What is lada diabetes. Lada diabetes diagnostic criteria

Diabetes mellitus is a disease caused by a disruption in the endocrine system, resulting in a failure of the process of carbohydrate metabolism and an increased accumulation of glucose in the blood.

Pathology has several types, differing among themselves in the causes of occurrence and methods of treatment. One of these types is LADA-diabetes.

The main classification of disorders of carbohydrate metabolism

According to the classification, diabetes mellitus is divided into the following main types:

According to the varieties are distinguished:

1. MODY-diabetes belongs to the A-class and occurs with pathologies of the pancreas.
2. Medication belongs to the B-class and develops under the influence of taking medicines.
3. C-class, which is formed against the background of endocrine disorders;
4. LADA, known as autoimmune diabetes. This variety has signs of both types 1 and 2, only unlike the first type, the symptoms appear much later.

The main symptoms of carbohydrate metabolism disorders are:

• increased frequency of urge to urinate and excretion of a significant amount of urine;
• increased feelings of thirst and hunger;
• feeling of dryness in the mouth;
• decreased performance against the background of rapid fatigue;
• increased glucose levels, accompanied by lethargy, chills and dizziness.

Progressing, the pathology stimulates the process of splitting fat cells, which leads to the formation of ketone bodies and the development of ketoacidosis, which causes such manifestations:

• unquenchable thirst;
• the appearance of plaque on the tongue;
• sensation of acetone taste and smell;
• bouts of vomiting.

Depending on the type of disorder, the symptoms may be more or less pronounced, appear at the onset of the disease (in type 1), or the disease may proceed long time asymptomatic (type 2).

Differences between LADA-diabetes and other forms of the disease

How does LADA-diabetes differ from other types of diabetes? This variety is a latent form of type 1 diabetes, proceeding according to the scenario of type 2 of the disease.

With LADA, pancreatic cells are completely destroyed as a result of exposure to antibodies produced by the body's immune system.

That is the failure mechanism metabolic processes similar to the insulin-dependent type of the disease. But violations are found already in adults, which is more typical for type 2 diabetes.

The complete cessation of the natural production of insulin occurs after a short period of time from the onset of the development of the disease. After 1-3 years, all the beta cells responsible for the production of the hormone die.

Due to the lack of the hormone, glucose accumulates, which leads to hyperglycemia, and the body compensates for the lack of energy by splitting fat cells, resulting in ketoacidosis.

Thus, the difference between LADA-diabetes is the manifestation of signs of ketoacidosis and hyperglycemia against the background of a failure of autonomic immune system in patients older than 35 years of age.

The reasons contributing to the occurrence of pathology include:

• hereditary predisposition;
• low physical activity;
• different degrees of obesity;
• weakened immunity;
• abuse of high-carbohydrate foods;
• tendency to overeat;
• concomitant autoimmune pathologies or such diseases in history;
• self-medication with antibacterial and hormonal drugs;
• prolonged nervous strain;
• trauma or surgery;
• environmental factor.

Symptoms of the disease may begin to appear a couple of months after the failure of metabolic processes, which allows you to quickly diagnose and prescribe treatment. Unfortunately, most patients are misdiagnosed as type 2. diabetes and administration of sugar-lowering drugs is prescribed at a time when insulin therapy should be started as soon as possible.

Diagnostic methods

Diagnosis of LADA is carried out according to the results of analyzes:

• blood biochemistry;
• blood test for glucose;
• general clinical analysis of blood and urine.

Additionally, studies of the following indicators are assigned:

The main diagnostic criteria are positive indicators of autoimmune tests in the presence of such factors:

• signs of type 2 diabetes mellitus in the absence of obesity in patients;
• age younger than 45 years;
• insulin deficiency is compensated by increased physical activity and diet food;
• insulin dependence that occurred 1-3 years after the onset of the disease;
• autoimmune diseases in history or among relatives;
• increased thirst, frequent urination, decreased performance.

Two variants of the clinical picture can be observed.

LADA with signs of insulin-dependent diabetes:

• the disease develops in young patients;
• there are HLA genotypes and haplotypes characteristic of type 1 diabetes mellitus;
• in a blood test on an empty stomach, a low level of c-peptide is observed.

The second option is characterized by such manifestations:

• symptoms of type 2 disease;
• elderly patients with varying degrees of obesity;
• HLA genotypes and haplotypes are not observed;
• dyslipidemia.

Latent diabetes is more common with increased production of antibodies that destroy the pancreas. The remaining cells begin to intensively synthesize insulin, which further depletes the gland. Another indicator of gland damage is a low level of c-peptides in blood taken on an empty stomach.

