Hals Ingrid K
Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Curr Diabetes Rev. 2019;15(3):188-193. doi: 10.2174/1573399814666180716144429.
Latent Autoimmune Diabetes in Adults (LADA), although formally classified as Type 1 Diabetes (T1D), very often (at least in Western countries) appear clinically with Type 2 Diabetes (T2D)-like features as overweight and insulin resistance. LADA patients do not need exogenous insulin at the time they are diagnosed with diabetes, but a large percentage will within a few years develop need for such treatment. The decline in beta cell function progresses much faster in LADA than in T2D, presumably because of the ongoing autoimmune assault in LADA, and therefore necessitates insulin therapy much earlier in LADA than in T2D. Despite high prevalence of LADA (about 10% of the total diabetic population in many countries), the treatment of LADA patients is far less elucidated than is the case for T1D and T2D. Finding a treatment strategy for LADA from the time of diagnosis, that can reduce the decline of beta cell function, ensure adequate metabolic control and thereby reduce the risk of diabetic complications is thus an important clinical challenge. Conclusions from the randomized treatment studies so far do not indicate an optimal treatment strategy in LADA. This review aims to give an overview of current practices for the medical treatment of LADA as well as an update on results from recent studies on the treatment of the disease.
成人隐匿性自身免疫性糖尿病（LADA），尽管在形式上被归类为1型糖尿病（T1D），但在临床上常常（至少在西方国家）表现出与2型糖尿病（T2D）相似的特征，如超重和胰岛素抵抗。LADA患者在被诊断为糖尿病时不需要外源性胰岛素，但很大一部分患者在几年内会发展为需要这种治疗。LADA患者β细胞功能的下降比T2D患者快得多，这可能是因为LADA中持续存在自身免疫攻击，因此LADA患者比T2D患者更早需要胰岛素治疗。尽管LADA的患病率很高（在许多国家约占糖尿病总人口的10%），但与T1D和T2D相比，LADA患者的治疗方法远未得到充分阐明。因此，从诊断时起就为LADA找到一种治疗策略，以减少β细胞功能的下降，确保充分的代谢控制，从而降低糖尿病并发症的风险，是一项重要的临床挑战。迄今为止，随机治疗研究的结论并未表明LADA的最佳治疗策略。本综述旨在概述LADA的当前医学治疗方法，并更新该疾病治疗的最新研究结果。
