{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:40:07Z","timestamp":1787020807295,"version":"build-2736575974"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T00:00:00Z","timestamp":1606780800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T00:00:00Z","timestamp":1606953600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Diabetol Metab Syndr"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Adult-onset autoimmune diabetes (AID) has two different phenotypes: classic type 1 diabetes mellitus (T1DM), with insulin requirement just after diagnosis, and latent autoimmune diabetes in adults (LADA). The purpose of this study is to characterize patients with AID followed on a tertiary centre, comparing classic T1DM and LADA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We collected data from patients with diabetes and positive islet autoantibodies, aged 30\u00a0years old and over at diagnosis. Patients who started insulin in the first 6\u00a0months were classified as T1DM and patients with no insulin requirements in the first 6\u00a0months were classified as LADA. Data regarding clinical presentation, autoantibodies, A1C and C-peptide at diagnosis, pharmacologic treatment and complications were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 92 patients, 46 with classic T1DM and 46 with LADA. The percentage of females was 50% in T1DM group and 52.1% in LADA group. The median age at diagnosis was 38\u00a0years (IQR\u201315) for T1DM and 42\u00a0years (IQR\u201315) for LADA (\n                      <jats:italic>p\u2009<\/jats:italic>\n                      =\u20090.057). The median time between diagnosis of diabetes and diagnosis of autoimmune aetiology was 0\u00a0months in T1DM group and 60\u00a0months in LADA group (\n                      <jats:italic>p\u2009<\/jats:italic>\n                      &lt;\u20090.001). The mean BMI at diagnosis was 24.1\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      in T1DM group and 26.1\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      in LADA group (\n                      <jats:italic>p\u2009<\/jats:italic>\n                      =\u20090.042). In T1DM group, 67.4% of the patients had more than one positive autoantibody, comparing to 41.3% of LADA patients (\n                      <jats:italic>p\u2009<\/jats:italic>\n                      =\u20090.012). There was no statistical difference in what concerns to title of GAD autoantibodies, A1C and C-peptide at diagnosis of autoimmune aetiology. The presence of symptoms at diagnosis was associated with T1DM group (\n                      <jats:italic>p\u2009<\/jats:italic>\n                      &lt;\u20090.001). The median daily insulin dose was 40\u00a0IU for T1DM (0.58\u00a0IU\/kg) and 33.5\u00a0IU for LADA (0.57\u00a0IU\/kg), with no statistical difference. LADA patients were more often under non-insulin antidiabetic drugs (\n                      <jats:italic>p\u2009<\/jats:italic>\n                      =\u20090.001). At 10\u00a0years follow up, 21.1% of T1DM patients and 63.3% of LADA patients had microvascular complications (\n                      <jats:italic>p\u2009<\/jats:italic>\n                      =\u20090.004). Diabetic nephropathy was present in 23.5% of T1DM patients and 53.3% of LADA patients (\n                      <jats:italic>p\u2009<\/jats:italic>\n                      =\u20090.047). At the last evaluation, 55.6% of T1DM and 82.6% of LADA patients had metabolic syndrome and this difference was independent of diabetes duration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with classic T1DM presented more often with symptoms, lower BMI and higher number of autoantibodies, which may be related to a more aggressive autoimmune process. Patients with LADA developed more frequently microvascular complications for the same disease duration, namely diabetic nephropathy, and had more often metabolic syndrome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13098-020-00616-1","type":"journal-article","created":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T06:03:41Z","timestamp":1606975421000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Adult-onset autoimmune diabetes: comparative analysis of classical and latent