ESPE Abstracts

Introduction: LADY (latent autoimmune diabetes in youth) have been proposed in younger type 2 DM with presence of beta cell autoantibodies like LADA in adult. LADA patients showed greater complication risk in the later course of disease compared with type 2 DM. When we see the LADY and the LADA in an age-related continuous spectrum, LADY will have more adverse results than type 2 DM. And a large number of LADY is expected as diabetes related autoimmunity in youth has been reported greater than in adults. In Korea, the presence of autoantibodies among patients with type 2 DM in the age of children and adolescents was reported near one-third and the positive rate was higher in the younger age group. The incidence of prediabetes and type 2 DM among childhood and adolescence is increasing along with the increase of obesity and high autoimmunity with beta cell autoantibodies are expected. However, there are no criteria or clinical guidelines for diagnosing and management these children and adolescents.

Case: Here, we present three cases of obese adolescents with type 2 diabetes or prediabetes with beta-cell autoantibodies. Their clinical characteristics were examined in detail; average height z-score was 0.92, weight z-score 3.37 and BMI z-score was 3.62. Insulin resistance symptom such as acanthosis nigricans showed in all three patients. They are under currently monitoring and continuing life style intervention with two of them are receiving oral hypoglycemic agent.

Conclusion: As more LADY patients with prediabetes or type 2 DM are expected, more efforts for early detection of diabetes progression risk associated autoimmune markers in adolescent population are needed. Long-term studies of beta-cell function monitoring and identification factors which accelerate the clinical courses should be followed.