Sunday, 24 June 2018
Diabetes Editor Choice



 Lada diabetes is an autoimmune disease. The aim of  is to prevent further beta cell destruction as much as possible. In this article, I will point to its symptoms, methods of diagnosis and how to treat.

1.What is diabetes

 “Do you get diabetes from eating too much sugar?” This phrase is a false belief heard by diabetics from the common.

So, what really causes diabetes? Diabetes is a complex disease with a wide range and can not be easily classified.

However, diabetes is classified mainly to type 1 and type 2, but actually there’s a third type sometimes named type 1.5, or more scientifically lada (Latent Autoimmune Diabetes in Adults).lada diabetes cure Lada diabetes represents 10% of the population of diabetes, making it more widespread than type 1, representing only 5%.

This type of diabetes is phenotypically similar to type 2 diabetes, but what makes it different is the presence of auto antibodies in blood that overtime destroy the pancreas’ beta cells that produce insulin.

These auto antibodies start to appear during adulthood, making it different from type 1 diabetes. A lada diabetic may present with symptoms ranging from poor glycemic control to diabetic ketoacidosis. The symptoms depend on the number of functioning beta cells at time of diagnosis.


Definition of lada diabetes

  • Lada diabetes is a type of diabetes that starts during adulthood.
  • It is characterized by low levels of insulin due to decreased number of beta cells.
  • The disease is autoimmune in nature so beta cell destruction is modulated by auto antibodies.
  • Unlike type 1 which is discovered during childhood, lada starts to appear during adulthood.
  • Another difference is that lada diabetes requires insulin treatment in a few months or years unlike type 1 diabetes in which insulin treatment is started a dew day after diagnosis.
  • In addition, a lada diabetic may be overweight with an increased metabolic rate and sometimes insulin resistance is present.
  • However, Lada diabetics usually have a worse glycemic control when compared to type 2 diabetics.
  • Lada diabetics rarely get into a ketosis coma. Some physicians like to believe that lada diabetes is a stage in the spectrum of diabetes, however it is globally treated as an independent type. Many cases of Lada diabetes are misdiagnosed by physicians as type 2 diabetes as the case is only discovered by blood tests.
  • However, Lada Diabetes doesn’t respond to the medical treatment of type 2 diabetes but actually it may worsen the case. So, if you have been diagnosed with lada diabetes but have a lean body or are losing weight; you should ask your doctor if the treatment is right for you.
  • Lada diabetes cure may start with lifestyle modifications but eventually insulin is required to manage the case.


2.How to diagnose lada diabetes?

Correct diagnosis is essential for proper treatment and management of the case. Generally, for a case to be diagnosed as Lada diabetes, an auto antibody has to be detected in blood against the beta cells of the pancreas. There are mainly four types of antibodies:

  • antibodies to islet cell antigens.
  • antibodies to glutamic acid decarboxylase (GADA)
  • antibodies to tyrosine phosphatase proteins.
  • antibodies to insulin.

The presence of one antibody is sufficient for the diagnosis of lada diabetes. Although any of the antibodies may be present, GADA is usually associated with lada diabetes more than the others. The level of antibodies circulating in blood is very essential in determining the lada diabetes cure.

The higher the level of antibodies, the faster the beta cells are going to be depleted and the patient is going to need insulin.

The second criterion essential for diagnosis is the age of the patient. An age above 30 is essential for diagnosis. A range of 25-40 years is acceptable for diagnosis as adulthood starts earlier than 30 years; however, an average of 30 years is currently used.LADA diabetes cure

The last criterion for diagnosis is 6 months insulin free period after diagnosis. Type 1 diabetics usually start insulin treatment in a few weeks while type 2 diabetics may not need insulin treatment at all. Type 1.5, or lada diabetes cure, should be insulin free for the first 6 months. Although this period depends on the physician’s choice of lada diabetes cure and some searches suggest that starting insulin treatment early is beneficial for the patient, the standard period globally is 6 months insulin free.


3.Symptoms and complications of lada diabetes

 The symptoms of lada diabetes are similar to those of type 2 diabetes.

These are mainly:Lada diabetes cure

  • increased thirst.
  • frequent urination.
  • delayed healing of wounds.
  • numbness or tingling of extremities.
  • and weight loss despite increased appetite.
  • Sometimes blurring of vision.
  • dry itchy skin.
  • or fatigue may be present.

Complications are mainly microvascular morbidities as:

  • retinal complications.
  • kidney dysfunction.
  • heart anomalies.
  • macro vascular problems.
  • high blood pressure.