That is, the disease is confirmed by a combination of reduced levels of c-peptides with the presence of antibodies to glutamate decarboxylase. Diagnosis is ruled out if antibodies are absent. Additional studies will be required if antibodies are present with acceptable values ​​of c-peptides.

The main difficulty in diagnosing lies in insufficient funding medical institutions, resulting in a lack of equipment necessary for autoimmune research. In this regard, patients have to go to paid private clinics for testing, so the reliability of the results of such studies is often in doubt.

Methods of treatment

For a favorable prognosis for patients with LADA, correct diagnosis and competent therapy are very important. However, it often happens that treatment similar to the treatment of type 2 diabetes mellitus is prescribed, for example, it is recommended to take sulfonylurea drugs and Metformin.

Such appointments lead to even greater destruction of pancreatic cells, which is unacceptable in this type of disease.

Adequate treatment implies the longest possible preservation of the productivity of the gland and should be aimed at solving such problems:

• keep glucose levels within acceptable limits, preventing the occurrence of hypo- and hyperglycemia;
• prolong the natural production of insulin in the body;
• unload the pancreas, reducing the need for hormone production to prevent its depletion.

The achievement of the set goals is carried out through the following clinical recommendations:

1. insulin therapy. Regardless of the level of sugar in the blood plasma, patients are given injections of small doses of a long-acting hormone.
2. Glucose monitoring should be carried out regularly, not only before meals and after, but also at night.
3. Diet change. Dietary nutrition should be based on reducing the consumption of foods high in rapidly absorbed carbohydrates. Pasta, rich pastries, starchy vegetables, sweets and bread products made from wheat flour are excluded from the menu. An important condition is to maintain water balance. Drinking 1.5-2 liters of water daily helps thin the blood and prevents dehydration.
4. Increase physical activity. Daily sports loads are aimed at reducing weight, increasing energy consumption, improving blood circulation and accelerating metabolic processes. In addition, physical education will strengthen the heart muscle and vascular walls, which will be an excellent prevention of the development of cardiovascular diseases.

Video material about the LADA disease - consultation with an endocrinologist:

Latent or latent diabetes- a disease affecting adults over 35 years of age. The danger of latent diabetes lies in the complexity of diagnosis and incorrect methods of treatment.

The scientific name of the disease is LADA (LADA or LADO), which stands for Latent Autoimmune Diabetes in Adults.

Symptoms of LADA are misleading, the disease is often confused with the diagnosis, which leads to a deterioration in the condition of patients, in rare cases, death.

In this article we will try to talk about what kind of diagnosis it is, how to identify a latent form of diabetes.

In standard type 2 diabetes, the person's pancreas produces defective insulin, which leads to high levels of glucose in the blood and urine.

Another option is that peripheral tissues are not sensitive to natural insulin, even if its production is within the normal range. With LADA, the situation is more complicated.

The organs do not produce the wrong insulin, but they do not produce the correct insulin either, or the production is reduced to very low levels. Peripheral tissues do not lose sensitivity, resulting in depletion of beta cells.

A person with latent diabetes needs insulin injections on a par with diabetics suffering from

Symptoms

In connection with the ongoing processes in the body of the diseased, the following symptoms occur:

• Weakness and fatigue;
• Fever, dizziness, possible fever;
• Elevated blood glucose;
• Unreasonable weight loss;
• Strong thirst and diuresis;
• The appearance of plaque on the tongue, acetone breath;

LADA often occurs without any significant symptoms. There is no identified difference between male and female symptoms. However, the occurrence of LADA DM occurs more often in women during pregnancy or some time after childbirth. Women develop autoimmune diabetes at the age of 25, much earlier than men.

Changes in the work of the pancreas during the secretion of insulin are associated, first of all, with the ability to bear children.

How is it different from diabetes?

Lada diabetes has an autoimmune origin, its development is associated with damage to the pancreas, but the mechanisms of the development of the disease are similar to other types of diabetes. A few years ago, scientists did not suspect the existence of LADA (type 1.5), only types 1 and 2 diabetes were distinguished.

Difference between autoimmune and type 1 diabetes:

• The need for insulin is lower, and the disease proceeds sluggishly, with periods of exacerbation. Even without concomitant treatment, the symptoms of diabetes 1.5 are often not noticeable to a person;
• The risk group includes people over 35 years of age, people of any age get sick with type 1 diabetes;
• The symptoms of LADA are often confused with those of other diseases, resulting in a misdiagnosis.

The nature and manifestation of type 1 diabetes are relatively well understood.

