Endocrine Abstracts

JOINT194

Introduction: Latent autoimmune diabetes in adults (LADA) is a hybrid form of diabetes often misdiagnosed as type 2 diabetes mellitus (T2DM) in older adults. Early and accurate diagnosis of LADA is critical for effective management and prevention of complications. Ultrasound (US) has emerged as a valuable tool for stratifying patients with LADA by assessing metabolic and structural changes in associated organs [1-4].

Materials and Methods: We evaluated 10 cases of LADA treated at an endocrinology clinic (age 56–70 years, 6 females). Clinical and laboratory assessments included:

• Measurement of glutamic acid decarboxylase antibodies (GAD-Ab) and islet cell antibodies (ICA-Ab).

• Abdominal ultrasound (2–10 MHz convex probe) to assess multiparameter features of the kidneys, pancreas, and liver.

• Doppler ultrasound, shear wave elastography (SWE), and quantification of visceral fat (VF) and subcutaneous fat (SF) thickness and areas.

Results: • All patients had increased antibody levels, with positive GAD-Ab and ICA-Ab confirming LADA.• Treatment with anti-inflammatory agents led to improved glycemic control and normalization of laboratory parameters.

• US findings included:

• Pancreatic hypoechoic loci in all patients.

• Signs of autoimmune thyroiditis in 6 patients, with corresponding US changes.

• Altered liver parenchyma attenuation and abnormal renal Doppler flow in a subset of patients.

• Body composition analysis revealed overweight in most cases, one patient was underweight, and visceral fat accumulation was prominent.

Conclusion: A comprehensive diagnostic approach integrating imaging and laboratory biomarkers is essential for stratifying LADA in older patients. Ultrasound techniques such as SWE and Doppler imaging provide valuable insights into metabolic and structural organ changes, supporting tailored therapeutic strategies to optimize glycemic control and manage comorbidities.

References: 1. Bubnov R. Ultrasound diagnosis of diabetic nephropathy. Endocrine Abstracts, 2024; 99:P475. DOI: 10.1530/endoabs.99.P475. 2. Bubnov R. Ultrasound imaging in metabolic syndrome-related kidney disease. Nephrol Dial Transplant, 2023; 38(Supplement_1):gfad063c_4869. DOI: 10.1093/ndt/gfad063c_4869. 3. Bubnov R, Petrenko L, Mukhomor O. Ultrasound Diagnosis of the Pancreatic Lesion not Detected on Contrast CT, MRI and PET Evoking Severe Biliary Hypertension: Considerations for Autoimmune Pancreatitis. KSUM 2020, November 16-17 2020, Seoul, Korea. Abstract book: 243. 4. Bubnov R, Kalika L, Spivak M. Ultrasound evaluation of visceral fat and posture: relevance for diagnosing metabolic syndrome and obesity. Ultrasound in Medicine and Biology, 2019, 45:S83-S84. DOI: 10.1016/j.ultrasmedbio.2019.07.283.