Some studies show that lada diabetics have a better cardiovascular profile compared to type 2 diabetics. A lower risk of nephropathy is also reported. lada diabetes is sometimes associated with other autoimmune diseases especially thyroid disease.

Although LADA diabetes is similar in pathology to type 1 diabetes, the complications are more delayed due to later onset and slower progression of the course of the disease. The life expectancy of lada diabetics is a concern of many patients.

The life expectancy of type 1 diabetes is approximately reduced a decade compared to non-diabetics; however, that of lada diabetics depends largely on how soon they progress to absolute insulin dependency.


4.  lada diabetes cure: Therapeutic approach

As mentioned before, proper diagnosis is essential for proper lada diabetes cure. Beta cell count determines the course of the disease. The lada diabetes cure should not only aim for a better metabolic rate and lower blood glucose level but also for the perseverance of beta cell function.

Studies show that a preserving the natural function of beta cells, even if at a low rate, delays the appearance of morbidities and the eventual need for insulin treatment.

Till now there is no accurate way for measuring the beta cell number, however a higher C-peptide level is a good indicator of their function. The C-peptide response test is the most accurate and appropriate test available. Routine screening for GADA might be of great value as it is commonly present in lada.

The treatment is initially similar to that of type 2 diabetes:

  • diet control and exercise.
  • Proper glycemic control is important in the course of treatment.
  • However medical treatment is needed sooner or later as the beta cell function is markedly decreased.
  • The imminent lada diabetes cure is absolute insulin dependency.


5. lada diabetes cure: medical treatment

At the beginning of lada diabetes cure, drugs can be used to control hyperglycemia of lada diabetes. The aim of drug use is to preserve beta cells and delay absolute insulin dependence. Many drugs have been tried in lada diabetes cure, and some actually had positive results while others were deleterious.

  • Sulfonylureas

      Sulfonylureas are chemical agents that stimulate insulin release from the pancreas and are commonly used in the treatment of type 2 diabetes.

Insulin release is triggered by binding of sulfonylureas to ATP potassium channels leading to the opening of calcium channels that lead to insulin release from beta cells.

Despite the efficacy of this treatment at the beginning of disease as it increases insulin blood level, this therapeutic approach is highly not recommended by most of the studies.

This lada diabetes cure hastens beta cell depletion and aids in the progress of the autoimmune disease. Some studies suggest that sulfonylureas increase the production of auto antibodies in response to increased insulin production.

The preservation of beta cells is very important because beside their role as insulin secretors, they have a vital role in the delay of the morbidities of diabetes. Therefore, the use of sulfonylureas in lada diabetes cure is an absolute contraindication as it worsens the disease progression.

  • Insulin

This title may seem out of place as lada diabetes cure is characterized by an insulin free period at the start of the treatment.

Many studies show that the administration of insulin as early as possible helps prevent the rapid exhaustion of beta cells. This is important as it aids the aim of therapy: delaying insulin dependence. Insulin also aids in keeping blood sugar level closest to normal.

So many physicians like to start insulin treatment once the diagnosis is confirmed. From a practical point of view, initiating early insulin treatment in a lada diabetic patient with a moderate beta cell destruction thereby a a slightly higher than normal blood glucose level is hard. In this case, long acting insulin is a good choice.

  • Insulin sensitizers (Metformin, Thialzidones)

Because some lada diabetics have a degree of insulin resistance and features of metabolic syndrome, the use of insulin sensitizers sound as a good lada diabetes cure. They act by increasing the cell’s sensitivity to insulin and easing glucose utilization.

Metformin is not generally used in lada diabetes cure due to its dangerous potential of causing ketosis due to the prolonged course of treatment. Ketosis is not a potential threat to lada diabetics when they have a good reserve of beta cells at start of diagnosis, but as the disease is progressive in nature metformin is not recommended.

Thialzidones are a better treatment choice because in addition to their role as insulin sensitizers, thialzidones are proved to have other positive effects on beta cells. Thialzidones are proved to increase insulin secretion, preserve beta islet cell island mass and secretion, have anti-inflammatory effect, prevent beta cell apoptosis, and even stimulate beta cell proliferation.

Studies show that they act through modulating genes responsible for beta cell differentiation and proliferation. The use of thialzidones in lada diabetes cure is showing promising results.

  • Incretins

Incretins are new pharmacological drugs used in the treatment of type 2 diabetes. This drug acts as a full agonist at glucagon like peptide receptors and has a glucose-regulatory action similar to incretin hormones: glucose dependent enhancement in insulin secretion and inhibition to glucagon secretion as well as slowing gastric emptying and decreasing food intake.

