{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T01:26:42Z","timestamp":1783906002544,"version":"3.55.0"},"reference-count":11,"publisher":"The Endocrine Society","issue":"8","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Latent autoimmune diabetes in adults (LADA) may be misclassified as type 2 diabetes mellitus (T2DM) and remain unrecognized without targeted evaluation. We describe 2 octogenarians with LADA initially managed as T2DM. The first, an 84-year-old man with chronic kidney disease and normal body mass index, developed glycemic variability with hypoglycemia on multiple daily insulin injections and was intolerant of noninsulin therapies. Evaluation revealed positive pancreatic autoantibodies and preserved C-peptide of 5.68\u2005ng\/mL (SI: 1.89\u2005nmol\/L) (reference range, 1.1-5.5\u2005ng\/mL [SI: 0.37-1.83\u2005nmol\/L]). Following transition to automated insulin delivery (AID), time in range (TIR; glucose 70-180\u2005mg\/dL [SI: 3.9-10.0\u2005mmol\/L]) improved from 33% to 75% and glucose management indicator (GMI) from 8.4% (SI: 68\u2005mmol\/mol; targets individualized) to 7.0% (SI: 53\u2005mmol\/mol), within 1 month, sustained at 6 months without hypoglycemia. The second, an 80-year-old woman receiving insulin and metformin, developed hypoglycemia; evaluation showed positive pancreatic autoantibodies and preserved C-peptide (1.6\u2005ng\/mL [SI: 0.53\u2005nmol\/L]). She underwent treatment de-escalation, achieving control on metformin alone with 77% TIR and GMI of 7.0% (SI: 53\u2005mmol\/mol) at 1 month, sustained at 3 months without hypoglycemia. These cases highlight preserved endogenous insulin secretion and therapeutic heterogeneity in LADA, requiring individualized management, including AID.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag184","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T01:02:59Z","timestamp":1783904579000},"source":"Crossref","is-referenced-by-count":0,"title":["Late-onset autoimmune diabetes in 2 octogenarians: diagnostic misclassification and therapeutic heterogeneity"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8750-3148","authenticated-orcid":false,"given":"Saraswathi","family":"Saiprasad","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Baylor Scott & White Health , Fort Worth, TX 76104 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2319-8982","authenticated-orcid":false,"given":"Narayana","family":"Swamy","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Baylor Scott & White Health , Fort Worth, TX 76104 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"issue":"Supplement_1","key":"2026071221005205300_luag184-B1","doi-asserted-by":"crossref","first-page":"S266","DOI":"10.2337\/dc25-S013","article-title":"13. older adults: standards of care in diabetes\u20142025","volume":"48","author":"American Diabetes Association Professional Practice Committee","year":"2025","journal-title":"Diabetes Care"},{"issue":"12","key":"2026071221005205300_luag184-B2","doi-asserted-by":"crossref","first-page":"4635","DOI":"10.1210\/jc.2009-1120","article-title":"Latent autoimmune diabetes in adults","volume":"94","author":"Naik","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"issue":"Supplement_5","key":"2026071221005205300_luag184-B3","first-page":"S1","article-title":"KDIGO 2022 clinical practice guideline for diabetes management in chronic kidney disease","volume":"102","author":"Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group","year":"2022","journal-title":"Kidney Int"},{"issue":"Supplement_1","key":"2026071221005205300_luag184-B4","doi-asserted-by":"crossref","first-page":"S146","DOI":"10.2337\/dc25-S007","article-title":"7. diabetes technology: standards of care in diabetes\u20142025","volume":"48","author":"American Diabetes Association Professional Practice Committee","year":"2025","journal-title":"Diabetes Care"},{"issue":"22","key":"2026071221005205300_luag184-B5","doi-asserted-by":"crossref","first-page":"2262","DOI":"10.1001\/jama.2021.7444","article-title":"Effect of continuous glucose monitoring on glycemic control in patients with type 2 diabetes treated with basal insulin: a randomized clinical trial","volume":"325","author":"Martens","year":"2021","journal-title":"JAMA"},{"issue":"9950","key":"2026071221005205300_luag184-B6","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1016\/S0140-6736(14)61037-0","article-title":"Insulin pump treatment compared with multiple daily injections for treatment of type 2 diabetes (OpT2mise)","volume":"384","author":"Reznik","year":"2014","journal-title":"Lancet"},{"key":"2026071221005205300_luag184-B7","article-title":"Analysis of detrended fluctuation function derived from continuous glucose monitoring may assist in distinguishing latent autoimmune diabetes in adults from type 2 diabetes","volume":"13","author":"Zhang","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"8","key":"2026071221005205300_luag184-B8","doi-asserted-by":"crossref","first-page":"e3536","DOI":"10.1002\/dmrr.3579","article-title":"The continuous spectrum of glycemic variability changes with pancreatic islet function: a multicenter cross-sectional study","volume":"38","author":"Zhang","year":"2022","journal-title":"Diabetes Metab Res Rev"},{"issue":"1","key":"2026071221005205300_luag184-B9","doi-asserted-by":"crossref","first-page":"16","DOI":"10.2337\/dc14-1770","article-title":"Latent autoimmune diabetes in adults with low-titer GAD antibodies: similar disease progression with type 2 diabetes (LADA China study 3)","volume":"38","author":"Liu","year":"2015","journal-title":"Diabetes Care"},{"issue":"1","key":"2026071221005205300_luag184-B10","article-title":"Missed autoimmune diabetes: latent autoimmune diabetes in adults in the setting of autoimmune clustering","volume":"18","author":"Saiprasad","year":"2026","journal-title":"Cureus"},{"issue":"10","key":"2026071221005205300_luag184-B11","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.2337\/dbi20-0017","article-title":"Management of latent autoimmune diabetes in adults: a consensus statement from an international expert panel","volume":"69","author":"Buzzetti","year":"2020","journal-title":"Diabetes"}],"container-title":["JCEM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/4\/8\/luag184\/68762024\/luag184.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/4\/8\/luag184\/68762024\/luag184.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T01:03:01Z","timestamp":1783904581000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcemcr\/article\/doi\/10.1210\/jcemcr\/luag184\/8732979"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":11,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,7,2]]}},"URL":"https:\/\/doi.org\/10.1210\/jcemcr\/luag184","relation":{},"ISSN":["2755-1520"],"issn-type":[{"value":"2755-1520","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,8]]},"published":{"date-parts":[[2026,7,2]]},"article-number":"luag184"}}