Latent Autoimmune Diabetes in Adults and Why Some Call It Type 1.5 DM

LADA (Latent Autoimmune Diabetes In Adults) is a form of type 1 diabetes that occurs when the body’s immune system, which normally fights infection and disease, mistakenly attacks its own pancreatic beta cells. The destruction of the beta cells reduces their ability to produce insulin, leading to higher blood glucose levels. This can lead to symptoms, such as frequent urination and fatigue. LADA is often mistaken for type 2 Diabetes because of the usual age of onset. In this article, we’ll discuss LADA and why it’s also sometimes called Type 1.5 Diabetes. 

LADA vs. Type 1 and Type 2 DM

LADA develops gradually. It shares some characteristics with type 1 and type 2 diabetes (but more of Type 1) – hence the name, Type 1.5 Diabetes. But, what are its unique characteristics? 

Like Type 1 Diabetes, LADA is a type of autoimmune disease. 

This means that your body’s immune system mistakenly attacks its own cells — particularly the pancreatic cells involved in the production of insulin. As insulin allows cells to use sugar; producing less of it means sugar stays in the blood, resulting in hyperglycemia. 

Unlike Type 1 Diabetes, LADA progresses more slowly. 

While the peak age for diagnosis of type 1 Diabetes is 13 to 14 years old, diagnosis with LADA usually happens after the age of 30 or 35. This is why many adults with type 1.5 Diabetes receive a type 2 diagnosis.

Unlike in Type 1 Diabetes, Insulin Therapy may NOT be Needed Until Months or Years After Diagnosis

After receiving a Type 1 DM diagnosis, a person will most likely need insulin therapy right away. This is not the case for LADA. As the progress is slow, there might be no need for insulin therapy until after months or years of diagnosis. 

Type 1.5 Diabetes has the Signs and Symptoms of Type 1 and 2 DM

Individuals with LADA may present with polyuria, nocturia, polydipsia, visual changes, fatigue, weight loss, and tingling in the feet. Of course, they might also be initially asymptomatic.  

Cause and Risk Factors for Developing LADA

Ultimately, the cause of Type 1.5 Diabetes is the presence of auto-antibodies against the pancreatic cells, insulin, or enzymes involved in the functions of the pancreas. 

LADA is a rare form of adult-onset diabetes that can occur in adults. Your risk for developing LADA is higher if you are:

• A low birthweight baby (strong risk factor)
• Overweight or obese in adulthood
• Sedentary, with low physical activity
• Smoking
• Drinking sweetened beverage

According to reports, the more risk factors you have, the higher the possibility is of developing Type 1.5 Diabetes. For example, if you have low birth weight and adult obesity, your risk becomes higher. 

How is LADA Diagnosed?

LADA patients need to undergo all other tests for other types of diabetes, including Fasting Blood Sugar (FBS), HbA1c, self-monitoring of blood glucose, urinalysis, lipid profile, and serum creatinine. Of course, if there are complications, other tests may be necessary. 

On top of this, The Immunology for Diabetes Society (IDS) has specified three criteria for LADA diagnosis3: 

• Age older than 35
• Presence of auto-antibodies to islet beta cells
• Insulin independence for at least 6 months after the initial diagnosis – this means the patient does not need to receive insulin therapy for at least 6 months after being diagnosed. 

How Is LADA Treated?

LADA is a chronic disease, which means there is no cure and the patient might need treatment for a long time. 

Treatment usually involves a combination of medications, diet and lifestyle changes, exercise, insulin therapy, and possibly corticosteroids if your blood sugar levels are very high.

The goal of treatment for LADA is to get your blood glucose within the normal range as soon as possible. If you have mild symptoms that come on slowly over time (as opposed to more rapidly), then your doctor may recommend lifestyle changes, such as losing weight or getting more exercise instead of starting medication right away. 

It’s important to work closely with your doctor so that you can manage your diabetes early on before complications develop significantly later in life!

Is LADA Preventable?

You may be wondering if it’s possible to prevent Latent Autoimmune Diabetes in Adults (LADA). The answer is, in part, yes. Only in part because you cannot do anything about your genes or the development of autoantibodies. But there are some measures you can take to help reduce your chances of developing LADA:

• Be more physically active as a sedentary lifestyle is a risk factor. 
• Achieve a healthy weight. Being overweight and obesity also increase insulin resistance, which can make it more difficult for your body to regulate glucose levels on its own without medication.
• Stop or avoid smoking. 
• Have a healthy diet with more fruits and vegetables, whole grains instead of refined carbohydrates, lean protein, and healthy fats. You might also want to cut back on sweetened beverages and processed foods. 

Learn more about Type 1 Diabetes here.