Difference between autoimmune and type 2 diabetes:

• Patients may not have excess weight;
• The need for insulin consumption may occur as early as 6 months from the onset of the disease;
• The patient's blood contains antibodies that indicate an autoimmune disease;
• With modern equipment, markers of type 1 diabetes can be detected;
• Reducing hyperglycemia with medication has little or no effect.

Important:

When symptoms of type 2 diabetes are present in non-obese adults, clinicians are increasingly leaning towards the diagnosis of LADA. The main criterion for the detection of type 1.5 diabetes is the presence of autoimmune markers.

Diagnostic criteria

Unfortunately, many endocrinologists do not do a deep analysis when diagnosing a type of diabetes. After incorrect diagnosis, medications are prescribed that lower blood glucose levels. For people with LADA, such treatment is harmful.

When diagnosing autoimmune diabetes, several methods are used that are recognized as the most effective.

At the initial stage, the patient undergoes standard procedures:

• Comprehensive blood tests;
• Analysis of urine.

In case of suspicion of latent diabetes, the endocrinologist issues a referral for narrowly focused studies. The latent form of diabetes mellitus is detected using:

• Glycated hemoglobin;
• reaction to glucose;
• Fructosamine;
• Antibodies to IAA, IA-2A, ICA;
• Microalbumin;
• Genotyping.

In addition to laboratory tests, the following are examined:

• The patient's age is over 35;
• How insulin is produced (the study takes several years);
• The patient's weight is normal or below normal;
• Is it possible to compensate for insulin with the help of drugs and changes in the nutrition system.

Only with deep diagnosis with a long-term study in laboratories, monitoring the patient and the processes in his body, it is possible to correctly diagnose autoimmune diabetes.

In Russia, obsolete samples can be used:

• Glucose tolerance test with prednisolone. Within a few hours, the patient takes prednisolone and glucose. The task of the study is to track glycemia against the background of the funds used.
• Shtab-Traugott test. On an empty stomach in the morning after measuring the glucose level, the patient consumes hot tea with dextropur. An hour and a half later, a patient with diabetes has glycemia, healthy people there is no such reaction.

These diagnostic methods are considered ineffective and are rarely used.

What is the danger of misdiagnosis

Incorrect diagnosis of the type of DM and subsequent incorrect treatment entail consequences for the patient's health:

• Autoimmune destruction of beta cells;
• Falling insulin levels and production;
• The development of complications and the general deterioration of the patient's condition;
• At long-term use improper treatment - the death of beta cells.

Unlike people with type 1 or type 2 diabetes, patients with LADA need fast insulin in small doses without the use of drug treatment.

Prescribing drugs that are inappropriate for an autoimmune disease lowers the chances of a cure and restoration of the pancreas.

Treatment

Patients with LADA need early detection of the disease and the use of insulin injections.

It is on the consumption of insulin in small doses that the most effective treatment is built.

Patients who started insulin therapy for early stages diseases, have every chance to restore the production of natural insulin over time.

Together with insulin therapy is prescribed:

• low-carb diet;
• Doing sports;
• Constant monitoring of blood glucose levels, including at night;
• Exclusion of certain medications indicated for overweight people and other types of diabetes.

It is important to reduce the load on the pancreas to facilitate the production of natural insulin in the future. The goal of treatment is to stop the death of beta cells by immune changes.

Preparations based on sulfourea are contraindicated in people with latent diabetes mellitus. These drugs increase pancreatic insulin secretion and only increase the death of beta cells.

Latent Autoimmune Diabetes of Adults, in Russian - latent autoimmune diabetes in adults, is diagnosed in people aged 25+. The main reason for the development of the disease is a malfunction of the immune system, which, instead of performing a protective function, begins to destroy the cells and tissues of its own body. The autoimmune process that characterizes Lada diabetes is aimed at destroying pancreatic cells and stopping their insulin synthesis.

Features of Lada-diabetes

Insulin is a hormone internal secretion(endogenous), the main purpose of which is to transport glucose to the tissues and cells of the body, as an energy source. A deficiency in the production of the hormone leads to the accumulation of dietary sugar in the blood. At juvenile diabetes Type 1 insulin synthesis is disturbed or stops in childhood and adolescence, due to the hereditary nature of the disease. Lada diabetes is, in fact, the same insulin-dependent type of disease as the first, only declaring itself at a later age.

A feature of the disease is that its symptoms are similar to type 2 diabetes, and the mechanism of development corresponds to the first type, but in a delayed latent form. The second type of pathology is characterized by insulin resistance - the inability of cells to perceive and consume insulin, which is produced by the pancreas. Because Lada diabetes develops in adults, the disease is often misdiagnosed.

