This Article Full Text Full Text (PDF) All Versions of this Article: 91/5/1654    most recent Author Manuscript (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Leslie, R. D. G. Articles by Pozzilli, P. Search for Related Content PubMed PubMed Citation Articles by Leslie, R. D. G. Articles by Pozzilli, P. Pubmed/NCBI databases Medline Plus Health Information Autoimmune Diseases Diabetes Type 1 Related Collections Autoimmunity Diabetes and Insulin Pediatric Endocrinology

Type 1 Diabetes and Latent Autoimmune Diabetes in Adults: One End of the Rainbow

Institute of Cell and Molecular Science (R.D.G.L., P.P.), Queen Mary College, University of London, London E1 4NS, United Kingdom; University of Wales School of Medicine (R.W.), Swansea SA2 8PP, United Kingdom; and Department of Endocrinology and Diabetes (P.P.), University Campus Bio-Medico, 83-00155 Rome, Italy

Address all correspondence and requests for reprints to: Professor David Leslie, Department of Diabetes, St. Bartholomew’s Hospital, West Smithfield, London EC1A 7BE, United Kingdom. E-mail: r.d.g.leslie{at}qmul.ac.uk.

Context: The aim of this review was to explore the pathogenic and clinical spectrum of type 1 diabetes, which includes a form of adult onset autoimmune diabetes usually referred to as latent autoimmune diabetes in adults (LADA). We looked at this entire range of forms of autoimmune diabetes as a spectrum of genetic and nongenetic environmental influences, diabetes-associated immune responses, and metabolic changes.

Evidence Acquisition: We assessed epidemiological, genetic, immunological, and clinical data from major articles on autoimmune diabetes, including LADA and type 1 diabetes, published since 1992.

Evidence Synthesis: Data analysis of autoimmune diabetes indi-cates that type 1 diabetes and LADA occupy different poles of the same spectrum.

Conclusion: Evidence is presented that LADA represents one end of a rainbow encompassing type 1 diabetes. The clinical nature and management of autoimmune diabetes poses important therapeutic questions regarding conventional therapy for hyperglycemia as well as therapy aiming to protect residual ß-cell function. Limiting loss of endogenous insulin secretion using immunomodulation could be valuable, not only for LADA but also for type 1 diabetes.

This article has been cited by other articles:

				J. P. Dunn, J. M. Perkins, and S. M. Jagasia Latent Autoimmune Diabetes in Adults and Pregnancy: Foretelling the Future Clin. Diabetes, January 1, 2008; 26(1): 44 - 46. [Full Text] [PDF]

				M. Pietropaolo, E. Barinas-Mitchell, and L. H. Kuller The Heterogeneity of Diabetes: Unraveling a Dispute: Is Systemic Inflammation Related to Islet Autoimmunity? Diabetes, May 1, 2007; 56(5): 1189 - 1197. [Abstract] [Full Text] [PDF]