Treatment of Latent Autoimmune Diabetes in Adults: Sustaining Residual Beta-Cell Function
Latent autoimmune diabetes in adults (LADA) is characterised by progressive autoimmune beta-cell loss in the context of an adult presentation. A defining clinical opportunity is the window during which residual insulin secretion remains measurable — making its preservation the central therapeutic objective.
Clinical Goal
Maintenance of residual beta-cell function, reflected by preserved serum C-peptide secretion.
Treatment Approach — Partial Overview
Evidence supports add-on therapy to insulin with a specific class of incretin-based agents; in patients with more pronounced insulin-resistant traits, an insulin sensitizer may also be considered. The full selection criteria, agent choices, and sequencing are in the complete protocol.
References
DOI: 10.4093/dmj.2018.0190
- Based on the newest evidences, DPP-4 inhibitors and GLP-1RAs might be used in LADA as an add-on therapy to insulin to sustain residual β-cell function, especially in patients with a relative maintenance of C-peptide secretion.
- With respect to LADA, interesting findings emerge from three recent trials, testing the role of sitagliptin, linagliprin, and saxagliptin in preserving β-cell function.
- Insulin sensitizers have been shown to be helpful in subjects with autoimmune diabetes who share more pronounced insulin-resistant traits.
- Thus, insulin sensitizers might be helpful in subjects with LADA who share more pronounced insulin-resistant features.
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