Slowly Progressive Type 1 Diabetes Mellitus: Current Knowledge And Future Perspectives

Akihiro Nishimura,1 Kimio Matsumura,1 Shota Kikuno,1 Kaoru Nagasawa,1 Minoru Okubo,1 Yasumichi Mori,1 Tetsuro Kobayashi2 1Department of Endocrinology and Metabolism, Toranomon Hospital, Tokyo, Japan; 2Division of Immunology and Molecular Medicine, Okinaka Memorial Institute for Medical Research, Tok...

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Autores principales:	Nishimura A, Matsumura K, Kikuno S, Nagasawa K, Okubo M, Mori Y, Kobayashi T
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	slowly progressive type 1 diabetes mellitus (spiddm) latent autoimmune diabetes in adults (lada) insulitis panin gad antibody Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/0bab72bec8654155aa5f4ea905fc636f
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spelling	oai:doaj.org-article:0bab72bec8654155aa5f4ea905fc636f2021-12-02T02:27:33ZSlowly Progressive Type 1 Diabetes Mellitus: Current Knowledge And Future Perspectives1178-7007https://doaj.org/article/0bab72bec8654155aa5f4ea905fc636f2019-11-01T00:00:00Zhttps://www.dovepress.com/slowly-progressive-type-1-diabetes-mellitus-current-knowledge-and-futu-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Akihiro Nishimura,1 Kimio Matsumura,1 Shota Kikuno,1 Kaoru Nagasawa,1 Minoru Okubo,1 Yasumichi Mori,1 Tetsuro Kobayashi2 1Department of Endocrinology and Metabolism, Toranomon Hospital, Tokyo, Japan; 2Division of Immunology and Molecular Medicine, Okinaka Memorial Institute for Medical Research, Tokyo, JapanCorrespondence: Tetsuro KobayashiOkinaka Memorial Institute for Medical Research, 2-2-2 Toranomon, Minato-Ku, Tokyo, JapanTel +81-3-3588-1111Fax +81-3-3582-7068Email tetsurou@yamanashi.ac.jpAbstract: Slowly progressive type 1 insulin-dependent diabetes mellitus (SPIDDM), sometimes referred to as latent autoimmune diabetes in adults (LADA), is a heterogeneous disease that is often confused with type 1 and type 2 diabetes. As a result, there were few diagnostic criteria for this disorder until 2012, when the Japan Diabetes Society established criteria that could be used in clinical practice. A primary question is whether pathologic markers for type 1 or type 2 diabetes are present in the pancreas of patients with SPIDDM, because the phenotype of SPIDDM is similar to both type 1 and type 2 diabetes. Recent studies clarified pathologic findings in the pancreas of patients with SPIDDM, which included T-cell-mediated insulitis, a marker of type 1 diabetes; pseudoatrophic islets (islets specifically devoid of beta cells), another hallmark of type 1 diabetes; and a lack of amylin (ie, islet amyloid polypeptide) deposition to the islet cells, a pathologic marker of type 2 diabetes. In terms of preventing the loss of beta-cell function in patients with SPIDDM, several studies have shown that some drugs, including dipeptidyl peptidase-4 inhibitors, are effective. There is an increased need for early diagnosis of SPIDDM to preserve beta-cell function. This review presents updated findings on the pathogenesis and immunologic findings of the affected pancreas, diagnostic markers, risk factors for progression of beta-cell dysfunction, epidemiology, clinical features, diagnostic strategies, prevention strategies, and clinical options for patients with SPIDDM.Keywords: slowly progressive type 1 diabetes mellitus; SPIDDM, latent autoimmune diabetes in adults; LADA, insulitis, PanIN, GAD antibody  Nishimura AMatsumura KKikuno SNagasawa KOkubo MMori YKobayashi TDove Medical Pressarticleslowly progressive type 1 diabetes mellitus (spiddm)latent autoimmune diabetes in adults (lada)insulitispaningad antibodySpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 12, Pp 2461-2477 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	slowly progressive type 1 diabetes mellitus (spiddm) latent autoimmune diabetes in adults (lada) insulitis panin gad antibody Specialties of internal medicine RC581-951