presentation"],"prefix":"10.1186","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1513-2722","authenticated-orcid":false,"given":"L\u00facia","family":"Fadiga","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joana","family":"Saraiva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Catarino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o","family":"Frade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Melo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Paiva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,12,3]]},"reference":[{"issue":"11","key":"616_CR1","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1038\/nrendo.2017.99","volume":"13","author":"R Buzzetti","year":"2017","unstructured":"Buzzetti R, Zampetti S, Maddaloni E. Adult-onset autoimmune diabetes: current knowledge and implications for management. Nat Rev Endocrinol. 2017;13(11):674\u201386. https:\/\/doi.org\/10.1038\/nrendo.2017.99.","journal-title":"Nat Rev Endocrinol."},{"issue":"3","key":"616_CR2","doi-asserted-by":"publisher","first-page":"199","DOI":"10.2174\/1573399814666180730105351","volume":"15","author":"EP S\u00f8rgjerd","year":"2019","unstructured":"S\u00f8rgjerd EP. Type 1 diabetes-related autoantibodies in different forms of diabetes. Curr Diabetes Rev. 2019;15(3):199\u2013204. https:\/\/doi.org\/10.2174\/1573399814666180730105351.","journal-title":"Curr Diabetes Rev"},{"key":"616_CR3","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2890","author":"A Kumar","year":"2017","unstructured":"Kumar A, de Leiva A. Latent autoimmune diabetes in adults (LADA) in Asian and European populations. Diabetes Metab Res Rev. 2017. https:\/\/doi.org\/10.1002\/dmrr.2890.","journal-title":"Diabetes Metab Res Rev."},{"issue":"11","key":"616_CR4","doi-asserted-by":"publisher","first-page":"2206","DOI":"10.1007\/s00125-005-1960-7","volume":"48","author":"S Fourlanos","year":"2005","unstructured":"Fourlanos S, Dotta F, Greenbaum CJ, Palmer JP, Rolandsson O, Colman PG, Harrison LC. Latent autoimmune diabetes in adults (LADA) should be less latent. Diabetologia. 2005;48(11):2206\u201312.","journal-title":"Diabetologia"},{"issue":"7","key":"616_CR5","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1111\/dme.12700","volume":"32","author":"E Laugesen","year":"2015","unstructured":"Laugesen E, \u00d8stergaard JA, Leslie RD. Danish Diabetes Academy Workshop and Workshop Speakers. Latent autoimmune diabetes of the adult: current knowledge and uncertainty. Diabet Med. 2015;32(7):843\u201352. https:\/\/doi.org\/10.1111\/dme.12700.","journal-title":"Diabet Med"},{"issue":"10","key":"616_CR6","doi-asserted-by":"publisher","first-page":"320","DOI":"10.3389\/fphys.2019.00320","volume":"26","author":"S Carlsson","year":"2019","unstructured":"Carlsson S. Etiology and Pathogenesis of Latent Autoimmune Diabetes in Adults (LADA) Compared to Type 2 Diabetes. Front Physiol. 2019;26(10):320. https:\/\/doi.org\/10.3389\/fphys.2019.00320.","journal-title":"Front Physiol."},{"issue":"16","key":"616_CR7","doi-asserted-by":"publisher","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","volume":"120","author":"KG Alberti","year":"2009","unstructured":"Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120(16):1640\u20135. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.109.192644.","journal-title":"Circulation"},{"issue":"3","key":"616_CR8","first-page":"1","volume":"2013","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO","year":"2012","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO. clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2012;2013(3):1\u2013150.","journal-title":"Kidney Int Suppl"},{"key":"616_CR9","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.1007\/s00592-019-01387-6","volume":"56","author":"L Yang","year":"2019","unstructured":"Yang L, Liu X, Liang H, et al. Pathophysiological characteristics in patients with latent autoimmune diabetes in adults using clamp tests: evidence of a continuous disease spectrum of diabetes. Acta Diabetol. 2019;56:1217\u201324. https:\/\/doi.org\/10.1007\/s00592-019-01387-6.","journal-title":"Acta Diabetol"},{"issue":"5","key":"616_CR10","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1111\/j.1399-5448.2006.00198.x","volume":"7","author":"LC Stene","year":"2006","unstructured":"Stene LC, Barriga K, Hoffman M, et al. Normal but increasing hemoglobin A1c levels predict progression from islet autoimmunity to overt type 1 diabetes: diabetes Autoimmunity Study in the Young (DAISY). Pediatr Diabetes. 