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Expert Opinion / Cases · June 04, 2021

54 y/o Male With a History of Diabetes Mellitus, Presumed to be LADA (Positive GAD-65) Presents for a Second Opinion

Written by
Jacqueline A. Seiglie MD, MSc


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  • Chandrakant Madgaonkar

    Jun 08, 2021

    In this case, 54y/0, LADA with positive GAD antibodies, and strong family H/O DM , and HBA1c 8%, low BMI, a combination of metformin with DPP–4 inhibitors, or SGLT2 inhibitors, with Vitamin D3 can be considered (in place of insulin); further consider to rule out other auto-immune disorders such as thyroid dysfunction ... etc. Thank you. 

  • Javier Morales

    Jun 11, 2021

    I have a similar patient with a similar story. Again, intolerance to injectable GLP one therapy and SGL T2 inhibitor therapy resulted in significant and severe dyslipidemia. Currently, and for physiologic replacement and believe it or not, seems to have better glycemic control on Janumet than when on a GLP1 , Possibly due to glucagon suppression. The curious thing was the better glycemic control while on DPP4 Which makes me question his adherence  with GLP one. As a rule, I stay way from SUs

  • Ermir Nelaj

    Jun 17, 2021

    I would try to treat him ...
    Metformin 2 x 100mg/d + SGTL2 inhibitor (dinner) + Gliclaside (MR) 60mg daily

  • roohi ilyas

    Nov 20, 2021

    For LADA insulin basal bolus regimen is going to control the sugar. Since diagnosis of diabetes is 10 years old, no benefit from DPP4 inhibitors or GLP1 or piaglitazone etc is going to help.

  • Dec 04, 2023

    Pending Moderator approval.

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