Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Latent autoimmune diabetes in adults (LADA)—or type 1.5 diabetes—is an irreversible autoimmune disease that affects insulin function. Although similar totype 1 diabetes, which typically is diagnosed during childhood, LADA develops in adulthood, usually after age 30.
For this reason, and because the symptoms are similar, LADA is sometimes first misdiagnosed as type 2 diabetes. In fact, LADA may account for up to 10% of diabetes cases of all types.
This article discusses the symptoms of LADA, along with how to receive a diagnosis and available treatment options.
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A Controversial ClassificationSome experts regard LADA as a subtype of type 1 diabetes (it is sometimes called type 1.5 diabetes), while others don’t see it as a separate condition or view it as part of the diabetes continuum.
A Controversial Classification
Some experts regard LADA as a subtype of type 1 diabetes (it is sometimes called type 1.5 diabetes), while others don’t see it as a separate condition or view it as part of the diabetes continuum.
Symptoms of LADA
When it first appears, latent autoimmune diabetes in adults is often misdiagnosed as type 2 diabetes. This is because the symptoms align closely with those of type 2 diabetes and tend to come on slowly for several months.
They include:
Whereas type 1 diabetes develops rapidly, the progression of LADA is much slower and may appear to be a slowly progressing form of type 1. (When type 1 diabetes affects a child, it tends to come on suddenly and dramatically.)
One thing to note about LADA is that, unlike type 2 diabetes, it is not associated with excess body weight or obesity. Most people with LADA are unlikely to be overweight; they have abody mass index(BMI) below 25 and a low waist-to-hip ratio.
BMI is a dated, flawed measure. It does not take into account factors such asbody composition, ethnicity, sex, race, and age. Even though it is abiased measure, BMI is still widely used in the medical community because it’s an inexpensive and quick way to analyze a person’s potential health status and outcomes.
Complications
Without proper diagnosis and prompt treatment, LADA can result in a complication calleddiabetic ketoacidosis. This is a dangerous condition in which the body starts to break down fat for fuel because no glucose can get into cells.
This occurs when the function of beta cells in the pancreas, which are responsible for the production of insulin, begins to decline. Ketoacidosis can require immediate insulin injection.
Other complications of LADA are the same as those of all types of diabetes, including:
Like type 1 diabetes, LADA is an autoimmune disease in which the body views beta cells as foreign and attacks them, resulting in a shutdown of insulin production. That said, people with LADA also may develop insulin resistance—the cause of type 2 diabetes.
What may cause someone to develop autoimmune diabetes later in life is not fully understood, but researchers have been able to pinpoint certain risk factors for LADA:
Thyroid disease is a common comorbidity with LADA, meaning that the two conditions often coexist. It is not known if one causes the other, however.
Comorbidities: Meaning and Common Examples
Diagnosing LADA can be tricky. Not all practitioners recognize it as a distinct type of diabetes and may mistake it for type 2 diabetes—at least initially.
Once the disease is suspected, bloodwork may be done to test for the following factors associated with LADA:
The Immunology of Diabetes Society recommends specific criteria to help standardize the diagnosis of LADA:Age greater than 30 yearsPositive for at least one of the four possible antibodiesNo treatment with insulin in the first six months post-diagnosis
The Immunology of Diabetes Society recommends specific criteria to help standardize the diagnosis of LADA:
Like type 1 diabetes, LADA is an irreversible condition that requires treatment for life.
Treatment may also include oral diabetes medications to help control blood sugar and support insulin output.
However, oral medications and lifestyle changes likely won’t be enough to preserve insulin function and control blood sugar levels in the long term.After that point, insulin support will be needed—typically within five years of diagnosis.
Specific oral medications that may be helpful in treating LADA include:
Metformin, a biguanide, which is typically used as a first-line treatment in type 2 diabetes, should be used with caution in LADA. There is a potential risk for a condition called lactic acidosis, a dangerous buildup of lactic acid in the body that may be fatal.
Sulfonylureas, another class of anti-diabetes drugs, should be avoided. They may exhaust beta cells (the cells in the pancreas responsible for producing insulin) and further deplete insulin levels.
