Features of diagnostics and treatment of the patient with slowly evolving immune-mediated diabetes and multiple complications

Slowly developing immune-mediated diabetes mellitus in adults combines the phenotypic and immunological characteristics of type 1 and type 2 diabetes mellitus, which often complicates the correct diagnosis and timely initiation of appropriate glucose-lowering therapy. The article presents a clinical case of a 46-year-old patient with slowly evolving immune-mediated diabetes with multiple complications, initially diagnosed as type 2 diabetes mellitus, upon hospitalization in a surgical hospital for phlegmon of the right foot. A feature of the clinical case is the complications, the severity of which did not correspond to the known duration of the disease and was due to a "hidden", long-term course. The correct diagnosis established during the diagnostic search will avoid attempts to prescribe incorrect therapy to the patient in the future, which can lead to decompensation of carbohydrate metabolism and progression of late complications. With this article, we want to draw the attention of endocrinologists and doctors of other specialties to the complexity, diversity of the clinical course of LADA diabetes and the need for differential diagnosis, a detailed collection of the disease history, as well as the importance of determining autoantibodies in the atypical course of type 2 diabetes mellitus.