Latent autoimmune diabetes in adults (LADA) is a less prevalent version of Diabetes that progresses gradually. It is also known as type 1.5 diabetes because people with LADA might exhibit both type 1 and type 2 diabetes symptoms.
LADA develops when your pancreas stops making enough insulin, possibly due to some insult that slowly harms the insulin-producing cells in the pancreas, similar to autoimmune type 1 diabetes. However, you frequently won’t need insulin for several months to years following your diagnosis. The patients are often older than 30. Hence, people with LADA are frequently misdiagnosed as having type 2 diabetes (T2D).
This article will give you an insight into all there is to know about LADA, along with how it varies from other types of diabetes.
What makes LADA different from types 1 and 2?
Diabetes type 1 and type 2 differ from LADA in several ways, which are summarized in the table below.
Type 1 Diabetes | Type 2 Diabetes | LADA | |
Age at diagnosis | Childhood (Highest in age 5-7 years and puberty) | Adults (commonly >40 years but can be less) | >30 or equal to 30 |
| Insulin level at diagnosis | Very low | Very High | Low |
| Time to require insulin | At onset | Many years later | >6 months and <6 years |
| Presence of insulin resistance | No | Yes | Varies |
| Presence of autoantibodies | Yes | No | Yes |
Body mass index | Low | High | Low |
What are the symptoms of LADA?
The most common signs and symptoms associated with LADA are as follows:
- Frequent urination
- Excessive hunger
- Excessive thirst
- Frequent cuts and bruises that take a long time to heal
- Tiredness and lethargy
- Extreme weakness
- Weight loss despite eating more than usual
- Numbness or tingling in the hands or feet
Diagnosis and prevalence
The term latent autoimmune diabetes mellitus was first used to characterize slow-onset type 1 autoimmune diabetes in adults in 1993, even though type 1 diabetes (T1D) has been known to be an autoimmune illness since the 1970s. This was in line with the idea that T1D, not T2D, is characterized by GAD autoantibodies. However, many places have yet to acknowledge it, and research is ongoing.
It can be challenging to diagnose LADA, and occasionally persons are mistakenly given a type 2 diabetes diagnosis. According to estimates, it affects 10% of the population with diabetes.
If you have LADA, your blood will typically contain antibodies that are usually present in patients with type 1 diabetes. These are discovered via a procedure known as a GADA antibody test.
In addition to this, people with type 1.5 diabetes frequently fit the following description:
- They are not overweight
- They’ve been unable to control their diabetic symptoms with oral medications or lifestyle and dietary adjustments at the time of diagnosis.
Moreover, a fasting plasma glucose test, performed on blood drawn after an eight-hour fast, and an oral glucose tolerance test, performed on blood drawn after an eight-hour fast and two hours after consuming a high-glucose beverage, are two tests used to identify any diabetes. A random plasma glucose test can also be done.
Also, another element that aids doctors in differentiating between different forms of diabetes is C-peptide. The C-peptide blood levels in people with LADA can range from low to normal, but they are lower in people with type 1 and 2 diabetes.
What are the risk factors for developing LADA?
Some common risk factors associated with the development of LADA are as follows:
- Obesity
- Low birth weight
- Lack of physical activity
- Psychosocial stress
How is LADA treated?
LADA contains traits from both T1D and T2D, hence the management plan is devised keeping both in consideration. For example, once your blood sugar levels start to rise, you’ll typically begin to take an oral medicine, usually metformin, and then switch to insulin. However, if you have type 2 diabetes, you usually take insulin considerably sooner than you would.
The preferred form of treatment for type 1.5 diabetes is insulin therapy. However, insulin and insulin regimens come in a wide variety. In addition, your daily insulin dosage may change, so it’s crucial to regularly check your blood sugar levels to monitor your glucose levels.
However, there has yet to be a widely accepted method of controlling LADA. Numerous studies are presently being conducted to determine the prevalence of LADA and the most effective ways to care for it. Most medical practitioners concur that the goal of treatment is to prolong the time that insulin is generated. So early initiation of insulin therapy is advised.
The most crucial treatment component is taking any medication that enables you to control your blood sugar levels effectively. This will keep you healthy in the short term and prevent diabetes issues in the future.
Health risks associated with untreated LADA
If LADA is left untreated, it may have a detrimental impact on the person. Outcomes of untreated LADA include:
- Microvascular complications – including kidney damage
- Nerve damage – results in tingling, discomfort, and a loss of sensation in the hands and feet
- Vision problems – blurry vision, faded colors, loss of side vision, seeing dark spots
- Cardiovascular diseases – hypertension, heart failure, coronary artery disease
- Increased cholesterol levels – high LDL (“bad”) cholesterol and low HDL (“good”) cholesterol, high triglycerides (a type of fat in your blood)
- Diabetic ketoacidosis – it can happen when the body burns fat for energy instead of supplying the cells with the necessary glucose. This may result in the production of ketones, which give off a fruity breath odor. Moreover, it can result in a diabetic coma.
Can digital technologies help?
LADA patients have similar life expectancies to those with other kinds of diabetes. However, chronically elevated blood sugar levels may cause complications as described above. But many of these issues can be avoided with proper blood sugar management.
Some medical professionals believe that starting insulin therapy as soon as you are diagnosed assists you in maintaining the function of beta cells. If that is the case, it is crucial to have a diagnosis as soon as possible.
There are a lot of people who believe that digital technologies can help in diagnosing and treating LADA. The Diabetes:M management app is one of them. You can easily store all your daily diabetes readings and insulin intake in it. Have a detailed logbook with your nutrition information, medications, injection sites, and notes in one place. Try it now by downloading it from here.
Conclusion
Any diagnosis of diabetes calls for a significant shift in lifestyle, and individuals with LADA, which typically manifests in young to middle adulthood. Being diagnosed as an adult rather than a youngster has the benefit of giving the adverse health issues less time to manifest. But receiving an autoimmune diabetes diagnosis later in life has significant psychosocial effects and necessitates an abrupt lifestyle change.
The most excellent method to prevent complications from LADA is through early, accurate diagnosis and symptom control. Open communication with family members and online and offline support from people who share your diabetes diagnosis is also essential.
Dr. Ahmed is licensed by the General Medical Council, United Kingdom, and the Pakistan Medical Commission, Pakistan. With three years of experience, he has dealt with all kinds of diabetic patients and managed them with counseling and prescriptions. He is about to start his journey as a Junior Clinical Fellow in spinal surgery and orthopedic surgery in the United Kingdom.
