Latent Autoimmune Diabetes in Adults (LADA) is the term used to describe adults who have a slowly progressive form of diabetes mellitus (DM) of autoimmune etiology, but that may be treated initially without insulin. Although the American Diabetes Association (ADA) currently does not recognize this disease as a specific type, there is increasing information about it, as well as groups dedicated to its study. LADA shares some immunological and genetic aspects with DM type 1, it affects an age group that is typically affected by type 2 DM. Therefore, it could be considered a type of intermediate diabetes. This process can be detected by specific antibodies in the peripheral blood, months or even years before the clinical onset of the disease. Diagnosis is based on clinical and laboratory criteria: age of onset, initial response to oral hypoglycemic agents and the presence of specific antibodies for diabetes. Although the definitive treatment is insulin, glitazones may be useful in early stages of the disease. Currently, its management represents a challenge for the physician, including specialists, and it is a form of DM to keep in mind.
Part of the book: Diabetes and Its Complications
The World Health Organization (WHO) estimates, worldwide, approximately 1300 million people with a form of visual impairment. More than 314 million have a severe visual impairment. Of these, 37 million are blind and 124 million suffer from low vision. Eighty percent of all these cases are considered avoidable. The main causes of blindness from one country to another, in order of frequency, are cataract (39%), uncorrected refractive errors (18%), and glaucoma (10%). In Latin America and the Caribbean, the loss of vision in adults continues to be a public health problem. Blindness and visual impairment tombs have a remarkable impact on the socioeconomic development of individuals and societies and the prevention of avoidable visual disabilities in the long term in terms of attention to health care and social expenditures. Of all the organs of the body, the eye is more accessible to direct examination. The visual function can be evaluated by means of simple subjective tests. The same can be taken care of from an adequate primary care service.
Part of the book: Topics in Primary Care Medicine