I've been diagnosed with LADA — latent autoimmune diabetes in adults. What's the difference between it and other forms of diabetes?
Answer From M. Regina Castro, M.D.
Latent autoimmune diabetes in adults (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 some "insult" that slowly damages 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.
Many researchers believe LADA, sometimes called type 1.5 diabetes, is a subtype of type 1 diabetes, while others do not recognize it as a distinct entity. Other researchers believe diabetes occurs on a continuum, with LADA falling between type 1 and type 2 diabetes.
People who have LADA are usually over age 30. Because they're older when symptoms develop than is typical for someone with type 1 diabetes and because initially their pancreases still produce some insulin, people with LADA are often misdiagnosed with type 2 diabetes.
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.
At first, LADA can be managed by controlling your blood sugar with diet, losing weight if appropriate, exercise and, possibly, oral medications. But as your body gradually loses its ability to produce insulin, you'll eventually need insulin shots.
More research is needed before the best way to treat LADA is established. Talk with your doctor about the best LADA treatment options for you. As with any type of diabetes, you'll need close follow-up to minimize progression of your diabetes and potential complications.
Feb. 23, 2021
M. Regina Castro, M.D.
See more Expert Answers
- Pozzilli P, et al. Latent autoimmune diabetes in adults: Current status and new horizons. Endocrinology and Metabolism. 2018;33:147.
- Cousminer DL, et al. First genome-wide association study of latent autoimmune diabetes in adults reveals novel insights linking immune and metabolic diabetes. Diabetes Care. 2018;341:2396.
- Symptoms and causes of diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes. Accessed April 18, 2019.
- Forlenza FP, et al. Classification and diagnosis of diabetes. In: Diabetes in America. 3rd ed. Washington, D.C.: National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/about-niddk/strategic-plans-reports/diabetes-in-america-3rd-edition. Accessed April 19, 2019.
- Pieralice S, et al. Latent autoimmune diabetes of adults: A review on clinical implications and management. Diabetes and Metabolism Journal. 2018;42:451.
- Carlsson S. Etiology and pathogenesis of latent autoimmune diabetes in adults (LADA) compared to type 2 diabetes. Frontiers in Physiology. 2019;10:320.
- McCulloch DK. Classification of diabetes mellitus and genetic diabetic syndromes. https://www.uptodate.com/contents/search. Accessed April 18, 2019.
- Castro MR (expert opinion). Mayo Clinic, Rochester, Minn. April 22, 2019.