The patient is assigned the status of a diabetic for insulin-independent type 2 disease. This leads to the wrong choice of treatment tactics, as a result, to its inefficiency.

When prescribing hypoglycemic drugs intended for type 2 therapy, the pancreas begins to force the production of insulin. Excessive activity of cells against the background of autoimmune processes leads to their death. There is a certain cyclical process.

Due to autoimmune effects, gland cells suffer - insulin production drops - medications are prescribed to reduce sugar - cells synthesize the hormone in an active mode - autoimmune reactions intensify. Ultimately, improper therapy leads to depletion (cachexia) of the pancreas and the need for high doses of medical insulin. In addition, if an autoimmune mechanism is running in the body, its effect may not be limited to only one organ. The internal environment is disturbed, which leads to the development of other autoimmune diseases.

Additionally

In Lada medicine, diabetes occupies an intermediate step between the first and second types of the disease, so you can find the name "diabetes 1.5". Dependence of the patient on regular injections of insulin is formed on average for two years.

Differences in autoimmune pathology

Factors affecting the occurrence

A high predisposition to Lada-diabetes is observed if there is a history of autoimmune diseases:

• damage to the intervertebral joints (ankylosing spondylitis);
• chronic pathology of the central nervous system (central nervous system) - multiple sclerosis;
• granulomatous inflammation digestive tract(Crohn's disease);
• dysfunction thyroid gland(Hashimoto's thyroiditis);
• destructive-inflammatory damage to the joints (arthritis: juvenile, rheumatoid);
• violation of pigmentation of the skin (vitiligo);
• chronic inflammation mucous membrane of the large intestine ( ulcerative colitis)
• systemic disease connective tissue(Sjögren's syndrome).

Genetic risks should not be discounted either. In the presence of autoimmune pathologies in close relatives, the chances of developing the Lada-type increase. With special attention to control the level of sugar should be women with a history of gestational diabetes. It is generally accepted that the disease is temporary, but with low immunity, against the background of an experienced gestational complication, a latent form of autoimmune diabetes may develop. Probability risk is 1:4.

Triggers (triggers) for starting autoimmune processes in the body can be:

• Infectious diseases. Untimely treatment of bacterial and viral diseases leads to a decrease in immunity.
• HIV and AIDS. The immunodeficiency virus and the disease caused by this virus cause the immune system to fail.
• Alcohol abuse. Alcohol destroys the pancreas.
• Chronic allergies.
• Psychopathology and permanent nervous stress.
• Decreased hemoglobin levels (anemia) due to a poor diet. Deficiency of vitamins and minerals weakens the body's defenses.
• Hormonal and endocrine disorders. The correlation between the two systems is that some endocrine glands produce hormones that regulate the activity of the immune system, and some of the immune cells of the system have the properties of hormones. Dysfunctionality of one of the systems automatically leads to failure in the other.

The combination of these factors causes many autoimmune diseases, including Lada-diabetes.

Symptoms

Diabetes mellitus type Lada may not show symptoms from several months to several years. Signs of pathology appear gradually. Changes in the body that should alert are:

• polydipsia ( constant thirst);
• pollakiuria (frequent urge to void) Bladder);
• dysania (sleep disorder), decreased performance;
• weight loss (without diets and sports activities) against the background of polyphagia (increased appetite);
• long healing mechanical damage skin;
• psycho-emotional instability.

Such symptoms rarely cause potential diabetics to seek medical advice. medical assistance. Deviations in plasma glucose are detected by chance during a medical examination or in connection with another disease. Detailed diagnosis is not carried out, and the patient is mistakenly diagnosed with non-insulin-dependent diabetes, while his body needs strictly dosed insulin.

Important! If there is no effect or worsening of the condition from erroneously prescribed pills to reduce sugar, it is necessary to undergo a special diagnosis.

Diagnostic measures

The age period of manifestation of Lada diabetes begins after 25 years. According to the norms of digital blood glucose values, age group from 14 to 60 years correspond to indicators from 4.1 to 5.7 mmol / l (on an empty stomach). Standard Diagnostics diabetes mellitus includes a study of blood and urine:

• Blood sugar level.
• Testing for glucose tolerance. Glucose tolerance test- This is a technique for double blood sampling: on an empty stomach, and two hours after the “load” (drinking sweet water). The evaluation of the results is made according to the table of standards.
• Blood test for HbA1c - glycated hemoglobin. This study makes it possible to track the change in carbohydrate metabolism over a period of 120 days by comparing the percentage of glucose and protein (hemoglobin) in blood cells. The percentage norm of glycated hemoglobin by age is: age up to 30 years - up to 5.5%, up to 50 years - up to 6.5%.
• General analysis urine. Glycosuria (sugar in the urine) in diabetes is allowed in the range of 0.06-0.083 mmol / l. If necessary, a Reberg test can be added to assess the concentration of creatinine (metabolic product) and albumin protein.
• Biochemical analysis blood. First of all, the indicators of liver enzymes AST (aspartate aminotransferase), ALT (alanine aminotransferase), Alpha-Amylase, alkaline phosphatase ( alkaline phosphatase), bile pigment (bilirubin), and cholesterol levels.

