When it is not Type 1 or Type 2 Diabetes mellitus: A case of Slowly Evolving Immune-mediated Diabetes of Adult

https://www.doi.org/10.60787/tnhj-759

Authors

  • Okunowo BO Lagos State University Teaching Hospital
  • Shittu F Maryamville Hospital, Lagos

Keywords:

C-peptide, diabetes mellitus, islet cell autoantibodies, latent autoimmune diabetes of adult

Abstract

Background: Slowly Evolving Immune-mediated Diabetes of Adult (SEIDA) previously termed Latent Autoimmune Diabetes of Adult (LADA) is a heterogenous disorder characterized by the presence of serum islet autoantibodies at diagnosis with slow progression of islet failure. These patients often require insulin therapy within six months of diagnosis. Most of the presenting clinical symptoms can mimic either type 1 or type 2 diabetes mellitus.

Methods: We report a clinical case of a 37-year-old woman who was newly diagnosed with Type 2 diabetes mellitus.

Finding: She presented with history of polyuria, polydipsia, and weight loss of six months duration with a family history of type 2 diabetes mellitus in her father. She presented with worsening glycemic control despite her adherence to her medications. A clinical suspicion of SEIDA was made in view of her age and worsening glycemic control. This was confirmed with a positive result of serum Glutamic Acid Decarboxylase -65 (GAD-65) and low serum c-peptide levels.

Conclusion: This is to alert physicians that not all diabetes mellitus is type 1 or type 2 hence SEIDA should be suspected in any young adults presenting with features of uncontrolled diabetes mellitus in spite of optimal doses of oral hypoglycemic agents.

Author Biography

Shittu F, Maryamville Hospital, Lagos

He is the Medical Director, Maryamville Hospital, Lagos

References

World Health Organization. (‎2019)‎. Classification of diabetes mellitus. World Health Organization. https://apps.who.int/iris/handle/10665/325182.

Rajkumar V, Levine SN. Latent Autoimmune Diabetes. [Updated 2022 Jun 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; Jan 2023: https://www.ncbi.nlm.nih.gov/books/NBK557897/

Raffaella Buzzetti, Tiinamaija Tuomi, Didac Mauricio, Massimo Pietropaolo, Zhiguang Zhou, Paolo Pozzilli, Richard David Leslie; Management of Latent Autoimmune Diabetes in Adults: A Consensus Statement from an International Expert Panel. Diabetes 1 October 2020; 69: 2037–2047.

Adeleye OO, Ogbera AO, Fasanmade O, Ogunleye OO, Dada AO, Ale AO, Abatan FM. Latent Autoimmune Diabetes Mellitus in Adults (LADA) and its characteristics in a subset of Nigerians initially managed for type 2 diabetes. Int Arch Med. 2012; 15:23-26.

Muazu SB, Okpe I, Anumah F. The prevalence and characteristics of latent autoimmune diabetes in adults’ subset among type two diabetes mellitus patients in Northern Nigeria. Ann Afr Med. 2016; 15:163-170.

Arinola Ipadeola, Jokotade O. Adeleye, Kehinde S. Akinlade, Latent autoimmune diabetes amongst adults with type 2 diabetes in a Nigerian tertiary hospital. Primary Care Diabetes. 2015;9: 231-236,

Nark RG, Brooks –Worrell BM, Palmer JP. Latent autoimmune diabetes in adult. J clin Endocrinol Metab 2009;94: 4635-4644

Pipi E, Marketou M, Tsirogianni A. Distinct clinical and laboratory characteristics of latent autoimmune diabetes in adult in relation to type 1 and type 2 diabetes mellitus. World J Diabetes 2014;5:505-510

Fourlanos S, Dotta F, Greenbaum CJ. Latent autoimmune diabetes in adult (LADA) should be less latent. Diabetologia 2005;48: 2206-2212

Tuomi T, Gnop LC, Zimmet PZ. Antibodies to glutamic acid decarboxylase reveal latent autoimmune diabetes mellitus in adult with a non-insulin-dependent onset of disease. Diabetes 1993;42: 359-362

Tiberti C, Giordano C, Locatelli M. Identification of tyrosine phosphatase 2 as a new sensitive marker for the detection of islet autoimmunity in type 2 diabetes patients. Diabetes 2008; 57: 1276-1283

Johansen OE, Bocm BO, Grill V. C peptide levels in latent autoimmune diabetes of adult treated with linagliptin versus glimepiride exploratory results from a 2 year double blind randomized control study. Diabetes care 2014; 37: E11-E12.

Rajkumar V, Levine SN. Latent Autoimmune Diabetes. [Updated 2022 Jun 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557897/

Downloads

Published

2024-01-15

How to Cite

Okunowo, B., & Shittu, F. (2024). When it is not Type 1 or Type 2 Diabetes mellitus: A case of Slowly Evolving Immune-mediated Diabetes of Adult : https://www.doi.org/10.60787/tnhj-759. The Nigerian Health Journal, 23(4), 997–1000. Retrieved from https://tnhjph.com/index.php/tnhj/article/view/759

Issue

Section

Case Report and Series

Similar Articles

1 2 3 4 5 6 7 8 > >> 

You may also start an advanced similarity search for this article.