Type 1 vs. Type 2 Diabetes: Different Insulin Effects
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Hals IK.Treatment of latent autoimmune diabetes in adults: What is best?.Current diabetes reviews. 2019 Jun 1;15(3):188-93. doi:10.2174/1573399814666180716144429Poudel RR.Latent autoimmune diabetes of adults: From oral hypoglycemic agents to early insulin.Indian JEndocrinol Metab. 2012;16 Suppl 1:S41-6. doi:10.4103/2230-8210.94257Laugesen E, Østergaard JA, Leslie RD.Latent autoimmune diabetes of the adult: Current knowledge and uncertainty.Diabet Med. 2015;32(7):843-52. doi:10.1111/dme.12700Unger J.Latent autoimmune diabetes in adults.Am Fam Physician.2010 Apr 1;81(7):843-847.Pozzilli P, Pieralice S.Latent autoimmune diabetes in adults: Current status and new horizons.Endocrinol Metab (Seoul). 2018;33(2):147‐159. doi:10.3803/EnM.2018.33.2.147O’Neal KS, Johnson JL, Panak RL.Recognizing and appropriately treating latent autoimmune diabetes in adults.Diabetes Spectrum. 2016 Nov 1;29(4):249-52. doi:10.2337/ds15-0047
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Hals IK.Treatment of latent autoimmune diabetes in adults: What is best?.Current diabetes reviews. 2019 Jun 1;15(3):188-93. doi:10.2174/1573399814666180716144429Poudel RR.Latent autoimmune diabetes of adults: From oral hypoglycemic agents to early insulin.Indian JEndocrinol Metab. 2012;16 Suppl 1:S41-6. doi:10.4103/2230-8210.94257Laugesen E, Østergaard JA, Leslie RD.Latent autoimmune diabetes of the adult: Current knowledge and uncertainty.Diabet Med. 2015;32(7):843-52. doi:10.1111/dme.12700Unger J.Latent autoimmune diabetes in adults.Am Fam Physician.2010 Apr 1;81(7):843-847.Pozzilli P, Pieralice S.Latent autoimmune diabetes in adults: Current status and new horizons.Endocrinol Metab (Seoul). 2018;33(2):147‐159. doi:10.3803/EnM.2018.33.2.147O’Neal KS, Johnson JL, Panak RL.Recognizing and appropriately treating latent autoimmune diabetes in adults.Diabetes Spectrum. 2016 Nov 1;29(4):249-52. doi:10.2337/ds15-0047
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Hals IK.Treatment of latent autoimmune diabetes in adults: What is best?.Current diabetes reviews. 2019 Jun 1;15(3):188-93. doi:10.2174/1573399814666180716144429Poudel RR.Latent autoimmune diabetes of adults: From oral hypoglycemic agents to early insulin.Indian JEndocrinol Metab. 2012;16 Suppl 1:S41-6. doi:10.4103/2230-8210.94257Laugesen E, Østergaard JA, Leslie RD.Latent autoimmune diabetes of the adult: Current knowledge and uncertainty.Diabet Med. 2015;32(7):843-52. doi:10.1111/dme.12700Unger J.Latent autoimmune diabetes in adults.Am Fam Physician.2010 Apr 1;81(7):843-847.Pozzilli P, Pieralice S.Latent autoimmune diabetes in adults: Current status and new horizons.Endocrinol Metab (Seoul). 2018;33(2):147‐159. doi:10.3803/EnM.2018.33.2.147O’Neal KS, Johnson JL, Panak RL.Recognizing and appropriately treating latent autoimmune diabetes in adults.Diabetes Spectrum. 2016 Nov 1;29(4):249-52. doi:10.2337/ds15-0047
Hals IK.Treatment of latent autoimmune diabetes in adults: What is best?.Current diabetes reviews. 2019 Jun 1;15(3):188-93. doi:10.2174/1573399814666180716144429
Poudel RR.Latent autoimmune diabetes of adults: From oral hypoglycemic agents to early insulin.Indian JEndocrinol Metab. 2012;16 Suppl 1:S41-6. doi:10.4103/2230-8210.94257
Laugesen E, Østergaard JA, Leslie RD.Latent autoimmune diabetes of the adult: Current knowledge and uncertainty.Diabet Med. 2015;32(7):843-52. doi:10.1111/dme.12700
Unger J.Latent autoimmune diabetes in adults.Am Fam Physician.2010 Apr 1;81(7):843-847.
Pozzilli P, Pieralice S.Latent autoimmune diabetes in adults: Current status and new horizons.Endocrinol Metab (Seoul). 2018;33(2):147‐159. doi:10.3803/EnM.2018.33.2.147
O’Neal KS, Johnson JL, Panak RL.Recognizing and appropriately treating latent autoimmune diabetes in adults.Diabetes Spectrum. 2016 Nov 1;29(4):249-52. doi:10.2337/ds15-0047
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