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TYPE 1.5 DIABETES MELLITUS OR LADA (Latent Autoimmune Diabetes in Adults)

1. What is Latent Autoimmune Diabetes in Adults (LADA) or Type 1.5 Diabetes Mellitus?

 LADA is "a slowly developing kind of type 1 diabetes." It is a genetically linked hereditary autoimmune disorder that results in the destruction of the insulin-producing beta cells of the pancreas.

At diagnosis, people with LADA usually do not require insulin right away because they are still producing some insulin. Because of their older age, they are often misdiagnosed as type 2 and started on oral medications. They may be normal weight or slightly overweight (not typical in type 2).

LADA has characteristics of type 1 and may include insulin resistance, like type 2 diabetes. The main difference between LADA and type 2 is the autoimmune response, which is similar to type 1.

The loss of beta cells is much more gradual in LADA than in type 1, though. It can take several years before blood glucose control starts to worsen.

 2. Diabetes Types :

 

Diabetes Types

Key characteristics of type 1, LADA (latent autoimmune diabetes in adults), and type 2.

 

Type 1

LADA

Type 2

Typical age of onset

Youth or adult

Adult

Adult

Progression to insulin dependence

Rapid (days/weeks)

Latent (months/years)

Slow (years)

Presence of autoantibodies*

Yes

Yes

No

Insulin dependence

At diagnosis

Within 6 years

Over time, if at all

Insulin resistance

No

Some

Yes

*Proteins that indicate the body has launched an autoimmune attack on the insulin-producing beta cells in the pancreas.

 3. How is LADA diagnosed?

LADA can be seen at any age.

Tests for LADA are the same as for type 1.

A blood test is done to see if any antibodies are present, and a measure of C-peptide levels is taken to determine how much insulin is being produced. If levels of GAD and islet cell antibodies are high, along with a low C-peptide level, LADA is diagnosed.

4. How should LADA be treated?

Most experts agree that early treatment with insulin may preserve the functioning beta cells. Although many people with LADA will initially respond to changes in diet and exercise, along with oral medications, these will not halt or slow the progression of beta cell destruction. So, people with LADA will eventually require insulin to maintain blood glucose control.

The label for your diabetes matters less than your seeking and receiving treatment that helps you maintain your best health.







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Dr. Ashwini Joshi

MBBS DNB Medicine, MRCP UK
Consultant Physician and Diabetologist

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