Is latent autoimmune diabetes in adults distinct from type 1 diabetes or just type 1 diabetes at an older age?

被引:93
作者
Palmer, JP
Hampe, CS
Chiu, H
Goel, A
Brooks-Worrell, BM
机构
[1] DVA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA
[2] Univ Washington, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA
关键词
D O I
10.2337/diabetes.54.suppl_2.S62
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Diabetes is classified clinically into two types: type 1 and type 2 diabetes. Type 1 diabetes is an autoimmune diabetes, whereas, in contrast, type 2 diabetes is nonautoimmune. However, there is a group of phenotypic adult type 2 diabetic patients (similar to 10%) who have islet autoantibodies similar to type 1 diabetes. These patients are said to have latent autoimmune diabetes in adults (LADA) or type 1.5 diabetes. T-cells reacting with islet proteins have been demonstrated in type 1 and type 1.5 diabetic patients. In contrast, classic autoantibody-negative type 2 diabetic patients are also negative for T-cell responses to islet proteins. Therefore, we questioned whether type 1 and type 1.5 diabetes are similar or different autoimmune diseases. We have investigated the immunological and metabolic differences between type 1, type 1.5, and classic type 2 diabetic patients. We have identified autoantibody differences, differences in islet proteins recognized by T-cells, and differences in insulin resistance. We have also identified a small group of patients who have T-cells responsive to islet proteins but who are autoantibody negative. These patients appear to be similar to type 1.5 patients in having decreased stimulated C-peptide values. These immunological differences between type I and type 1.5 diabetes suggest at least partially distinct disease processes.
引用
收藏
页码:S62 / S67
页数:6
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