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When it is not Type 1 or Type 2 Diabetes mellitus: A case of Slowly Evolving Immune-mediated Diabetes of Adult

2024/07/13 by Okunowo, Bolanle, Shittu, Folorunsho
#C-peptide #diabetes mellitus #islet cell autoantibodies #latent autoimmune diabetes of adult

paper · doi:10.60787/tnhj.v23i4.759

Abstract

Background: Slowly Evolving Immune-mediated Diabetes of Adult (SEIDA) previously termed Latent Autoimmune Diabetes of Adult (LADA) is a heterogenous disorder characterized by the presence of serum islet autoantibodies at diagnosis with slow progression of islet failure. These patients often require insulin therapy within six months of diagnosis. Most of the presenting clinical symptoms can mimic either type 1 or type 2 diabetes mellitus. Methods: We report a clinical case of a 37-year-old woman who was newly diagnosed with Type 2 diabetes mellitus. Finding: She presented with history of polyuria, polydipsia, and weight loss of six months duration with a family history of type 2 diabetes mellitus in her father. She presented with worsening glycemic control despite her adherence to her medications. A clinical suspicion of SEIDA was made in view of her age and worsening glycemic control. This was confirmed with a positive result of serum Glutamic Acid Decarboxylase -65 (GAD-65) and low serum c-peptide levels. Conclusion: This is to alert physicians that not all diabetes mellitus is type 1 or type 2 hence SEIDA should be suspected in any young adults presenting with features of uncontrolled diabetes mellitus in spite of optimal doses of oral hypoglycemic agents.

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