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Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Physiol. | doi: 10.3389/fphys.2019.00320

Etiology and pathogenesis of latent autoimmune diabetes in adults (LADA) compared to type 2 diabetes

  • 1Karolinska Institutet (KI), Sweden
  • 2Institute of Environmental Medicine, Karolinska Institutet, Sweden

As the heterogeneity of diabetes is becoming increasingly clear, opportunities arise for more accurate assessment of factors influencing disease onset, which may lead to more efficient primary prevention. LADA – latent autoimmune diabetes in adults – is a common, hybrid form of diabetes with features of both type 1 and type 2 diabetes. This review aims to summarize current knowledge on the pathophysiological and etiological overlap and differences between LADA and type 2 diabetes, and point at future research needs. Studies conducted to date show a clear genetic overlap between LADA and type 1 diabetes with a high risk conferred by variants in the HLA region. In contrast, data from the limited number of studies on lifestyle factors available indicate that LADA may share several environmental risk factors with type 2 diabetes including overweight, physical inactivity, alcohol consumption (protective) and smoking. These factors are known to influence insulin sensitivity, suggesting that insulin resistance, in addition to insulin deficiency due to autoimmune destruction of the beta cells, may play a key role in the pathogenesis of LADA. Moreover, this implies that onset of LADA, similar to type 2 diabetes, to some extent could be prevented or postponed by lifestyle modification such as weight reduction and increased physical activity. The preventive potential of LADA is an important topic to elucidate in future studies, preferably intervention studies.

Keywords: LADA (Latent Autoimmune Diabetes in Adults), type 2 diabetes, Epidemiology - analytic (risk factors), lifestyle, prevention

Received: 04 Jan 2019; Accepted: 11 Mar 2019.

Edited by:

Tongzhi Wu, University of Adelaide, Australia

Reviewed by:

Chi-Wen Lung, Asia University, Taiwan
Andrea Sorrentino, Brigham and Women's Hospital, Harvard Medical School, United States  

Copyright: © 2019 Carlsson. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Sofia Carlsson, Karolinska Institutet (KI), Solna, Sweden, sofia.carlsson@ki.se