High titer of diabetes-associated autoantibodies with normoglycemia in a child with a family history of LADA diabetes
Received: 2026-06-11 17:11:06
Published: 2026-05-21
Abstract
LADA (Latent Autoimmune Diabetes in Adults) is a slowly progressive form of autoimmune diabetes characterized by clinical and pathogenetic features of both type 1 and type 2 diabetes mellitus. Early detection of diabetes-associated autoantibodies in first-degree relatives of patients with autoimmune diabetes is of particular clinical importance, as these markers may precede the development of overt hyperglycemia by several years.
This paper presents a clinical case of elevated glutamic acid decarboxylase antibodies (anti-GAD65) in a normoglycemic child with a family history of LADA diabetes. The mother, aged 30 years, was diagnosed with LADA diabetes based on markedly elevated anti-GAD65 antibody levels (>2000 U/mL), decreased C-peptide level (0.71 ng/mL), and positive islet cell antibodies. Her 5-year-old daughter, who was overweight, demonstrated elevated anti-GAD65 levels despite normal fasting glucose and glycated hemoglobin values.
The presence of high anti-GAD65 titers in the child may indicate an early preclinical stage of autoimmune β-cell destruction. Family history of autoimmune diabetes represents a significant risk factor for the development of autoimmune diabetes in offspring. In addition, overweight may contribute to insulin resistance and potentially accelerate β-cell dysfunction in genetically predisposed individuals.
This clinical case highlights the importance of early immunological screening and dynamic follow-up in children with a familial predisposition to autoimmune diabetes, even in the absence of glycemic abnormalities. Periodic monitoring of diabetes-associated autoantibodies and carbohydrate metabolism parameters may improve early identification of individuals at high risk for future diabetes manifestation.
Keywords
- LADA diabetes
- latent autoimmune diabetes in adults
- anti-GAD65 antibodies
- diabetes-associated autoantibodies
- normoglycemia
- preclinical autoimmune diabetes
- type 1 diabetes mellitus
- β-cell autoimmunity
- family history
- pediatric endocrinology
- overweight in children
- autoimmune diabetes risk
- early immunological screening
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This work is licensed under a Creative Commons Attribution 4.0 International License.
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