Revista Cubana de Endocrinología
versão On-line ISSN 1561-2953
CABRERA RODE, Eduardo; PERICH AMADOR, Pedro A. e LICEA PUIG, Manuel E.. Latent autoimmune diabetes of the adult or type 1 diabetes of slow progression: definition, pathogeny, clinic, diagnosis and treatment. Rev Cubana Endocrinol [online]. 2002, vol.13, n.1, pp. 0-0. ISSN 1561-2953.
It is known that diabetes mellitus is an heterogeneous syndrome that has as a common element a chronic hyperglycaemia resulting from an insulin deficiency or from an insufficient effectiveness of its action. It is our purpose to describe the most significant aspects of the autoimmune diabetes of the adult and to show the result of our experience. It is considered that subjects suffer from it when they are initially classified as type 2 diabetics, with an onset of the disease after the age of 34. They generally have normal or low body weight and in a relatively short time need insulin treatment to attain a good metabolic control. They also present a greater association with the production of islet cell antibodies (ICA), antiglutamic acid decarboxylase (AGAD65), thyroid microsomial antibodies and parietal antigastric antibodies, with a genetic susceptibility due to the presence of HLA-DR haplotypes. They may have or not insulin deficiency at the time of the clinical diagnosis. It has been proved that insulin therapy is the ideal treatment for individuals with LADA. A high rate of negative conversion of the ICA with an increase of the levels of C-peptide in serum has been evidenced. On the contrary, the sulphonylurea treatment produces a persistence of the ICA, which are probably responsible for the destruction of the b-cells of the pancreas. Therefore, these observations justify the election of insulin therapy at the very moment of the diagnosis.
Palavras-chave : DIABETES MELLITUS, INSULIN DEPENDENT [classification]; DIABETES MELLITUS, INSULIN DEPENDENT [diagnosis]; DIABETES MELLITUS, INSULIN DEPENDENT [drug therapy].