**4. Why are LADA and non-diabetic type 1?**

Taking into account its subsequent and less aggressive presentation, different arguments have been formulated that explain the appearance of LADA. See **Table 2**.

However, in order to clarify and have a more unified concept at the time of diagnosis, The Immunology of Diabetes Society (IDS) [4] has proposed 3 criteria for diagnosis, including: diagnosis of diabetes according to criteria established at a higher age at 30 years, independence of insulin for at least 6 months after diagnosis and positivity of antibodies against

Andersen et al. mentions that patients with LADA have a higher body mass index (BMI) than type 1 diabetics, but less than type 2. The condition of normal weight is the most frequent

Patients with adult onset autoimmune diabetes generally have a better metabolic profile than those with type 2 diabetes, with lower levels of triglycerides, higher HDL cholesterol and

A clinical point of view that persists is that patients with LADA are usually thin at the time of diagnosis [5] similar to children with diabetes type 1. However, documentation of BMI in LADA populations of European extraction does not support this point of view. Most of the larger LADA cohort studies report an average BMI in categories of overweight or obesity (BMI > 25.0 kg/m2

[20, 38–40] and most report a BMI similar to the diabetes type 2 cohorts [20, 38, 40]. Therefore, a

The increase in the prevalence of metabolic syndrome (MetS) worldwide is alarming, even more so if we take into account that it is considered a risk factor for the development of diabetes, or a pre-diabetic state. The impact of MetS has been demonstrated by the increase in subclinical atherosclerotic disease in patients with the syndrome, even without the diagnosis of diabetes [41]. In countries such as the United States and Mexico, the prevalence of MetS is

Through a cross-sectional population-based study conducted by Wong-McClure et al. they claim that the general prevalence of MetS in Central America is high, being higher in Honduras

Given the presented and due to the absence of data in primary care in Honduras [44], a descriptive study is carried out; in which the prevalence of MetS was determined using the criteria of the third report of the Group of Experts in Adult Treatment (Adult Treatment Panel III) of the National Program of Education on Cholesterol or by its acronym in English «National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) [45] being 65.8%.

(21.1%, CI: 16.4–25.9) than in the other countries of the isthmus [43].

) should not be a diagnostic criterion for LADA.

)

Latent Autoimmune Diabetes in Adults http://dx.doi.org/10.5772/intechopen.72685 27

**5. Clinical presentation and relationship with chronic diseases**

However, it is not a Sine Qua Non standard in its diagnosis.

lower BMI, waist/hip ratio, and blood pressure [18, 33–37].

GADA (**Tables 3** and **4**).

nutritional status [32].

**5.1. Metabolic characteristics**

*5.1.1. Body mass index and LADA*

normal BMI (<25.0 kg/m2

*5.1.2. Metabolic syndrome and LADA*

around 25% of its adult population [42].

#### **4.1. When to think about LADA?**

Some characteristics have been related, which in order of frequency associated with the disease in comparison with type 2 diabetics are: age of onset <50 years, symptoms of acute onset, BMI <25 kg/m2 and personal or family history of autoimmune disease.

It is described that the presence of 2 or more of these criteria presents a 90% sensitivity and 71% specificity for the identification of LADA patients [25, 30].

In case of suspicion, specific antibodies should be requested to confirm the diagnosis.


The last three points would be the result of a better protection/risk gene balance compared to type 1 diabetics [3, 29].

**Table 2.** Postulates of Pozzilli and Di Mario [3], which differentiates LADA from DM type 1.

1. Appearance in adulthood, usually after 30 years

2. Presence of specific auto antibodies, anti-GAD the most prevalent

3. There is no need for insulin therapy at the onset of the disease, which should last at least 6 months

**Table 3.** LADA diagnostic criteria, proposed by Immunology of Diabetes Society (IDS).


**Table 4.** Characteristics of DM type 1, LADA and DM type 2.

However, in order to clarify and have a more unified concept at the time of diagnosis, The Immunology of Diabetes Society (IDS) [4] has proposed 3 criteria for diagnosis, including: diagnosis of diabetes according to criteria established at a higher age at 30 years, independence of insulin for at least 6 months after diagnosis and positivity of antibodies against GADA (**Tables 3** and **4**).
