LADA – Latent Autoimmune Diabetes of Adults
Latent autoimmune diabetes of adults (LADA), also known as type 1.5 diabetes, is adult onset autoimmune diabetes which shares features of both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Adults with LADA are often initially misdiagnosed as having type 2 diabetes based on their age, not etiology. It is estimated that more than 50% of persons diagnosed as having non-obesity-related type 2 diabetes may actually have LADA. Also, many physicians or diabetes specialists don’t recognize LADA or don’t know that Type 1 diabetes frequently occurs in adults, and so LADA is misdiagnosed as or mistaken for Type 2 diabetes very often.
The onset of LADA is in adult life (usually age >30 years), and the disease is at least initially not insulin-requiring, so the patients appear clinically to be affected by T2DM. But these patients have islet autoantibodies, most commonly glutamic acid decarboxylase (GAD) antibody, relatively low C-peptide secretion, and a higher rate of progression to insulin dependency, behaving like T1DM patients. Clinical dilemma exists in initial diagnosis, but early diagnosis and interventions can influence the speed of progression toward insulin dependency. The long-term complications of LADA are the same as for those with type 1 (formerly juvenile diabetes) and with type 2. According to one major study, the Diabetes Control and Complications Trial (DCCT), the risk of long-term problems are directly related to how well the blood glucose levels are managed. The American Diabetes Association recommends LADA patients strive for a HbA1c test of 7.0 or lower.
Some common factors with LADA are:
- Age of onset < 50 years
- Acute symptoms (unintentional weight loss)
- Body mass index (BMI) < 25
- Personal history of autoimmune disease
- Family history of autoimmune disease