Clinical Analysis Of 3 Cases Of Latent Autoimmune Diabetes In Adults (LADA) Combined With Graves Disease

Type 1 diabetes mellitus (TIDM) and the autoimmune thyroid disease (AITD) are the most common components of autoimmune polyglandular syndrome . Latent autoimmune diabetes in adults (LADA) is a subtype of type 1 diabetes mellitus . The autoimmune thyroid disease mainly involve Graves disease , chronic lymphocytic thyroiditis , atrophic thyroiditis and opthalmopathy of Graves disease . LADA combined with Graves disease can include in a type of autoimmune polyglandular syndrome type II . Abundant epidemiological datas support both TIDM and Graves disease have common etiological basis of genetic susceptibility , cellular immunity and humoral immunity . HLA and CTLA-4 contribute to the susceptibility to both disease . Additionaly , they have their organ-specific antibody respectively . Antibodies of insulin cell, insulin and glutamate decarboxylase are associated with TIDM . Antibodies of thyroglobulin (anti-TG) andthyroid peroxidase (anti-TPO) are associated with AITD . We report 3 cases of LADA combined with Graves disease, man ,age at the onset from 31 to 44 . They all have prominent symptoms of weight loss , fatigue, big range of blood glucose fluctuation and occurred diabetic ketosis .Because of LADA and Graves disease have some similar clinical symptoms, it is easy to result in loss one of diagnosis . When a patient take LADA combined with Graves disease , the state of he or she will be more severe , probably, the influence which thyroid hormone act on the metabolize of glucose as one reason . It is necessary to summary and analysis such cases in order to enhance the cognition of both diseases , which is helpful to early diagnosis and promptly treatment.