Treatment of Latent Autoimmune Diabetes in Adults (LADA)
LADA is characterised by an autoimmune process that leads to progressive beta-cell impairment in adults. This autoimmune basis distinguishes it from other diabetes types and makes therapy selection a critical clinical decision.
This protocol addresses first-line management of LADA — a clinical scenario in which the underlying autoimmune response drives beta-cell loss and requires a specific, evidence-informed approach to treatment.
Treatment approach
The protocol identifies a specific class of therapy as the treatment of choice in LADA, with guidance on when to initiate it and which agents carry particular concerns in this population. The full sequence, selection criteria, and clinical decision points are available in the complete protocol…
References
DOI: 10.4093/dmj.2018.0190
- Considering the autoimmune response in LADA, which generally lead to the β-cell impairment, insulin therapy should ideally represent the treatment of choice in these subjects.
- To date, according to the outcomes of large randomized clinical trials, physicians tend to prescribe insulin therapy at an earlier stage in patients with LADA, regardless C-peptide levels and residual β-cell function.
- To date, evidence shows that patients with LADA should be treated with insulin at an earlier stage, whereas sulfonylureas are discouraged due to their effects on β-cells.
- Therefore, it is recommended that sulfonylureas should be avoided in patients with LADA/SPIDDM.
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