In vitro, incretins showed actions similar to those of thialzidones concerning enhancement of beta cell proliferation. This action is thought to be through genetic modulation of growth and proliferation of beta cells. Although incretins have not been clinically used in lada diabetes cure, they are a potentially promising treatment.


6. Lada DIABETES cure: ImmUne modulation

 As mentioned earlier, lada diabetes is an autoimmune disease. It seems that the body doesn’t develop tolerance to the autoantibodies; so, the aim of this approach is to develop tolerance to the circulating autoantibodies to preserve beta cell function.

This is achieved by shifting from a TH1 phenotype of auto antigens towards a TH2 phenotype. The perseverance of beta cell is affected by many factors mainly the age of the patient at diagnosis, the number of functioning beta cells, and metabolic control.

The number of functioning beta cells is affected by HLA genotypes; having low to moderate risk HLA genotypes is associated with a higher residual of functioning beta cells.

The antigens that have been used so far as tolerogens in lada have included the following: insulin, GAD, heat shock protein (HSP), and their constituent peptides.

  • Peptide of HSP60 (Diapep277)

HSP60 is a protein found in the mitochondria of the mature insulin secreting beta cells of the pancreas and is considered an important auto antigen. The most important epitope of HSP60, HSP277 or a more stable form Diapep277, is used in recently diagnosed type 1 diabetics to preserve remaining beta 1 cells.

A study was conducted to test the efficacy of Diapep277 in lada diabetes cure; and the group taking the treatment showed better A1C level without the insulin treatment compared to the placebo group. A shift from TH1 cells to TH2 cells was significant, indicating a successful immune modulation.

  • GAD65 (Diamyd)

The isoform of GAD65, 65-kDa is found in beta cells of pancreas and is a major auto antigen in autoimmune diabetes. A large body of evidence shows that 70-75% of type 1 diabetes patients have circulating GAD65 autoantibody. GADA is the most sensitive autoantibody marker found in a large number of lada patients.

A recombinant form of GAD65, diamyd, was tested in a number of lada patients. The results were not promising as they were very similar to the placebo group. Till now, diamyd efficacy needs to be further studied.

  • Anti-CD3 monoclonal antibodies

Anti-CD3 antibodies mechanism of action is not fully understood till now but it may be through immune modulation, anergy and/or apoptosis, or induction of immune tolerance.

The use of anti-CD3 antibodies in lada diabetes cure has shown to help the perseverance of beta cells and improvement in insulin secretion as well as decreasing the need of exogenous insulin in the group treated over a year. Anti-CD3 antibody usage may be very beneficial but further studies are needed to confirm the hypothesis.


7. Conclusion

 To conclude, lada diabetes is an autoimmune disease characterized by self destruction of beta cells if the pancreas. The disease starts during adulthood with symptoms similar to those of type 2 diabetes, so the diagnosis is mainly confirmed by blood tests. The disease is treated as an independent type, sometimes referred to as 1.5 diabetes, since the 1940s.

The percent of lada diabetics is about 10% of the total population, making it more widespread than childhood autoimmune diabetes. In some countries, screening for lada diabetes is obligatory before school/ college. However, in other countries where health awareness is high, the screening is not required.

The symptoms of lada diabetes are no different from those of the other types: frequent thirst and urination, fatigue, blurring of vision, and headache. Micro and macrovascular morbidities depend mainly on the number of functioning beta cells at the time of diagnosis. The number of functioning beta cells depends not only on the time of diagnosis but also on the number of auto antibodies circulating in blood.

If the case is diagnosed at an early stage, the lada diabetes cure follows a regimen similar to that of type 2 diabetics. This regimen is composed of diet modification aiming at a closer to normal blood glucose level and an active lifestyle.

However, if at diagnosis insulin levels are inadequate, lada diabetes cure by medical treatment is required. Promising medical treatments of lada diabetes are insulin treatment, thialazidone treatment, and immune modulation.

The main goal of lada diabetes cure is the preservation of beta cells and delay of absolute insulin treatment. Preservation of beta cells means keeping adequate levels of endogenous insulin and decreasing the number of inflammatory cells.

This is important as it delays the morbidities and mortality of the disease.  Eventually patients need absolute insulin treatment due to the depletion of beta cells.

So, if you have the symptoms of diabetes but the medications of type 2 diabetes are not showing results, refer to your physician for further investigations to confirm the diagnosis as in this case you may suffer from Lada diabetes and Lada diabetes cure _as discussed before _.


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