diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM12994diaendo-12994Research ArticleОбзорыReviewЛатентный аутоиммунный диабет взрослых — современное представлениеModern understanding of latent autoimmune diabetes in adultshttps://orcid.org/0000-0003-0935-9004ГолодниковИ. И.GolodnikovI. I.

Голодников Иван Иванович – аспирант; Researcher ID: AAJ-8843-2021; Scopus Author ID: 57208628509

117036 Москва, ул. Дм. Ульянова, д. 11

Ivan I. Golodnikov - MD, PhD student; Researcher ID: AAJ-8843-2021; Scopus Author ID: 57208628509

11 Dm. Ulyanova street, 117036 Moscow

dog1997@yandex.ruhttps://orcid.org/0000-0003-3628-2102РусяеваН. В.RusyaevaN. V.

Русяева Надежда Владимировна - аспирант; Researcher ID: AAY-6365-2021; Scopus Author ID: 5722002496.

Moscow

Nadezhda V. Rusyaeva -- MD, PhD student; Researcher ID: AAY-6365-2021; Scopus Author ID: 5722002496.

Moscow

nadshul@gmail.comhttps://orcid.org/0000-0001-5656-2596НиконоваТ. В.NikonovaT. V.

Никонова Татьяна Васильевна - доктор медицинских наук.

Moscow

Tatiana V. Nikonova - MD, PhD.

Moscow

tatiana_nikonova@mail.ruhttps://orcid.org/0000-0003-4929-1526КононенкоИ. В.KononenkoI. V.

Кононенко Ирина Владимировна - кандидат медицинских наук, доцент; Researcher ID: H-5947-2016; Scopus Author ID: 35744972400.

Moscow

Irina V. Kononenko - MD, PhD, Аssociate Professor; Researcher ID: H-5947-2016; Scopus Author ID: 35744972400.

Moscow

shakhtarina@bk.ruhttps://orcid.org/0000-0002-5057-127XШестаковаМ. В.ShestakovaM. V.

Шестакова Марина Владимировна - доктор медицинских наук, профессор, академик РАН; Researcher ID: D-9123-2012; Scopus Author ID: 7004195530.

Moscow

Marina V. Shestakova - MD, PhD, Professor, Academician of Russian Academy of Medical Sciences; Researcher ID: D-9123-2012; Scopus Author ID: 7004195530.

Moscow

shestakova.mv@gmail.comГНЦ РФ ФГБУ «Национальный медицинский исследовательский центр эндокринологии»РоссияEndocrinology Research CentreRussian Federation202314072023263262274Copyright © Голодников И.И., Русяева Н.В., Никонова Т.В., Кононенко И.В., Шестакова М.В., 20232023Голодников И.И., Русяева Н.В., Никонова Т.В., Кононенко И.В., Шестакова М.В.Golodnikov I.I., Rusyaeva N.V., Nikonova T.V., Kononenko I.V., Shestakova M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/12994

Латентный аутоиммунный диабет взрослых (LADA), по разным данным, составляет от 4 до 12% всех случаев сахарного диабета 2 типа (СД2). Его уникальность заключается в одновременном сочетании наличия аутоантител к β-клеткам (характерных для сахарного диабета 1 типа (СД1)) и возможности лечения таблетированными сахароснижающими препаратами (характерной для СД2) как минимум в течение 6 мес. В основе этого лежит патогенез, характерный и для СД1, и СД2, — наличие аутоиммунной реакции с одновременным вовлечением адаптивного и врожденного иммунитета, а также, в меньшей степени, инсулинорезистентности и ряда компонентов метаболического синдрома. У LADA больше общего с СД1 — одинаковые этапы в развитии заболевания, начиная от генетической предрасположенности, заканчивая безусловным развитием инсулиновой зависимости; отличие заключается в продолжительности каждого из периодов и возрасте манифестации. Для LADA характерен более поздний возраст манифестации — от 30–35 лет и более медленный темп деструкции β-клеток. В данной статье представлены данные о диагностике, течении LADA, его сходстве и различии с другими типами СД, иммунологических особенностях. Также в статье представлены современный подход к лечению пациентов с LADA и перспективные методы лечения. Поиск информации осуществлялся в опубликованных источниках, представленных в поисковых системах PubMed, Google Scholar, Scopus, Web of Science, eLibrary.ru за последние 10 лет. Использованы медицинские предметные рубрики: latent autoimmune diabetes in adults, diabetes mellitus type 1 and 2, immunology, pancreas, genetic, treatment в различных комбинациях с применением логических операторов OR и AND.

Latent autoimmune diabetes in adults (LADA) according to various sources is from 4 to 12% of all cases of type 2 diabetes mellitus (T2DM). Its uniqueness lies in the simultaneous combination of autoantibodies to β-cells (characteristic of T1DM) and the possibility of treatment with oral hypoglycemic drugs (characteristic of T2DM) for at least 6 months. This is based on the pathogenesis common for T1DM and T2DM — the presence of an autoimmune reaction with the simultaneous involvement of adaptive and innate immunity, as well as, to a lesser extent, insulin resistance and a number of components of the metabolic syndrome. LADA has more in common with T1DM — the same stages in the development of the disease, from genetic predisposition to the undoubted development of insulin dependence, the difference lies in the duration of each of the periods and the age of manifestation. LADA is characterized by an older age of manifestation of 30–35 years and a slower rate of destruction of β-cells. This article presents data on the diagnosis, progress of LADA, its similarities and differences with other types of DM, and immunological features. The article also analyzes the modern approach to the treatment of patients with LADA and promising methods of treatment. The search for information was processing in published sources attached to the search engines PubMed, Google Scholar, Scopus, Web of Science, eLibrary.ru over the past 10 years. The following medical subject headings were used: latent autoimmune diabetes in adults, diabetes mellitus type 1 and 2, immunology, pancreas, genetic, treatment in various combinations using OR and AND logical operators.

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The authors declare that there are no conflicts of interest present.