Sustained metabolic control in latent autoimmune diabetes in adults (LADA) with semaglutide therapy in a patient with multiple autoimmune comorbidities: a case report and literature review.

Authors

Settimio D'Andrea, Antonella Berardicurti, Vincenza Di Stasi, Anna Tortora, Livia Santarelli, Marco Giorgio Baroni, Onorina Berardicurti

Published in

Acta diabetologica. Jul 13, 2026. Epub Jul 13, 2026.

Abstract

Latent Autoimmune Diabetes in Adults (LADA) is a complex form of autoimmune diabetes characterised by the presence of pancreatic autoantibodies and a progressive β-cell decline, often leading to eventual insulin dependence. Evidence supporting glucagon-like peptide-1 receptor agonists (GLP-1RAs)-notably semaglutide-in LADA remains limited. Here, we present the case of a 55-year-old woman, initially diagnosed with type 2 diabetes mellitus, who exhibited class II obesity and multiple autoimmune disorders, including vitiligo, celiac disease, autoimmune thyroiditis, and undifferentiated arthritis. Laboratory evaluation revealed positive anti-glutamic acid decarboxylase antibodies and preserved fasting C-peptide, prompting a revised diagnosis of LADA. Given her obesity and residual β-cell function, metformin was discontinued and semaglutide initiated. Over five years of follow-up, the patient maintained durable glycemic control, significant weight loss, and stable β-cell function without requiring insulin. A temporary transition from injectable to oral semaglutide due to supply constraints did not compromise metabolic stability. To contextualize these findings, we conducted a systematic review of literature regarding semaglutide in LADA, identifying only two eligible case reports-underscoring the paucity of data. This case highlights the potential value of early LADA recognition in adults with preserved β-cell function, enabling a personalised approach with semaglutide to achieve metabolic control and possibly delay insulin requirement. Larger, prospective studies are warranted to elucidate the role of GLP-1 receptor agonists in LADA management and to define predictors of therapeutic response.

PMID:
42440093
Bibliographic data and abstract were imported from PubMed on 13 Jul 2026.

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