The main goal of diagnosis is to differentiate Lada diabetes from the first and second types of pathology. If Lada diabetes is suspected, extended diagnostic criteria have been adopted. The patient undergoes blood tests to determine the concentration of immunoglobulins (Ig) to specific antigens- enzyme immunoassay or ELISA. Laboratory diagnostics evaluates three main types of antibodies (immunoglobulins of the IgG class).

ICA (antibodies to pancreatic islet cells). Islets are clusters in the tail of a gland endocrine cells. Autoantibodies to islet cell antigens are detected in the presence of diabetes in 90% of cases. Anti-IA-2 (to the enzyme tyrosine phosphatase). Their presence indicates the destruction of pancreatic cells. Anti-GAD (to the enzyme glutamate decarboxylase). The presence of antibodies (positive) confirms autoimmune damage to the pancreas. A negative result rules out type 1 diabetes and type Lada.

Separately, the level of C-peptide is determined as a stable indicator of insulin production in the body. The analysis is carried out in two stages, similar to glucose tolerance testing. A reduced level of C-peptide indicates low insulin production, that is, the presence of diabetes. The results obtained during diagnosis can be as follows: negative Anti-GAD - no Lada-diagnosis, positive Anti-GAD in the background low scores C-peptide - the presence of Lada-diabetes.

In the case when antibodies to glutamate decarboxylase are present, but the C-peptide does not go beyond the normative limits, the patient needs additional examination by determining genetic markers. When making a diagnosis, attention is given to age category patient. Additional diagnostics necessary for young patients. Be sure to measure the body mass index (BMI). In insulin-independent type 2 disease, the main symptom is overweight, patients with Lada diabetes have a normal BMI (from 18.1 to 24.0) or insufficient (from 16.1 to) 17.91.

Of the hardware diagnostic methods, ultrasound is used abdominal cavity to study the state of the pancreas and ECG (electrocardiogram of the heart).

Treatment of pathology

Therapy of the disease is based on the use of medications, diet, moderate physical activity.

insulin therapy

The main drug treatment consists in the selection of adequate doses of insulin, corresponding to the stage of the disease, the presence of concomitant pathologies, the weight and age of the patient. Early use of insulin therapy helps to stabilize sugar levels, not overload the cells of the pancreas (they are quickly destroyed during intensive work), stop autoimmune processes, and maintain the residual performance of insulin.

When the gland retains reserves, it is easier for the patient to maintain a stable normal level of glucose in the blood. In addition, such a "reserve" allows you to delay the development of diabetic complications, and reduces the risk of a sharp drop in sugar (hypoglycemia). Early prescription of insulin preparations is the only correct tactic for managing the disease.

According to medical research, early insulin therapy for Lada diabetes gives a chance to restore the pancreas to produce its own insulin, albeit in a small amount. The treatment regimen, the choice of drugs and their dosage are determined only by the endocrinologist. Self-medication is unacceptable. Hormone doses, at the initial stage of treatment, are maximally reduced. Combination therapy with short and prolonged insulins is prescribed.

diet therapy

In addition to drug treatment, the patient must follow a diabetic diet. Nutrition is based on the therapeutic diet "Table No. 9" according to the classification of Professor V. Pevzner. The main emphasis in the daily menu is on vegetables, fruits, cereals and legumes with a low glycemic index (GI). GI is the rate of breakdown of food that enters the body, release of glucose, and its resorption (absorption) into the systemic circulation. Thus, the higher the GI, the faster glucose enters the bloodstream and the sugar levels “jump”.

Brief table of products indicating the glycemic index

Foods indexed from 0 to 30 are allowed, you can eat foods with an average GI (from 30 to 70) to a limited extent

It is strictly forbidden to use simple fast carbohydrates: confectionery desserts, milk chocolate and sweets, pastries from puff, butter, shortbread dough, ice cream, marshmallows, jams, jams, packaged juices and bottled tea. If not change eating behavior, treatment will not give positive results.

