Latent Autoimmune Diabetes in Adults (LADA)

What is latent autoimmune diabetes in adults (LADA)?

Latent autoimmune diabetes in adults (LADA) is a type of diabetes that features elements of both Type 1 and Type 2 diabetes. That’s why it’s also known as Type 1.5 diabetes. Healthcare providers believe an autoimmune condition causes LADA (like Type 1 diabetes). But a diagnosis typically comes in adulthood and happens gradually (like Type 2 diabetes). For this reason, it’s often misdiagnosed as Type 2.

Healthcare providers diagnose it in adults between ages 30 and 50.

How rare is LADA diabetes?

Even though many people haven’t heard of it, LADA is fairly common. Studies suggest that between 4% and 12% of people who initially receive a Type 2 diabetes diagnosis end up having LADA. To put that in perspective, about 530 million adults worldwide have Type 2. This means several million people potentially have LADA diabetes.

What are the symptoms of LADA diabetes?

The symptoms of Type 1.5 diabetes are like those of other forms of diabetes. Some of the most common are:

• Being very thirsty (polydipsia).
• Needing to pee more often.
• Losing weight unexpectedly.
• Blurred vision.
• Fatigue.
• Itchy, dry skin.

What causes it?

Researchers suspect LADA happens when antibodies mistakenly attack and destroy cells in your pancreas that make insulin. When you can’t release insulin, sugar (glucose) builds up in your bloodstream. In this way, it’s like Type 1 diabetes. People with Type 1 need insulin injections to survive. Many people with Type 1 are diagnosed as a child or in their teens.

But, like Type 2 diabetes, a LADA diagnosis happens more often in adults with symptoms beginning slowly. This is because your pancreas stops making insulin gradually, which can make it hard to notice symptoms. You may not need insulin injections for months or years. This is why some providers initially suspect Type 2 and not LADA diabetes.

What triggers LADA diabetes?

There aren’t any triggers for LADA because it’s something your immune system does without your control. LADA diabetes can go unnoticed because your pancreas still releases enough insulin not to cause symptoms.

What are the risk factors?

LADA has a strong genetic component, which means you may be susceptible to it if your biological parents or grandparents have it. There’s also evidence that environmental and lifestyle factors play a role in developing LADA. These include things like having obesity.

What are the complications?

The biggest complication comes from not receiving the right treatment for the condition. Because it can appear to be Type 2 diabetes, you may not get treatment with insulin as early as you need it. This can increase your risk for health complications like kidney damage.

Diabetes-related ketoacidosis (DKA) is a life-threatening complication of LADA diabetes. It happens when your liver starts breaking down body fat for energy because you don’t have enough glucose (blood sugar) in your cells to use for energy.

How is LADA diabetes diagnosed?

LADA usually affects adults who initially receive a Type 2 diabetes diagnosis. But, once you’re unable to manage your blood sugar with oral medications (like metformin) and lifestyle modifications (like eating nutritious foods), healthcare providers may suspect Type 1.5 diabetes.

Your healthcare provider will diagnose LADA with a blood test called a GAD Antibodies Test (glutamic acid decarboxylase antibodies). It looks for autoantibodies that target glutamic acid decarboxylase (GAD). If your provider finds signs of these autoantibodies in your blood, it can mean you have an autoimmune disorder that affects your pancreas. If you’re an adult, that likely means you have LADA.

Your provider may also order a C-peptide test, which measures how much C-peptide is in your blood. C-peptides tell your provider how much insulin your pancreas is making.

What’s the treatment for LADA diabetes?

Treating LADA is tricky because, initially, you may respond to oral diabetes medications. They may help you manage your blood sugar levels temporarily. But as the condition worsens, your body will respond less. You’ll need to switch to insulin injections to manage your blood sugar because your pancreas will completely lose its ability to create its own insulin. This can happen after a few months or a few years.

There isn’t one agreed-upon treatment for LADA. Some experts believe treatment with insulin from the get-go is best, while others may wait to start you on insulin injections.

The dosage and amount of insulin you need can vary, so you’ll still need to monitor your blood sugar levels.

Can you prevent LADA diabetes?

There’s no way to prevent LADA diabetes, because you can’t control or prevent the autoimmune condition that causes it. Getting an early diagnosis and starting treatment right away is the best way to prevent complications from the condition.

What can I expect if I have this condition?

There’s no cure for Type 1.5 diabetes, but your healthcare provider will help you find treatments to manage it. Once you begin taking insulin, you’ll be better able to manage your blood sugar levels.

What is the life expectancy of someone with LADA diabetes?

Your life expectancy depends on several factors. Having Type 1.5 diabetes alone doesn’t decrease your lifespan. But if you have LADA diabetes and can’t manage your glucose levels, you’re at risk for health complications that can shorten your life expectancy. This is mainly because chronic high blood sugar levels can lead to issues like heart disease, which can impact lifespan.

How do I take care of myself if I have type 1.5 diabetes?

The best way to take care of yourself is to manage your blood sugar. LADA diabetes is often misdiagnosed. It can be frustrating to think you’re doing everything right, only to find that your blood sugar is still hard to manage. If you receive a LADA diagnosis, follow the treatment plan your provider helps you create. Be sure to attend all your follow-up appointments. These visits help your provider check on your pancreas and overall health. They’ll also adjust how much insulin you need.

When should I see my healthcare provider?

Contact a healthcare provider if you have symptoms of diabetes like excessive thirst and frequent urination. Be sure to share your complete health history with your healthcare provider.

If you receive a Type 2 diabetes diagnosis and find that your symptoms aren’t getting better after treatment, ask your provider about testing for Type 1.5 diabetes.