Sandhya Kiran Neupane1, Prakash Paudel Jaishi2, Divyaa Koirala3, Arjun Kandel4, Prabhat Kiran Neupane5. 1. Department of Medicine, Shadhak Polyclinic, Kathmandu, Nepal. 2. Al Kamil Health center, Al Kamil, South Sharqiyah, Oman. 3. Department of medicine, Danphe Health Care, Nepal. 4. Department of Medicine, Flatland Vascular Associates, Brooklyn New York, USA. 5. Internship at Department of Medicine, Kist Medical College, Kathmandu, Nepal.
Abstract
Introduction and importance: Latent autoimmune diabetes of adulthood is an autoimmune disease sharing similarities of type 1 and type 2 diabetics. It is also known as type 1.5 diabetes in adults. It occurs mostly at the age of 30-35 years. It is usually associated with other autoimmune diseases and patients usually have normal BMI. Patients are positive for glutamic acid dehydrogenase and islets cell autoantibodies with onset in adulthood. Case: We present a case of a 42 year old female from the capital city of Nepal who presented with chief complaints of excessive thirst and increased frequency of micturition. . She also reported feeling hungry most of the time. She added having symptoms of dry mouth, fatigue and occasional dizziness. Clinical findings and investigations: Fasting and post prandial blood glucose, Hba1c, blood pH and bicarbonate, Islet cell antibodies, Glutamic Acid Decarboxylase (GAD) and urine ketones were sent for diagnosis. Intervention and outcome: The patient was started on basal bolus glargine, 14 units and rapid acting insulin, lispro 6unit each with breakfast, lunch, and dinner. Beside insulin, the patient was started on statin (10mg, rosuvastatin) and aspirin (75mg, PO). In subsequent follow-up, her HbA1c level dropped in a few months. Conclusion: There are no studies found in LADA in Nepal. Our case report tends to highlight the importance of clinical recognition of LADA and raise awareness and importance of diagnostic methods to differentiate between Type 1, Type 2 DM and LADA.
Introduction and importance: Latent autoimmune diabetes of adulthood is an autoimmune disease sharing similarities of type 1 and type 2 diabetics. It is also known as type 1.5 diabetes in adults. It occurs mostly at the age of 30-35 years. It is usually associated with other autoimmune diseases and patients usually have normal BMI. Patients are positive for glutamic acid dehydrogenase and islets cell autoantibodies with onset in adulthood. Case: We present a case of a 42 year old female from the capital city of Nepal who presented with chief complaints of excessive thirst and increased frequency of micturition. . She also reported feeling hungry most of the time. She added having symptoms of dry mouth, fatigue and occasional dizziness. Clinical findings and investigations: Fasting and post prandial blood glucose, Hba1c, blood pH and bicarbonate, Islet cell antibodies, Glutamic Acid Decarboxylase (GAD) and urine ketones were sent for diagnosis. Intervention and outcome: The patient was started on basal bolus glargine, 14 units and rapid acting insulin, lispro 6unit each with breakfast, lunch, and dinner. Beside insulin, the patient was started on statin (10mg, rosuvastatin) and aspirin (75mg, PO). In subsequent follow-up, her HbA1c level dropped in a few months. Conclusion: There are no studies found in LADA in Nepal. Our case report tends to highlight the importance of clinical recognition of LADA and raise awareness and importance of diagnostic methods to differentiate between Type 1, Type 2 DM and LADA.
Authors: S Fourlanos; F Dotta; C J Greenbaum; J P Palmer; O Rolandsson; P G Colman; L C Harrison Journal: Diabetologia Date: 2005-09-29 Impact factor: 10.122
Authors: Y Z Grasso; S K Reddy; C R Rosenfeld; W I Hussein; B J Hoogwerf; C Faiman; M K Gupta Journal: Endocr Pract Date: 2001 Sep-Oct Impact factor: 3.443
Authors: Juan Huang; James Alexander Pearson; F Susan Wong; Li Wen; Zhiguang Zhou Journal: Diabetes Metab Res Rev Date: 2021-06-22 Impact factor: 4.876