Endocrine Abstracts

JOINT57

Aims and objectives.: To provide a report of an 88- year-old woman who treated for 29 years as T2DM but lately was diagnosed with LADA.

Background: Latent autoimmune diabetes in adults (LADA) is the most common term used to describe slow autoimmune β-cell destruction that occur in adults, leading to a long duration of marginal insulin secretory capacity. LADA often misdiagnosed as type 2 diabetes mellitus (T2DM), because of the resemblance in their clinical presentation. The diagnosis of LADA is similar to type 1 diabetes mellitus (T1DM), by detection of Islet autoantibodies in the blood. However, in most cases of patients with LADA are only glutamic acid decarboxylases (GADA) - positive. Currently, the Immunology of Diabetes Society (IDS) suggests diagnosing LADA at age of onset ≥ 30 years. While the threshold age for diagnosis LADA is still a matter of debate.

Design: Case study of one patient with uncontrolled T2DM, visiting a nurse practitioner diabetes Clinic.

Methods: A 88 -year-old Woman with history of T2DM participated in this case study. A full investigation was conducted and described by nurse practitioner diabetes to identifying a misdiagnosis.

Results: A patient treated for 29 years as T2DM was found with positive GADA (1869.6 IU/ml). Due to the newly results the patient was re-diagnosed with LADA and a change in treatment regime performed.

Conclusion: This Case highlights the complexity of investigation LADA among T2DM patients, and the importance to perform it among elderly patient as well. The key components for investigation LADA include: profound anamnesis, GADA testing and C-peptide levels. Relevance to clinical practice. The importance of role of Nurse practitioner diabetes in primary health care setting for a thorough diagnosis among uncontrolled glycemic patients revealing hidden types of this complex disease.