2006;7(5):247\u201353.","journal-title":"Pediatr Diabetes"},{"key":"616_CR11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s13340-014-0199-2","volume":"6","author":"S Tanaka","year":"2015","unstructured":"Tanaka S, Ohmori M, Awata T, et al. Diagnostic criteria for slowly progressive insulin-dependent (type 1) diabetes mellitus (SPIDDM) (2012): report by the Committee on Slowly Progressive Insulin-Dependent (Type 1) Diabetes Mellitus of the Japan Diabetes Society. Diabetol Int. 2015;6:1\u20137. https:\/\/doi.org\/10.1007\/s13340-014-0199-2.","journal-title":"Diabetol Int"},{"key":"616_CR12","unstructured":"Classification of diabetes mellitus. Geneva: World Health Organization; 2019. Licence: CC BY-NC-SA 3.0 IGO."},{"issue":"1","key":"616_CR13","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.endinu.2016.09.001","volume":"64","author":"A Arranz Mart\u00edn","year":"2017","unstructured":"Arranz Mart\u00edn A, Lecumberri Pascual E, Brito Sanfiel M\u00c1, et al. Clinical and metabolic profile of patients with latent autoimmune diabetes in adults in specialized care in Madrid. Endocrinol Diabetes Nutr. 2017;64(1):34\u20139. https:\/\/doi.org\/10.1016\/j.endinu.2016.09.001.","journal-title":"Endocrinol Diabetes Nutr."},{"issue":"4","key":"616_CR14","doi-asserted-by":"publisher","first-page":"505","DOI":"10.4239\/wjd.v5.i4.505","volume":"5","author":"E Pipi","year":"2014","unstructured":"Pipi E, Marketou M, Tsirogianni A. Distinct clinical and laboratory characteristics of latent autoimmune diabetes in adults in relation to type 1 and type 2 diabetes mellitus. World J Diabetes. 2014;5(4):505\u201310. https:\/\/doi.org\/10.4239\/wjd.v5.i4.505.","journal-title":"World J Diabetes."},{"issue":"2","key":"616_CR15","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1210\/jc.2017-01706","volume":"103","author":"OP Zaharia","year":"2018","unstructured":"Zaharia OP, Bobrov P, Strassburger K, et al. Metabolic characteristics of recently diagnosed adult-onset autoimmune diabetes mellitus. J Clin Endocrinol Metab. 2018;103(2):429\u201337. https:\/\/doi.org\/10.1210\/jc.2017-01706.","journal-title":"J Clin Endocrinol Metab"},{"issue":"12","key":"616_CR16","doi-asserted-by":"publisher","first-page":"2461","DOI":"10.2147\/DMSO.S191007","volume":"28","author":"A Nishimura","year":"2019","unstructured":"Nishimura A, Matsumura K, Kikuno S, Nagasawa K, Okubo M, Mori Y, Kobayashi T. Slowly progressive type 1 diabetes mellitus: current knowledge and future perspectives. Diabetes Metab Syndr Obes. 2019;28(12):2461\u201377. https:\/\/doi.org\/10.2147\/DMSO.S191007.","journal-title":"Diabetes Metab Syndr Obes."},{"issue":"10","key":"616_CR17","doi-asserted-by":"publisher","first-page":"3759","DOI":"10.1210\/jc.2012-2037","volume":"97","author":"S Zampetti","year":"2012","unstructured":"Zampetti S, Capizzi M, Spoletini M, Campagna G, Leto G, Cipolloni L, Tiberti C, Bosi E, Falorni A, Buzzetti R, NIRAD Study Group. GADA titer-related risk for organ-specific autoimmunity in LADA subjects subdivided according to gender (NIRAD study 6). J Clin Endocrinol Metab. 2012;97(10):3759\u201365. https:\/\/doi.org\/10.1210\/jc.2012-2037.","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"616_CR18","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1007\/s13340-015-0211-5","volume":"7","author":"S Tanaka","year":"2015","unstructured":"Tanaka S, Okubo M, Nagasawa K, Takizawa S, Ichijo M, Ichijo S, Kaneshige M, Aida K, Shimura H, Mori Y, Kobayashi T. Predictive value of titer of GAD antibodies for further progression of beta cell dysfunction in slowly progressive insulin-dependent (type 1) diabetes (SPIDDM). Diabetol Int. 2015;7(1):42\u201352. https:\/\/doi.org\/10.1007\/s13340-015-0211-5.","journal-title":"Diabetol Int."},{"issue":"1","key":"616_CR19","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/s12916-017-0846-0","volume":"15","author":"R Mishra","year":"2017","unstructured":"Mishra R, Chesi A, Cousminer DL, et al. Relative contribution of type 1 and type 2 diabetes loci to the genetic etiology of adult-onset, non-insulin-requiring autoimmune diabetes. BMC Med. 2017;15(1):88. https:\/\/doi.org\/10.1186\/s12916-017-0846-0.","journal-title":"BMC Med."},{"issue":"10","key":"616_CR20","doi-asserted-by":"publisher","first-page":"4815","DOI":"10.1210\/jc.2019-00183","volume":"104","author":"R Hjort","year":"2019","unstructured":"Hjort R, L\u00f6fvenborg JE, Ahlqvist E, et al. Interaction between overweight and genotypes of HLA, TCF7L2, and FTO in relation to the risk of latent autoimmune diabetes in adults and type 2 diabetes. J Clin Endocrinol Metab. 