Latent Autoimmune Diabetes In Adults (LADA).
What’s the difference between it and other forms of diabetes?
What is Lada Diabetes
Lada is a slow progressing form of autoimmune diabetes. Like the autoimmune disease type 1 diabetes, LADA occurs because your pancreas stops producing adequate insulin, most likely from your immunine system attacking the insulin-producing cells in the pancreas. But unlike type 1 diabetes, with LADA, you often won’t need insulin for several months up to years after you’ve been diagnosed.
LADA is sometimes referred to as type 1.5 diabetes. This is not an official term but it does illustrate the fact that LADA is a form of type 1 diabetes that shares some characteristics with type 2 diabetes. Doctors may mistakenly diagnose LADA as type 2 diabetes.
It is beneficial if LADA is diagnosed correctly, if LADA is incorrectly diagnosed as type 2 diabetes, it could lead to the wrong treatment regime that could lead to poor diabetes control and could speed up the loss of insulin producing ability.
There are some clues that can tell you if you have LADA rather than type 2 diabetes. These include:
- An absence of obesity, high blood pressure and cholesterol levels
- Constant high blood readings even with treatment by medicine and diet
- Evidence of other autoimmune diseases (including Graves’ disease and Anaemia)
If you’ve been diagnosed with type 2 diabetes and you’re lean and physically active or you’ve recently lost weight without effort, talk with your doctor about whether your current treatment is still the best one for you.
Symptoms of Lada
- Unusual thirst
- Frequent urination
- Weight loss despite an increase in appetite
- Blurred vision
- Nausea and vomiting
- Extreme weakness and fatigue
- Irritability and mood changes
- Frequent bladder and skin infections that don’t heal easily
- High levels of sugar in the blood when tested
- High levels of sugar in the urine when tested
- Dry, itchy skin
- Tingling or loss of feeling in the hands or feet
As LADA develops, a person’s ability to produce insulin will gradually decrease meaning high blood glucose levels.
Doctors may spend several months trying different oral medications, suspect you are not taking your medication or following a sensible diet, and enforce further lifestyle modifications when, in actuality, these patients are in need of insulin therapy. Medications that preserve β-cell function may be useful for LADA as well, given it’s relatively more rapid progression of β-cell loss compared to type 2 diabetes. Incorrect diagnosis can delay proper treatment, exposing patients to potential adverse effects from ineffective drugs, and ultimately increasing the risk of long-term complications.
Most cases of LADA are only “suspected” after a patient has little or no response to oral diabetes medications. When these LADA patients are started on injectable insulin, they do well.
How common is LADA?
LADA cases are found in between 6% and 10% of diabetes cases. Among people diagnosed with diabetes at an age younger than 35 years old, LADA may account for up to 25% of cases.
Diagnosing Type 1.5 Diabetes (LADA)
The only way to confirm LADA is through antibody testing.
A test for glutamic acid decarboxylase, or GAD, antibodies, with LADA as well as type 1 diabetes, the body’s immune system begins to attack it’s own beta cells. When the immune system attacks pathogens, one weapon in it’s arsenal is the creation of antibodies that bind to the foreign objects and mark them as invaders. In the case of autoimmune diabetes, the body begins to create antibodies against parts of proteins that are not foreign, but rather are associated with it’s own beta cells. GAD is one of the earliest proteins to be targeted by antibodies, and so by testing for the presence of GAD antibodies, doctors can determine whether there is an autoimmune reaction to beta cells taking place.
Other testing for LADA diabetes that may be used in conjunction with the GAD test to determine if a person has type 1.5 include determining c-peptide levels to measure insulin production levels, and tests for islet cell antibodies.
Both tests can be done with a simply blood test from the arm.
Patients with type 1 diabetes commonly have one or more of four islet auto antibodies — islet cell antigens (ICAs), glutamic acid decarboxylase auto antibodies (GADAs) or tyro sine phosphates proteins (IA-2s) — whereas patients with LADA typically only have one auto antibody. LADA patients have a far less incidence of IA-2 and ICA auto antibodies than patients with type 1
Results from a study by Stenström et al indicate that patients who developed type 2 diabetes that had two or three auto antibodies experienced severe deterioration of ß-cell function within five years, whereas patients with type 2 diabetes that had only one auto antibody did not develop severe ß-cell dysfunction until 12 years later. Five study patients that did not initially have auto antibodies at the time of diabetes diagnosis developed auto antibodies further in the study, which suggested that some patients may have an even later onset of severe ß-cell dysfunction after 12 years.
Treating LADA Diabetes
A healthy, carbohydrate-controlled eating plan along with exercise and weight loss can help your beta cells control your blood sugar better, Improving insulin sensitivity will allow the insulin you do have to work better. Reducing carbohydrates to a level recommended by your doctor will also keep your blood sugar a little lower, so insulin doesn’t have to move as much glucose into your cells, We use car analogies here. If you have a limited supply of gas, driving a small car will make that gas last longer than driving a Hummer. If you have limited insulin, make the most of it.”
And be prepared for the day when you do need insulin injections or a pump. Most people with LADA need insulin within six years of their diabetes diagnosis. “Needing insulin is not a failure,” . “When your body cannot produce it, it’s time to move to insulin. You’ll need it for blood glucose control and to lower your risk for complications.”
Read our article here for tips on how to help your body produce insulin, how to improve insulin sensitivity and preserve your B cell function.
Please leave any comments or questions below, I will respond within 24 hours.
Garry (Type 1)
Please join our Facebook group and meet new friends who are in your situation and totally understand what you are going through.