What prevents exogenous insulin therapy in Latent Autoimmune Diabetes in Adults (LADA)?

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From the FDA Drug Label

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From the Research

Factors Preventing Exogenous Insulin Therapy in LADA

  • Delay in insulin therapy due to lack of recommendations for islet antibody testing in adult-onset diabetes 1
  • Use of sulfonylureas, which can exhaust β-cells and lead to earlier insulin dependence 2
  • Heterogeneity of LADA, making it difficult to establish a priori treatment algorithm and resulting in treatment as type 2 diabetes, which may lead to quick progression to insulin-dependency 3
  • Limited understanding of the disease, with no specific guidelines for LADA therapy available 3, 4
  • Variability in β-cell destruction, insulin resistance, and islet autoantibody titers, suggesting different pathophysiological pathways and making treatment challenging 3

Treatment Challenges in LADA

  • Lack of significant evidence for or against specific lines of treatment, except for the indication that sulfonylureas should not be a first-line treatment for antibody-positive type 2 diabetes 2
  • Need for personalized medicine approach to attain optimal metabolic control and preserve β-cell function 3
  • Importance of early insulin therapy to achieve good metabolic control and better long-term outcomes by preserving β-cells and endogenous C-peptide secretion 1, 5

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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