The International Journal of Romanian Society of Endocrinology / Registered in 1938

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October - December 2018, Volume 14, Issue 4

Ionescu-Tirgoviste C, Gagniuc P, Guja C

A Commentary on Classification of Diabetes: Latent Autoimmune Diabetes in Adults (Lada) or Intermediary Diabetes Mellitus (Idm)?

Acta Endo (Buc) 2018, 14 (4): 520-524
doi: 10.4183/aeb.2018.520

Diabetes Mellitus is a huge syndrome which can be detected from the first day of life until the last year of life of a centenarian. In the current classification of diabetes among the so-called “idiopathic phenotypes”, apart Type 1 Diabetes (T1D) and Type 2 Diabetes (T2D) has been included provisionally term “Latent Autoimmune Diabetes in Adults” (LADA). This has unclear characterization regarding the age at onset, the presence of anti-β-cell antibodies and the level of insulin secretory function, in conformity with C-peptide levels. According to several recent publications, there are no specific biochemical or genetic markers for Latent Autoimmune Diabetes in Adults (LADA), but only a gradual transition from T1D to T2D. In addition, the word “latent” in the construction of “LADA” term is inaccurate because in this phenotype nothing is latent: both the autoimmunity and diabetes are present and are even parts of the diagnosis. So that, the best term should be what in reality this subphenotype is: an Intermediary Diabetes Mellitus (IDM). Some recent genetic data strongly support this designation.

Keywords: Classification of diabetes, LADA, IDM, primary insulin dependence, secondary insulin dependence.

Correspondence: Constantin Ionescu-Tirgoviste, “Carol Davila” University of Medicine and Pharmacy Bucharest, 5-7 Ion Movila Street, Bucharest 2, Romania, E-mail:;