2019;104(10):4815\u201326. https:\/\/doi.org\/10.1210\/jc.2019-00183.","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"616_CR21","doi-asserted-by":"publisher","first-page":"e66801","DOI":"10.5812\/ijem.66801","volume":"16","author":"I Shahramian","year":"2018","unstructured":"Shahramian I, Bazi A, Sargazi A. An overview of Celiac disease in childhood type 1 diabetes. Int J Endocrinol Metab. 2018;16(3):e66801. https:\/\/doi.org\/10.5812\/ijem.66801.","journal-title":"Int J Endocrinol Metab."},{"issue":"6","key":"616_CR22","doi-asserted-by":"publisher","first-page":"1042","DOI":"10.2337\/dc18-1796","volume":"42","author":"AOY Luk","year":"2019","unstructured":"Luk AOY, Lau ESH, Lim C, et al. Diabetes-related complications and mortality in patients with young-onset latent autoimmune diabetes: a 14-year analysis of the prospective Hong Kong Diabetes Register. Diabetes Care. 2019;42(6):1042\u201350. https:\/\/doi.org\/10.2337\/dc18-1796.","journal-title":"Diabetes Care"},{"issue":"3","key":"616_CR23","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1016\/S2213-8587(20)30003-6","volume":"8","author":"E Maddaloni","year":"2020","unstructured":"Maddaloni E, Coleman RL, Agbaje O, Buzzetti R, Holman RR. Time-varying risk of microvascular complications in latent autoimmune diabetes of adulthood compared with type 2 diabetes in adults: a post hoc analysis of the UK Prospective Diabetes Study 30-year follow-up data (UKPDS 86). Lancet Diabetes Endocrinol. 2020;8(3):206\u201315. https:\/\/doi.org\/10.1016\/S2213-8587(20)30003-6.","journal-title":"Lancet Diabetes Endocrinol."},{"key":"616_CR24","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.diabres.2018.02.042","volume":"139","author":"M Wod","year":"2018","unstructured":"Wod M, Thomsen RW, Pedersen L, Yderstraede KB, Beck-Nielsen H, H\u00f8jlund K. Lower mortality and cardiovascular event rates in patients with Latent Autoimmune Diabetes In Adults (LADA) as compared with type 2 diabetes and insulin deficient diabetes: a cohort study of 4368 patients. Diabetes Res Clin Pract. 2018;139:107\u201313. https:\/\/doi.org\/10.1016\/j.diabres.2018.02.042.","journal-title":"Diabetes Res Clin Pract"},{"issue":"9","key":"616_CR25","doi-asserted-by":"publisher","first-page":"2135","DOI":"10.2337\/diacare.27.9.2135","volume":"27","author":"P Ianne-Parikka","year":"2004","unstructured":"Ianne-Parikka P, Eriksson JG, Lindstr\u00f6m J, H\u00e4m\u00e4l\u00e4inen H, Kein\u00e4nen-Kiukaanniemi S, Laakso M, Louheranta A, Mannelin M, Rastas M, Salminen V, Aunola S, Sundvall J, Valle T, Lahtela J, Uusitupa M, Tuomilehto J, Finnish Diabetes Prevention Study Group. Prevalence of the metabolic syndrome and its components: findings from a Finnish general population sample and the Diabetes Prevention Study cohort. Diabetes Care. 2004;27(9):2135\u201340. https:\/\/doi.org\/10.2337\/diacare.27.9.2135.","journal-title":"Diabetes Care"}],"container-title":["Diabetology &amp; Metabolic Syndrome"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13098-020-00616-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s13098-020-00616-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13098-020-00616-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T06:21:30Z","timestamp":1606976490000},"score":1,"resource":{"primary":{"URL":"https:\/\/dmsjournal.biomedcentral.com\/articles\/10.1186\/s13098-020-00616-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["616"],"URL":"https:\/\/doi.org\/10.1186\/s13098-020-00616-1","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-69978\/v2","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.3.rs-69978\/v1","asserted-by":"object"}]},"ISSN":["1758-5996"],"issn-type":[{"value":"1758-5996","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12]]},"assertion":[{"value":"1 September 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 November 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 December 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the local review boards (Centro Hospitalar e Universit\u00e1rio de Coimbra) and all participants signed the consent to use their data for scientific purpose.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Consent for publication of raw data not obtained, but dataset is fully anonymous.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"107"}}