A study of non-obese diabetes mellitus in adults in a tertiary care hospital in Kerala, India

  • R. ChandniEmail author
  • Binoy J. Paul
  • V. Udayabhaskaran
  • K. P. Ramamoorthy
Original Article


The term Latent Autoimmune Diabetes in Adults (LADA) was introduced to define adult diabetic patients initially non–insulin-requiring but with immune markers of type 1 diabetes that, in a number of cases, progress to insulin dependency. This term has been largely used in the last few years when referring to autoimmune forms of diabetes not requiring insulin initially. In the present study we looked for the clinical, biochemical and immunological parameters of non-obese type 2 diabetes mellitus in adults and studied the frequency of antibodies to glutamic acid decarboxylase (GAD) and pancreatic islet cell antibodies (PICA). Subjects of 30 years or older with a history of diabetes of duration not more than 36 months and body mass index (BMI) of less than 23 kg/m2 were included. Fasting serum C-peptide, GAD antibody and islet cell auto antibody was estimated. GAD antibodies were positive in 25.81 %, ICA in 22.58 % and both in 9.70 % of lean diabetes. Fasting serum C-peptide was less than normal in 45.16 % of them.


Latent autoimmune diabetes in adult (LADA) Lean diabetes GAD antibody Islet cell antibody (ICA) Serum C-peptide 



Supported by a grant from the Research Society for the Study of Diabetes in India, Kerala chapter.

Conflict of interest

No conflicts of interest.


  1. 1.
    Zimmet PZ. The pathogenesis and prevention of diabetes in adults: genes, autoimmunity, and demography. Diabetes Care. 1995;18:1050–64.PubMedGoogle Scholar
  2. 2.
    Tuomi T, Groop LC, Zimmet PZ, et al. Antibodies to glutamic acid decarboxylase reveal latent autoimmune diabetes mellitus in adults with a non-insulin-dependent onset of disease. Diabetes. 1993;42:359–62.PubMedCrossRefGoogle Scholar
  3. 3.
    Turner R, Stratton I, Horton V, Manley S, Zimmet P, Mackay I, et al. UKPDS 25: autoantibodies to islet-cell cytoplasm and glutamic acid decarboxylase for prediction of insulin requirement in type 2 diabetes. Lancet. 1997;350:1288–93.PubMedCrossRefGoogle Scholar
  4. 4.
    Pozzilli P, Di Mario U. Autoimmune diabetes not requiring Insulin at diagnosis (Latent Autoimmune Diabetes of the Adult): definition, characterization, and potential prevention. Diabetes Care. 2001;24:1460–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Pitman WB, Action RT, Barger BO, Bell DS, Go RCP, Murphy CC, et al. HLA-A,-B, and –DR associations in type 1 diabetes mellitus with onset after age forty. Diabetes. 1984;31:122–5.CrossRefGoogle Scholar
  6. 6.
    Owen KR, Stride A, Ellard S, Hattersley AT. Etiological investigation of diabetes in young adults presenting with apparent type 2 diabetes. Diabetes Care. 2003;26:2088–93.PubMedCrossRefGoogle Scholar
  7. 7.
    Unnikrishnan AG, Singh SK, Sanjeevi CB. Prevalence of GAD 65 antibodies in lean subjects with type 2 diabetes. Ann N Y Acad Sci. 2004;1037:118–21.PubMedCrossRefGoogle Scholar
  8. 8.
    Hosszúfalusi N et al. Similar genetic features and different islet cell autoantibody pattern of Latent Autoimmune Diabetes in Adults (LADA) compared with adult-onset type 1 diabetes with rapid progression. Diabetes Care. 2003;26:452–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Thunander M, Thorgeirsson H, Torn C, Petersson C, Landin-Olsson M. β-cell function and metabolic control in latent autoimmune diabetes in adults with early insulin versus conventional treatment: a 3-year follow-up. Eur J Endocrinol. 2011;164:239–45.PubMedCrossRefGoogle Scholar

Copyright information

© Research Society for Study of Diabetes in India 2013

Authors and Affiliations

  • R. Chandni
    • 1
    Email author
  • Binoy J. Paul
    • 1
  • V. Udayabhaskaran
    • 1
  • K. P. Ramamoorthy
    • 1
  1. 1.Department of MedicineGovernment Medical CollegeCalicut, KozhikodeIndia

Personalised recommendations