spellingShingle	slowly progressive type 1 diabetes mellitus (spiddm) latent autoimmune diabetes in adults (lada) insulitis panin gad antibody Specialties of internal medicine RC581-951 Nishimura A Matsumura K Kikuno S Nagasawa K Okubo M Mori Y Kobayashi T Slowly Progressive Type 1 Diabetes Mellitus: Current Knowledge And Future Perspectives
description	Akihiro Nishimura,1 Kimio Matsumura,1 Shota Kikuno,1 Kaoru Nagasawa,1 Minoru Okubo,1 Yasumichi Mori,1 Tetsuro Kobayashi2 1Department of Endocrinology and Metabolism, Toranomon Hospital, Tokyo, Japan; 2Division of Immunology and Molecular Medicine, Okinaka Memorial Institute for Medical Research, Tokyo, JapanCorrespondence: Tetsuro KobayashiOkinaka Memorial Institute for Medical Research, 2-2-2 Toranomon, Minato-Ku, Tokyo, JapanTel +81-3-3588-1111Fax +81-3-3582-7068Email tetsurou@yamanashi.ac.jpAbstract: Slowly progressive type 1 insulin-dependent diabetes mellitus (SPIDDM), sometimes referred to as latent autoimmune diabetes in adults (LADA), is a heterogeneous disease that is often confused with type 1 and type 2 diabetes. As a result, there were few diagnostic criteria for this disorder until 2012, when the Japan Diabetes Society established criteria that could be used in clinical practice. A primary question is whether pathologic markers for type 1 or type 2 diabetes are present in the pancreas of patients with SPIDDM, because the phenotype of SPIDDM is similar to both type 1 and type 2 diabetes. Recent studies clarified pathologic findings in the pancreas of patients with SPIDDM, which included T-cell-mediated insulitis, a marker of type 1 diabetes; pseudoatrophic islets (islets specifically devoid of beta cells), another hallmark of type 1 diabetes; and a lack of amylin (ie, islet amyloid polypeptide) deposition to the islet cells, a pathologic marker of type 2 diabetes. In terms of preventing the loss of beta-cell function in patients with SPIDDM, several studies have shown that some drugs, including dipeptidyl peptidase-4 inhibitors, are effective. There is an increased need for early diagnosis of SPIDDM to preserve beta-cell function. This review presents updated findings on the pathogenesis and immunologic findings of the affected pancreas, diagnostic markers, risk factors for progression of beta-cell dysfunction, epidemiology, clinical features, diagnostic strategies, prevention strategies, and clinical options for patients with SPIDDM.Keywords: slowly progressive type 1 diabetes mellitus; SPIDDM, latent autoimmune diabetes in adults; LADA, insulitis, PanIN, GAD antibody
format	article
author	Nishimura A Matsumura K Kikuno S Nagasawa K Okubo M Mori Y Kobayashi T
author_facet	Nishimura A Matsumura K Kikuno S Nagasawa K Okubo M Mori Y Kobayashi T
author_sort	Nishimura A
title	Slowly Progressive Type 1 Diabetes Mellitus: Current Knowledge And Future Perspectives
title_short	Slowly Progressive Type 1 Diabetes Mellitus: Current Knowledge And Future Perspectives
title_full	Slowly Progressive Type 1 Diabetes Mellitus: Current Knowledge And Future Perspectives
title_fullStr	Slowly Progressive Type 1 Diabetes Mellitus: Current Knowledge And Future Perspectives
title_full_unstemmed	Slowly Progressive Type 1 Diabetes Mellitus: Current Knowledge And Future Perspectives
title_sort	slowly progressive type 1 diabetes mellitus: current knowledge and future perspectives
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/0bab72bec8654155aa5f4ea905fc636f
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Slowly Progressive Type 1 Diabetes Mellitus: Current Knowledge And Future Perspectives

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