Latent autoimmune diabetes in adults (LADA) is an autoimmune condition also known as type 1.5 diabetes. People with LADA follow similar T1D practices with insulin, eating, exercise, and blood sugar management.
Type 1.5 diabetes is commonly known as LADA, or latent autoimmune diabetes in adults. This type of diabetes shares characteristics of both type 1 (T1D) and type 2 (T2D) diabetes.
As an autoimmune condition that develops during adulthood, LADA is not tied to lifestyle habits or eating patterns, as T2D often is.
This type of diabetes may set in more gradually than T1D, which often develops suddenly with fast-rising blood sugar levels and related symptoms. With LADA, people may have a longer period of time before needing insulin.
With a diagnosis taking place during adulthood, LADA may be
Typical LADA symptoms are similar to
- increased thirst
- frequent urination, including at night
- unexplained weight loss
- blurred vision
- tingling nerves in the toes, feet, fingers, and hands
If LADA isn’t diagnosed and is left untreated, it can lead to diabetic ketoacidosis (DKA), an emergency situation where the body can’t use sugar as fuel and instead starts burning fat for energy. This produces ketones, which are toxic to the body.
This is considered a medical emergency that may require urgent care and hospitalization.
An estimated 2% to 12% of adult-onset diabetes diagnoses are LADA, though estimates vary given the different criteria used to define the condition and how it overlaps so much with both T1D and T2D.
The American Diabetes Association’s yearly guidelines point out that despite the controversy on how LADA is defined and diagnosed, it’s a common and acceptable term that many use in the clinical community.
People who have LADA tend to meet the following criteria:
- do not have obesity or overweight
- are over age 30 years
- are unable to manage their diabetes with non-insulin medications, lifestyle adjustments, or dietary changes
Your healthcare and diabetes care team can order a number of different lab tests to help diagnose diabetes, which is the same for determining other types of diabetes.
One test that may be different is an antibody test. Healthcare professionals use this test to determine if you have an autoimmune reaction in your body that helps determine your type of diabetes.
Misdiagnosis can happen
Research shows that as many as 40% of people 30 years and older with type 1 diabetes may have initially been misdiagnosed with T2D.
Treatments for T2D, including metformin, may temporarily manage blood sugar levels and other diabetes symptoms until the pancreas stops making insulin.
This is often the point at which many who have received a T2D diagnosis become frustrated with how treatment is no longer working effectively.
As a result, they may receive a new LADA diagnosis and realize that they may have had that type of diabetes all along.
LADA develops when your body does not make enough insulin and eventually stops producing that critical hormone.
While you may be able to treat LADA with oral medications at first (similar to T2D), you will eventually need to take insulin.
The time that change occurs may be different for everyone, but people with LADA typically require insulin within 5 years of diagnosis.
Establishing a diabetes care plan from there is the same as it would be for anyone with T1D. This includes
- blood sugar management
- meal planning
- routine physical activity
mental health awareness
Like any type of diabetes, your risk for developing diabetes-related complications is often tied to blood sugar levels. Genetics may also play a role, but higher blood sugar and A1C levels over time raises the risk of complications.
This can include the most common diabetes complications:
People receiving a diabetes diagnosis during adulthood may have a form of adult-onset diabetes called LADA. This type of diabetes may have a slower onset than traditional T1D, but it eventually requires insulin and daily management like T1D.