Diagnostic Dilemmas and Current Treatment Approaches in Latent Onset Autoimmune Diabetes in Adults: A Concise Review.

Abstract

Latent Onset Autoimmune Diabetes in Adults (LADA) is an autoimmune disorder between T1DM and T2DM and is often misdiagnosed as T2DM due to its late onset. The disease is characterized by β-cell failure and slow progression to insulin dependence. Early diagnosis is significant in limiting disease progression. C-peptide levels and autoantibodies against β-cells are the most critical diagnostic biomarkers in LADA. The review aims to understand the biomarkers used to diagnose LADA, and the treatment approaches followed. We have summarized LADA's pathophysiology and the autoantibodies involved in the condition, diagnostic approaches, and challenges. There are clear shortcomings concerning the feasibility of autoantibody testing. Finally, we explored the treatment strategies involved in the management of LADA. In Conclusion, the usual management includes treatment with metformin and the addition of low doses of insulin. The scope of newer oral hypoglycaemic agents such as GLP-1RA and DPP-4 inhibitors are brought into use. Since the disease is not entirely understood in the research level and clinical practice, we hope to encourage further research in this field to find the prevalence. Large randomized controlled trials are required to compare the efficacy of different treatment options available.