Case Report: Latent autoimmune diabetes in two young female patients successfully treated with oral semaglutide and basal insulin.

Lunati ME, Galesi G, Bernasconi D, Tinari C, Fiorina P

Frontiers in endocrinology30 Jun 2026

PMID42453509PMCIDPMC13364524DOI10.3389/fendo.2026.1833794PepBankPUB-42453509

Summary

Latent autoimmune diabetes in youth (LADY) is a poorly characterized form of autoimmune diabetes with onset between 8 and 29 years of age and with slow progression toward insulin dependence, similarly to latent autoimmune diabetes of the adult (LADA), which leads to diagnostic difficulties and possibly to therapeutic implications. In this case series, we discuss two cases of juvenile- and young adult-onset autoimmune diabetes with very low insulin need at least after diagnosis and the efficacy of treatment with semaglutide. In case 1, a 20-year-old woman with obesity (31.8 kg/m²) with a non-ketoacidotic onset of diabetes was initially put on metformin and basal insulin. Previous ultrasound of the abdomen showed a hyperechogenic liver pattern. Tests showed high-titer multiple diabetes-related autoantibodies positivity, but still detectable C-peptide levels; thus, metformin was stopped and semaglutide was started. After 12 months, the patient still continues oral semaglutide and basal insulin, with detectable C-peptide, and has experienced significant weight loss (-20 kg) and resolution of liver steatosis. In case 2, a 13-year-old girl was diagnosed with autoimmune diabetes, with tests showing high-titer multiple diabetes-related autoantibodies positivity. She was initially put on multiple daily insulin injections (MDI). After almost 2 years, presenting to our care with still detectable C-peptide, we decided to stop meal-time insulin and to start oral semaglutide. After 15 months of follow-up on the latter treatment, the patient presents optimal glycemic control and increased C-peptide levels. This is the first case series that shows the possibility of treating LADY with oral semaglutide and basal insulin with optimal glycometabolic outcomes. Moreover, semaglutide treatment also had beneficial effects on weight control and non-confirmed effects on metabolic dysfunction-associated steatotic liver disease (MASLD).

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study5

5 results from studies that gave the peptide. 5 results from people.

01HumanCase report or seriesEfficacy outcome
In a 20-year-old woman with obesity and autoimmune diabetes, oral semaglutide with basal insulin was followed by a weight loss of 20 kg after 12 months.
In plain wordsOne young woman with obesity and autoimmune diabetes lost 20 kg in 12 months on oral semaglutide and basal insulin.
Peptide
Semaglutide
Outcome
DecreaseWeight change in case 1
Study
n = 1
Outcome group
Body weight · Metabolic and weight
Studied dose
Dose not stated · oral · 12 monthsAs given in this study (human).
Measurements
Weight change
−20 kg
case 1
Source sentences
Summary
After 12 months, the patient still continues oral semaglutide and basal insulin, with detectable C-peptide, and has experienced significant weight loss (-20 kg) and resolution of liver steatosis.
1 context sentence(design, population, supporting numbers)
Summary · context
In case 1, a 20-year-old woman with obesity (31.8 kg/m²) with a non-ketoacidotic onset of diabetes was initially put on metformin and basal insulin.
Show in the study text Report a problemFND-4245350901
02HumanCase report or seriesEfficacy outcome
In a 20-year-old woman with obesity and autoimmune diabetes, resolution of liver steatosis was reported after 12 months of oral semaglutide with basal insulin.
In plain wordsOne young woman had her fatty liver pattern resolve after 12 months on oral semaglutide and basal insulin.
Peptide
Semaglutide
Outcome
DecreaseLiver steatosis in case 1
Study
n = 1
Outcome group
Liver fat and liver function · Liver
Studied dose
Dose not stated · oral · 12 monthsAs given in this study (human).
Source sentences
Summary
After 12 months, the patient still continues oral semaglutide and basal insulin, with detectable C-peptide, and has experienced significant weight loss (-20 kg) and resolution of liver steatosis.
1 context sentence(design, population, supporting numbers)
Summary · context
Previous ultrasound of the abdomen showed a hyperechogenic liver pattern.
Show in the study text Report a problemFND-4245350902
03HumanCase report or seriesEfficacy outcome
In a 20-year-old woman with autoimmune diabetes, C-peptide stayed detectable after 12 months of oral semaglutide with basal insulin.
In plain wordsOne young woman with autoimmune diabetes still had measurable C-peptide after 12 months on oral semaglutide and basal insulin.
Peptide
Semaglutide
Outcome
No significant changeC-peptide in case 1
Study
n = 1
Outcome group
Glycemic control · Endocrine and hormones
Studied dose
Dose not stated · oral · 12 monthsAs given in this study (human).
Source sentences
Summary
After 12 months, the patient still continues oral semaglutide and basal insulin, with detectable C-peptide, and has experienced significant weight loss (-20 kg) and resolution of liver steatosis.
1 context sentence(design, population, supporting numbers)
Summary · context
Tests showed high-titer multiple diabetes-related autoantibodies positivity, but still detectable C-peptide levels; thus, metformin was stopped and semaglutide was started.
Show in the study text Report a problemFND-4245350903
04HumanCase report or seriesEfficacy outcome
In a 13-year-old girl with autoimmune diabetes, optimal glycemic control was reported after 15 months of oral semaglutide, with meal-time insulin stopped.
In plain wordsOne girl with autoimmune diabetes had good blood sugar control after 15 months on oral semaglutide, after meal-time insulin was stopped.
Peptide
Semaglutide
Outcome
Direction not reportedGlycemic control in case 2
Study
n = 1
Outcome group
Glycemic control · Metabolic and weight
Studied dose
Dose not stated · oral · 15 monthsAs given in this study (human).
Source sentences
Summary
After 15 months of follow-up on the latter treatment, the patient presents optimal glycemic control and increased C-peptide levels.
1 context sentence(design, population, supporting numbers)
Summary · context
After almost 2 years, presenting to our care with still detectable C-peptide, we decided to stop meal-time insulin and to start oral semaglutide.
Show in the study text Report a problemFND-4245350904
05HumanCase report or seriesEfficacy outcome
In a 13-year-old girl with autoimmune diabetes, C-peptide levels increased after 15 months of oral semaglutide.
In plain wordsOne girl with autoimmune diabetes had higher C-peptide levels after 15 months on oral semaglutide.
Peptide
Semaglutide
Outcome
IncreaseC-peptide in case 2
Study
n = 1
Outcome group
Glycemic control · Endocrine and hormones
Studied dose
Dose not stated · oral · 15 monthsAs given in this study (human).
Source sentences
Summary
the patient presents optimal glycemic control and increased C-peptide levels.
1 context sentence(design, population, supporting numbers)
Summary · context
After almost 2 years, presenting to our care with still detectable C-peptide, we decided to stop meal-time insulin and to start oral semaglutide.
Show in the study text Report a problemFND-4245350905

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 2Current
11 Oct 2026, 00:04 UTC
Study results updated
Version 1
9 Oct 2026, 03:06 UTC
First added · source update from Europe PMC

Subjects

Terms as the source lists them.

Publication types

MeSH terms

Keywords

PepBank is a research reference. Talk to a doctor before you use any peptide.