Latent Autoimmune Diabetes in Adults: A Case Series and Clinical Insights

Introduction: Diabetes mellitus (DM) is a disease spectrum ranging from classic insulin deficiency of type 1 diabetes (T1DM) to insulin-resistant type 2 diabetes (T2DM). Latent autoimmune diabetes in adults (LADA) is a type of DM with clinical characteristics of both T1DM and T2DM. Despite its clinical significance, LADA remains underdiagnosed and mismanaged due to overlapping characteristics with other diabetes types. Methods: It is a case series describing clinical, immunological, and metabolic characteristics of ten patients diagnosed with LADA based on three criteria identified by the Immunology of Diabetes Society. Results: We found that these patients had uncontrolled diabetes not controlled with oral hypoglycemic drugs, were mostly males aged above 30 years with a mean body mass index of 22.6 kg/m², and everyone had positive anti-glutamic acid decarboxylase (GAD) antibody. At the presentation, one patient had combined moderate non-proliferative diabetic retinopathy and peripheral neuropathy. Four patients had mild non-proliferative diabetic retinopathy, and two had peripheral neuropathy as complications of uncontrolled diabetes. Conclusion: LADA remains a diagnostic challenge, as its phenotypic picture resembles T2DM, while immunologically it resembles T1DM. A high index of suspicion, early diagnosis, and correct treatment can prevent further damage to the beta islet cells and help prevent short-term and long-term complications of DM.