Latent Autoimmune Diabetes (LADA) – Unveiling the Mystery
Latent Autoimmune Diabetes in Adults (LADA) represents a significant, yet often misdiagnosed type of diabetes. In fact, it’s estimated that about 5-10% of individuals who are initially diagnosed with Type 2 diabetes may actually have LADA (1). This leads to many challenges in management and treatment of the condition (2). By enhancing awareness and unveiling the mysteries of what LADA is, individuals will be able to seek appropriate medical attention and advocate for their health, leading to better health outcomes and quality of life.
In this article you will learn:
What is LADA?
Latent Autoimmune Diabetes in Adults, often termed as Type 1.5 diabetes, shares characteristics with both Type 1 and Type 2 diabetes. Its distinct nature often leads to confusion and misdiagnosis. Unlike Type 2 diabetes, which can often be managed through lifestyle changes and medication, LADA is an autoimmune condition, much like Type 1 diabetes. However, unlike Type 1, which typically presents in childhood or adolescence, LADA develops in adulthood, often after the age of 30 (3). The condition can be distinguished by the following characteristics:
- Autoimmune Nature: LADA occurs when the body’s immune system mistakenly attacks the insulin-producing cells in the pancreas.
- Adult Onset: It typically develops in individuals over 30, setting it apart from the juvenile onset of Type 1 diabetes.
- Insulin Production: Initially, individuals with LADA may still produce insulin, but over time, insulin production typically diminishes.
Symptoms of LADA in Adults
The symptoms of LADA can be subtle and easily mistaken for Type 2 diabetes, leading to misdiagnosis and delay in appropriate treatment (4).If you are within a healthy weight range, eat well, are active and have been diagnosed with Type 2 diabetes, there is a good chance that you actually have LADA. You may also be experiencing the following symptoms:
- Excessive Thirst and Urination: As with other forms of diabetes, high blood sugar levels in LADA can lead to increased thirst and a higher frequency of urination.
- Unexplained Weight Loss: Despite eating normally, individuals with LADA might experience sudden weight loss.
- Fatigue: Persistent tiredness and lack of energy are common symptoms.
- Rapid Progression to Insulin Dependence: Unlike Type 2 diabetes, individuals with LADA often progress more quickly to requiring insulin.
Recognising these symptoms and their nuances is critical for early diagnosis and effective management of LADA. If you resonate with these symptoms, please seek advice from your general practitioner for further testing and investigation
What causes LADA?
The exact causes of LADA are unknown, but rest assured, it has nothing to do with what you have done wrong. It is primarily considered an autoimmune condition where the immune system mistakenly attacks and destroys insulin-producing beta cells in the pancreas. Two factors are believed to play significant roles in the development of LADA (5):
- Genetic Factors: A family history of autoimmune diseases can increase the risk of developing LADA.
- Environmental Triggers: Certain environmental factors, such as viral infections, may trigger the autoimmune response in those who are genetically susceptible.
How to Diagnose LADA?
Diagnosing LADA requires a careful examination of symptoms, along with specific blood tests. Blood tests typically check for glucose levels and the presence of certain antibodies that are common in autoimmune diabetes. This diagnostic process is crucial, as it significantly influences the treatment approach, which is markedly different from that of Type 2 diabetes (6). Blood tests that your general practitioner may request are:
- Fasting blood sugars and HbA1c: These tests measure the amount of glucose in your bloodstream. High levels of blood glucose indicate diabetes.
- Specific antibodies: The presence of certain antibodies can indicate an autoimmune response
- C-Peptide Test: This test measures the amount of C-peptide, a byproduct of insulin production, which can be lower in individuals with LADA.
Misdiagnosis can lead to ineffective treatment plans, making accurate diagnosis essential for effective management.
How to Treat LADA?
Managing LADA involves a combination of lifestyle modifications, dietary management, and potentially insulin therapy. Unlike Type 2 diabetes, where oral medications and lifestyle changes may suffice, LADA often requires insulin therapy much earlier in the disease process. Personalised treatment plans are essential (6), and may include:
- Lifestyle Changes: This includes dietary modifications and exercise, similar to that of Type 1 diabetes.
- Insulin Therapy: Many individuals with LADA eventually require insulin, usually 5 years after diagnosis.
- Monitoring Blood Sugar Levels: Regular monitoring is crucial for managing the condition effectively.
Make sure to see a dietitian for a personalised treatment plan that meets your specific needs. Regularly reviewing your plan with a health professional is essential in managing the progressive nature of LADA. (7)
Conclusion
Latent Autoimmune Diabetes in Adults is a complex condition that requires a specific understanding and approach to management. Its unique nature, bridging the gap between Type 1 and Type 2 diabetes, demands comprehensive care and attention. The key to managing LADA effectively lies in early diagnosis, understanding the symptoms, and a tailored approach to treatment. Make sure you speak to your general practitioner for advice and timely diagnosis. By working with a dietitian, alongside your medical team, you can receive the lifestyle support you need, so that your health is no longer a mystery!
