What you need to know about LADA

Termed either as Type 1.5 diabetes, or latent autoimmune diabetes in adults (LADA), is a condition that shares characteristics of both type 1 and type 2 diabetes.

LADA is diagnosed during adulthood, and it sets in gradually, sometimes referred to as the honeymoon period. Unlike type 2 diabetes, LADA is an autoimmune disease and isn’t reversible with changes in diet and lifestyle. Your beta cells stop functioning much more quickly if you have LADA than if you have type 2. It’s estimated that 10% of people who have diabetes have LADA.

LADA can easily be — and is often — misdiagnosed as type 2 diabetes. If you’re in a healthy weight range, have an active lifestyle, and have been diagnosed with type 2 diabetes, there’s a chance that what you actually have is LADA.

LADA symptoms 

LADA symptoms can be vague at first. They may include:

• frequent thirst

• increased urination, including at night

• unexplained weight loss

• blurred vision and tingling nerves

If left untreated, LADA can lead to diabetic ketoacidosis, which is a condition where the body can’t utilise sugar as fuel due to the absence of insulin and starts burning fat. This produces ketones, which are toxic for the body.

LADA causes 

To understand what causes LADA, it helps to understand the difference between the other main types of diabetes.

Type 1 diabetes is considered an autoimmune condition because it’s the result of your body destroying pancreatic beta cells. These cells are what helps your body make insulin, the hormone that allows you to store glucose (sugar) in your body. People who have type 1 diabetes need to inject insulin into their bodies to survive.

Type 2 diabetes is primarily characterised by your body resisting insulin’s effects. Insulin resistance is caused by genetic and environmental factors, such as a diet high in carbohydrates, inactivity, and obesity. Type 2 diabetes can be managed with lifestyle interventions and oral medication, but many may also need insulin to keep their blood sugar under control, eg older people or people in their senior years.

LADA can be triggered by damage done to your pancreas from antibodies against insulin-producing cells. Genetic factors may also be involved, such as a family history of autoimmune conditions. When the pancreas becomes damaged in LADA, the body destroys pancreatic beta cells, as with type 1. If the person with LADA also happens to be overweight or obese, insulin resistance might also be present.

LADA diagnosis 

LADA occurs in adulthood, which is why it’s commonly mistaken for type 2 diabetes. Most people with this type of diabetes are over the age of 40, and some can develop the condition even in their 70’s or 80’s. The process of getting a LADA diagnosis can take some time. Often, people (and doctors) may assume that they have type 2 diabetes because it developed later in life.

Type 2 diabetes treatments, like metformin, can work to manage symptoms of LADA until your pancreas stops making insulin. That’s the point at which many people discover that they were dealing with LADA all along. Typically, the progression to needing insulin is much faster than with type 2 diabetes, and the response to medication for lowering blood sugar levels (oral hypoglycaemic drugs) is poor.

People who have LADA tend to meet the following criteria:

·       They’re not obese.

·       They’re over the age of 30 at the time of diagnosis.

·       They’ve been unable to manage their diabetes symptoms with oral medications or lifestyle and dietary changes.

LADA treatment 

LADA results from your body not producing enough insulin. But since its onset is gradual, oral medication that treats type 2 diabetes can work, at least at first, to treat it.

People who have LADA also may test positive for at least one of the antibodies that people who have type 1 diabetes tend to have. As your body slows down its production of insulin, (this can happen over a number of years) you’ll need insulin as part of your treatment. People who have LADA often require insulin within five years of diagnosis.

Insulin treatment is the preferred treatment method for LADA. There are many different types of insulin and insulin regimens. The dosage of insulin that you need may vary daily, so monitoring your glucose levels through frequent blood sugar testing is essential.

LADA outlook 

Life expectancy for people who have LADA is similar to people who have other types of diabetes. Higher blood sugar over a sustained period of time can lead to diabetes complications, such as kidney disease, cardiovascular problems, eye disease, and neuropathy, which can adversely affect prognosis. But with good blood sugar control, many of these complications can be prevented.

In the past, people who had type 1 diabetes had a shortened life expectancy. But improved diabetes treatments are changing that statistic. With good blood sugar control, a normal life expectancy is possible.

Some experts feel that getting treated with insulin from the outset of your diagnosis can help preserve your beta cell function. If that’s true, getting a correct diagnosis as soon as possible is quite important.

In terms of complications that may impact outlook, thyroid disease is more prevalent in people who have LADA than in people who have type 2 diabetes. People who have diabetes that isn’t managed well tend to heal more slowly from wounds and are more likely to develop infections.

LADA prevention 

There’s currently no way to prevent LADA. Like type 1 diabetes, there are genetic factors at play in the progression of this condition. Early, correct diagnosis and symptom management is the best way to avoid complications from LADA.

Extracts taken from Kathryn Watson from https://www.healthline.com