Diabetes LADA
Diabetes in Adults (LADA) is a form of autoimmune diabetes (type 1A diabetes) which is diagnosed in individuals who are older than the usual age of onset of type 1 diabetes (that is, over 30 years of age at diagnosis). Alternate terms that have been used for "LADA" include Late-onset Autoimmune Diabetes of Adulthood, "Slow Onset Type 1" diabetes, and sometimes also "Type 1.5 [Type one-and-a-half]" diabetes.
Often, patients with LADA are mistakenly thought to have type 2 diabetes, based on their age at the time of diagnosis. Such misdiagnosis is easy to make when the person is older, and initially responds to treatment with diabetes pills. It is now thought that perhaps twenty percent of patients with apparent Type 2 diabetes really have LADA. Patients with LADA do not have insulin resistance, as do people with Type 2. Also, positive antibody tests would help make the diagnosis of LADA in a person who might be suspected of having either LADA or Type 2.
Some diabetes specialists feel that once LADA is diagnosed, it is important to promptly start the patient on insulin therapy (rather than using sulfonylureas or other diabetes pills), but it is unclear whether early treatment with insulin is beneficial for the remaining beta cells. Drug therapy to preserve insulin function in patients with LADA is being investigated.
Characteristics of LADA include
- Adult age at diagnosis (usually over 25 years of age)
- Initial presentation masquerades as non-obese type 2 diabetes (does not present as diabetic ketoacidosis)
- Initially can be controlled with meal planning with or without diabetes pills
- Insulin dependency gradually occurs, frequently within months
- Positive antibodies
- Low C-peptide levels
- Unlikely to have a family history of type 2 diabetes
What is latent autoimmune diabetes in adults (LADA)?
(Sometimes Referred to as Type 1.5 or Slow Onset Type 1)
'''Latent Autoimmune Diabetes in Adults''' (LADA) is a genetically-linked, hereditary autoimmune disorder that results in the body mistaking the pancreas as foreign and responds by attacking and destroying the insulin-producing beta islet cells of the pancreas. Simply stated, autoimmune disorders, including LADA, are an "allergy to self."
In its early stages LADA typically presents as type 2 diabetes and is often misdiagnosed as such. However, LADA more closely resembles the juvenile form of type 1 diabetes, although it is not classified as the same disease .LADA carries a high-risk factor of becoming insulin dependent and shares common physiological characteristics of type 1 diabetes for metabolic dysfunction, genetics, and autoimmune features but does not affect children.
Treatment for LADA
LADA often does not require insulin at the time of diagnosis, and may even be managed with changes in lifestyle in its early stages. However, some clinicians believe that insulin should be started at onset, or, as soon as possible rather than using sulfonylureas or other diabetes pills for initial treatment. It is not clear whether early insulin therapy is of benefit to the remaining beta islet cells 80% of persons initially diagnosed with type 2 but test positive for GAD (an indication of LADA). progress to insulin dependency within 6 years. But those who test positive for both GAD and IA2 will progress more rapidly to insulin dependence.
