Child's Health · Published 2026-06-24 · DOI 10.22141/2224-0551.21.4.2026.1959
I. Tsaryk, N. Pashkovska, V. I. Pankiv
Background. Latent autoimmune diabetes in youth (LADY) is an overlooked clinical entity on the autoimmune diabetes spectrum, typically manifesting between 16 and 29 years of age. Because endogenous insulin secretion is initially preserved and clinical features frequently overlap with type 2 diabetes mellitus, LADY is regularly misdiagnosed, which delays targeted therapeutic interventions. The aim of this study was to define the specific metabolic profile of young patients with LADY by comparing directly with classical type 1 diabetes mellitus (cT1DM) and latent autoimmune diabetes in adults (LADA). Materials and methods. We conducted a single-center cross-sectional study involving 106 individuals with validated autoimmune diabetes, stratified into three cohorts: cT1DM (n = 40), LADA (n = 36), and LADY (n = 30). Clinical tracks focused on fasting plasma glucose, glycated hemoglobin, body mass index, waist circumference, and waist-to-height ratio (WHtR). Group variations were examined using non-parametric statistical criteria. Results. Age at onset in the LADY group mirrored the cT1DM cohort but was drastically lower than in the LADA group (p < 0.001). Body mass index in LADY occupied a distinct middle ground, scaling higher than in cT1DM (p = 0.005) yet remaining lower than in LADA (p = 0.002). Interestingly, both waist circumference and WHtR in LADY tracked closely with cT1DM, falling well below the values observed in LADA (both p < 0.001). The median WHtR for LADY individuals did not breach the standard 0.5 cardiometabolic risk threshold. Among the tested metrics, WHtR demonstrated the highest sensitivity for mapping cardiovascular risk differences between LADY and LADA. The low WHtR in LADY indicates minimal central fat distribution and a benign metabolic setup. Conversely, elevated WHtR markers in LADA align with an accumulation of cardiovascular vulnerabilities and a higher baseline for future vascular issues. Conclusions. LADY functions as a distinct metabolic endotype characterized by early presentation, ongoing autoimmunity, and a favorable metabolic profile with low visceral adiposity. Using WHtR offers a simple, accessible clinical strategy to separate LADY from LADA, signaling which young patients require immediate pancreatic autoantibody screening.
Abstract from DOAJ. Public domain (CC0 1.0).
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Tsaryk, I., Pashkovska, N., Pankiv, V. (2026). Latent autoimmune diabetes in youth: characteristics of the metabolic endotype and anthropometric markers for differential diagnosis. Child's Health. https://doi.org/10.22141/2224-0551.21.4.2026.1959