosed with LADA the frequency of a common Type 2 gene was the same as it was in people of that age who were not positive for GAD antibodies. This led the authors to conclude: Common variants in the TCF7L2 gene help to differentiate young but not middle-aged GADA-positive and GADA-negative diabetic patients, suggesting that young GADA-negative patients have type 2 diabetes and that middle-aged GADA-positive patients are different from their young GADApositive counterparts and share genetic features with type 2 diabetes. Common variants in the TCF7L2 gene help to differentiate autoimmune from non-autoimmune diabetes in young (1534 years) but not in middle-aged (4059 years) diabetic patients E. Bakhtadze et. al. Diabetologia. DOI 10.1007/s00125-008-1161-2
So it is very important to get a correct diagnosis so you can avoid the drugs that stimulate insulin production by the beta cells. These drugs include the sulfonylureas like Amaryl and Glipizide and may also include the incretin drugs, Byetta and Januvia because they also stimulate insulin production by the beta cells.
C-peptide result suggests that the beta cells have stopped making insulin, possibly because they are dead. People with Type 2 diabetes often test with normal or high levels of C-peptide. So a low C-peptide level is suggestive of LADA, though it should be confirmed with antibody tests.
1 to 45 years of age and have a brother, sister, child, or parent with type 1 diabetes 1 to 20 years of age and have a cousin, aunt, uncle, niece, nephew, half sibling, or grandparent with type 1 diabetes
More information about the TrialNet screening and studies can be found at: Type 1 Diabetes TrialNet: Information for Study Participants
carbs allows you to fine tune your blood sugar control and avoid dangerous hypos and soaring post-meal blood sugars, read Dr. Bernstein's Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars. Though many people with LADA are able to eat higher amounts of carbohydrate than those that Dr. Bernstein recommends, the principles he explains hold true for all people with diabetes and reading this book will give you a much better idea of how to use insulin effectively. References Latent autoimmune diabetes of adulthood: Unique features that distinguish it from types 1 and 2 Fadi Nabhan, MD; Mary Ann Emanuele, MD; Nicholas Emanuele, MD. Postgraduate Medicine Vol 117, No 3, Mar 2005. Genetic Similarities Between Latent Autoimmune Diabetes in Adults, Type 1 Diabetes, and Type 2 Diabetes. Camilla Cervin et. al. Diabetes 57:1433-1437, 2008 Autoimmune Diabetes Not Requiring Insulin at Diagnosis (Latent Autoimmune Diabetes of the Adult) Definition, characterization, and potential prevention Paolo Pozzilli, Umberto Di Mario, Diabetes Care 24:1460-1467, 2001.