Physical training

Another important normalization method sugar indicators are rational physical activity on a regular basis. Sports activity increases glucose tolerance, as cells are enriched with oxygen during exercise. Recommended activities include gymnastics, moderate fitness, Finnish walking, swimming in the pool. Training should be appropriate to the patient's capabilities, without overloading the body.

As with other types of diabetes, patients should perform medical recommendations:

• purchase a glucometer, and monitor glucose readings several times in laziness;
• master the injection technique, and inject insulin in a timely manner;
• follow the rules of diet therapy;
• exercise regularly;
• keep a "Diary of a diabetic", which records the time and dose of insulin, as well as the qualitative and quantitative composition of the food eaten.

It is impossible to cure diabetes mellitus, but a person can take control of the pathology in order to improve the quality of life and increase its duration.

In diabetes, there is a constantly increased level of glucose in the body. If a sick person learns to competently monitor their well-being, keeping sugar at a normal level, then diabetes will turn from a serious illness into a special way of life that will not pose a threat.

There are several varieties of diabetes mellitus, which are closely related to the violation of metabolic processes in the body of a sick person. Each of the types of the disease, in addition to hyperglycemia, manifests itself by producing glucose in the urine. Against this background, the following symptoms may occur:

1. thirst begins to increase quite significantly;
2. appetite increases rapidly;
3. there is an imbalance fat metabolism substances in the form of hyperlipidemia, as well as dyslipidemia;
4. mineral metabolism in the body is disturbed;
5. complications of other ailments begin.

A significant increase in the number of patients with diabetes mellitus has necessitated the identification of various kinds this disease in order to clearly understand the difference between one condition and another.

If until recently, medicine believed that only people over 45 years of age could suffer from type 2 diabetes, today the age range of this disease has been shifted to 35.

Every year, the second type of diabetes mellitus is diagnosed in younger patients, which is associated with poor nutrition and the wrong way life.

The main classification of the disease

modern medicine identifies several main types of diabetes at once, which people can suffer, regardless of their age:

• Type I DM is insulin dependent. It is formed in the human body against the background of a decrease in the amount of this hormone. It usually occurs in young children, adolescents and young adults. With this ailment, it is important to inject yourself a certain dose of insulin daily;
• Type II disease is independent of the hormone insulin and can develop even with an excessive amount of it in the human blood. The second type of DM is typical for people over 40 years of age and develops against the background of an increase in body weight. In this type of diabetes, health can be improved by making dietary adjustments, shedding excess pounds, and by increasing the intensity and saturation of physical activity. Such diabetes mellitus in medicine is usually divided into two subtypes. Subtype A develops against the background of overweight, and subtype B is typical for lean patients.

In addition to the main types of SD, there are also its specific varieties:

1. LADA diabetes. It is characterized by a certain similarity with the disease of the first type, however, the speed of its course is slow. If we talk about the final stages of LADA diabetes, then it can be diagnosed as type 2 diabetes. At the moment, this name is outdated, and the term autoimmune diabetes mellitus has replaced it;
2. MODY-diabetes is a type of class A disease that is purely symptomatic and can be formed against the background of problems with the pancreas, with hemochromatosis, as well as cystic fibrosis;
3. drug-induced diabetes (class B diabetes);
4. class C diabetes mellitus, which occurs when the endocrine system is disturbed.

Differences between LADA-diabetes and other forms of the disease

The term LADA diabetes itself was assigned to a latent form of autoimmune diabetes in adult patients. All those who fall into this category of patients, along with patients with the first type of the disease, are in dire need of mandatory insulin therapy. As a rule, along with problems with sugar, in the body of patients there is a breakdown of pancreatic cells that produce insulin. As a result, an autoimmune process occurs.

AT medical practice you can meet the opinion that LADA-diabetes is sluggish, and sometimes it is also called DM "1.5".

Similar pathological condition characterized by the death of all cells of the insular apparatus upon reaching the patient of 35 years of age. The whole process is quite slow and similar to the course of type 2 diabetes.

The main difference is that in this case, absolutely all beta cells die, which causes the cessation of insulin secretion in the pancreas.

As a rule, complete dependence on the additional administration of insulin is formed within 1 to 3 years from the onset of the disease. It passes with characteristic symptoms in both males and females.

The course of the disease is more suitable for the second type, because for a sufficiently long time it is possible to control the course of the entire pathological process with the help of exercise and a sensible low-carbohydrate diet.

The relatively positive course of the disease makes it possible to think that DM will recede or its onset will be shifted indefinitely. The most important point in this case will be the control of the level of glycemia.

To raise awareness of patients, special diabetes schools are being created. Their main goal is to convey adequate and correct information to each individual patient that:

1. it is necessary to monitor the level of glycemia;
2. there are ways to control sugar levels;
3. special behavior is provided in the event of complications of diabetes.

How is LADA diabetes diagnosed?

In order to identify signs in a patient that indicate LADA-diabetes, it is necessary, in addition to all standard analyzes on the level of blood glucose, as well as glycated hemoglobin, apply the following practices:

• analysis and disassembly of autoantibodies to ICA cells (islet);
• study of HLA antigens;
• study of autoantibodies to medicines with insulin;
• verification of genetic markers;
• standard autoantibodies to glutamate decarboxylase GAD.

Deviations from the recognized norm in manifestations of such a type as LADA-diabetes will be the following parameters:

1. the patient's age is less than 35 years;
2. establishment of dependence on insulin already after some time (several years);
3. manifestation of symptoms of the second type of diabetes with normal weight or even thinness;
4. there is a compensation for insulin deficiency with the help of special diets and therapeutic physical culture.

For modern medicine, the diagnosis of diabetes mellitus is not difficult. To do this, there are a variety of diagnostic devices that help confirm the diagnosis in patients aged 25 to 50 years in cases where they have classic.

Modern laboratory research help the doctor choose the most effective methods of treatment as accurately as possible and prolong the period of production of the patient's own hormones.

Pregnant women who have been confirmed to have gestational diabetes mellitus are at a potential risk of developing type LADA diabetes. In most cases, these women are prone to developing diabetes after the end of their pregnancy or in the not too distant future. As a rule, the probability of such a course of the disease is noted in 25 percent of cases.

Methods of treatment

As noted, mandatory insulin therapy is provided for patients diagnosed with LADA-diabetes. Doctors recommend not to tighten with injections. If LADA-diabetes has been confirmed, then therapy will be based on this principle.

This category of patients needs the earliest possible detection of the disease and the adequate prescription of drugs, and insulin in particular. First of all, this is due to the high probability of the lack of stimulated insulin production. Very often, insulin deficiency can be combined with the resistance of body cells to this hormone if Lada diabetes is diagnosed.

In such situations, patients may be prescribed special means to reduce sugar in tablet format. Such drugs do not cause dryness of the pancreas, however, at the same time they increase the sensitivity threshold of peripheral tissues to the hormone insulin.

In addition, to medicines that can be prescribed include biguanide derivatives (Metformin), as well as glitazones (Avandia), the full one can be found on our website.

Insulin therapy is extremely important for absolutely all patients suffering from LADA-diabetes. In this case, administering insulin as early as possible will aim to save natural basal insulin production for as long as possible.

Those patients who are carriers of LADA-diabetes should be limited in the use of secretogens. These drugs are able to stimulate the production of insulin and will lead to rapid depletion of the pancreas, and then to insulin deficiency in patients with type Lada diabetes.

It will be a great addition to therapy.

Lada diabetes is a latent autoimmune diabetes that poses a rather serious danger.

It is difficult to diagnose but easily confused with type 2 diabetes.

As a result, the wrong treatment can be prescribed, which will lead to serious complications.

In the second half of the 20th century, nutritionists from Austria discovered a new type of diabetes - lada.

Patients who have antibodies and low levels of C-peptide secretion do not have type 2 diabetes. At the same time, the signs of both pathologies are similar. As a result of the fact that insulin must be administered on early dates, this form is not recognized as type 1. Thus, an intermediate form of pathology was revealed - latent autoimmune diabetes in adults - lada.

This diagnosis means that the beta cells of the pancreas that produce the hormone insulin break down.

As a result, an autoimmune process occurs that is difficult to diagnose without undergoing additional research.

The peculiarity of the disease is that in diabetes mellitus, the cells of the pancreas produce the wrong insulin, so the concentration of sugar in the blood rises.

The second option is that peripheral tissues do not feel insulin produced in proper quantities.

In diabetes, the relevant organs do not produce insulin or produce very little insulin. As a result, beta cells are depleted.

There are several reasons for this phenomenon:

• age: latent diabetes usually affects older people with a weak endocrine system,
• excess weight contributes to the disruption of metabolic processes,
• pancreatic diseases,
• genetic predisposition to diabetes
• pregnancy.

People who are predisposed to the appearance of autoimmune diabetes should be attentive to changes in the body. When the first symptoms of the disease appear, you should consult a doctor.

Lada diabetes has the following symptoms:

• increased fatigue, impotence,
• dizziness,
• in some cases, the body temperature increases,
• high blood sugar levels,
• constant thirst, as a result of frequent urination,
• plaque on the tongue,
• the smell of acetone from the mouth.

Most often, the disease proceeds without pronounced symptoms.

It can occur during pregnancy or after the baby is born. Adult women develop autoimmune diabetes earlier than men (around age 25).

The mechanisms of occurrence of pathology are similar to other types of diabetes. At the same time, there are certain differences.

Differences between type 1 and type 1 diabetes.

• in the first case, people fall ill after 35 years (women after 25), type 1 diabetes does not depend on age.
• the symptoms of diabetes mellitus resemble the signs of some other diseases, which is why an incorrect diagnosis is made and incorrect treatment is prescribed.
• the disease is mild, sometimes exacerbated, the need for insulin is low.

Difference between lada diabetes and type 2.

• overweight is observed not in all cases.
• six months later, you may need insulin injections.
• blood contains antibodies - signs of autoimmune diabetes.
• the use of drugs does not reduce high sugar.

The main difference is the death of all beta cells, insulin ceases to be produced by the pancreas.

After 1-3 years, complete dependence on additional insulin is formed. This does not depend on gender. The course of the disease resembles type 2 diabetes.

Latent autoimmune diabetes in adults has mild symptoms, patients do not feel the disease. In addition, basic analyzes cannot always detect it. A blood test for sugar will show normal results.

Most endocrinologists do not conduct an in-depth examination when diagnosing the type of diabetes. When staging misdiagnosis Medications that lower sugar levels may be prescribed, which is contraindicated in lada diabetes.

Diagnosis of the mode of diabetes involves several procedures. First, they study the analysis of blood and urine.

If there is a suspicion of latent diabetes mellitus, narrowly focused studies are carried out, where they study:

• response to glucose
• glycated hemoglobin,
• antibodies to IAA, IA-2A, ISA,
• fructosamine,
• genotyping,
• microalbumin.

At the same time, the specialist pays attention to the age and weight of the patient, how insulin is produced, the possibility of compensating it with drugs and diet.

Modern medicine makes it possible to recognize autoimmune diabetes mellitus. If the diagnosis is confirmed, the patient is registered. The doctor selects the most effective methods treatment to prolong the work of their own hormones as long as possible.

With the wrong treatment, various complications can occur:

• beta cells are completely destroyed,
• insulin production and levels fall,
• the patient's condition worsens.

In this case, large doses of insulin will be needed.

Lack of treatment leads to the development of disability, and in some cases death.

Unlike other types, Lada diabetes does not require the use of medications, additional insulin is sufficient.

The most effective treatment is one in which insulin is consumed in small doses. In some cases, prolonged insulin is prescribed, which is diluted (since a small dosage is needed). Injections are carried out regardless of sugar levels.

If therapy is started early, patients can restore their natural insulin production. In this case, patients live to a ripe old age without complications.

In addition to insulin therapy, doctors prescribe:

• diet - you need to eat foods low in carbohydrates,
• physical activity - it is not necessary to engage in professional sports, a small charge daily is enough,
• regular monitoring of blood sugar - readings should be monitored even at night,
• refusal of drugs that are contraindicated for diabetics.

The main goal of treating autoimmune diabetes is to stop the death of beta cells due to immune changes. It is contraindicated to use preparations containing sulfourea, as they contribute to the death of beta cells. It is also necessary to reduce the load on the pancreas.

It happens that insufficient insulin is accompanied by insulin resistance. In this case, patients should take oral hypoglycemic drugs. These funds increase the threshold of sensitivity of peripheral tissues to insulin.

With the permission of the attending physician, you can use folk methods treatment: take decoctions and tinctures that help reduce blood sugar levels.

To raise awareness of patients, special schools of diabetes are being created. They tell basic information about how to measure sugar correctly, what to do in case of complications.

If you notice the symptoms of diabetes lada mellitus in time, you can avoid further development illness.

Among preventive measures the following can be distinguished:

• If the patient finds that his weight is significantly higher than the norm, it is necessary to return his previous dimensions. To do this, use the following two points.
• Physical exercise. walking, running in the morning or in the evening, swimming, cycling.
• Compliance with dietary nutrition. As already mentioned, foods should be low-carbohydrate. It is necessary to eat fractionally (small portions) and often. Avoid sweet, fatty foods.
• follow emotional state: less nervous, tune in a positive way.
• Control of blood sugar levels by persons prone to diabetes.

It should be remembered that prevention should be regular. One dietary breakfast and two runs are not enough to overcome the disease.

Thus, if you do not pay attention to the symptoms in time, diagnose and treat Lada diabetes, various complications may appear. When diagnosing diabetes mellitus, additional studies should be carried out in order to prescribe a correct and effective therapy.