Home Diabetes Basics Overview Type 1.5 LADA

Type 1.5 - Latent Autoimmune Diabetes (LADA)

Latent autoimmune diabetes in adults (LADA) is a genetically-linked, hereditary autoimmune disorder that results in the body mistaking the pancreas as foreign and responding by attacking and destroying the insulin-producing beta islet cells of the pancreas. Simply stated, autoimmune disorders, including LADA, are an "allergy to self."

In its early stages LADA typically presents as type 2 diabetes and is often misdiagnosed as such. However, LADA more closely resembles type 1 diabetes and shares common physiological characteristics of type 1 for metabolic dysfunction, genetics, and autoimmune features, but LADA does not affect children and is classified distinctly as being separate from juvenile diabetes.

Comparison between LADA, type 1 diabetes and type 2 diabetes

LADA is neither classified as type 2 diabetes or type 1 diabetes but considered somewhere in between. It is a form of type 1 diabetes that has similarities and differences to both type 1 and type 2 diabetes.

  • Onset: Type 1 diabetes onsets rapidly and at a younger age than does LADA. Both LADA and type 2 onset is slow, over many months or years.
  • Family history: There is often an absence of family history of type 2 diabetes in a LADA patient's family, but a genetic marker of HLA genes found in type 1 and LADA, but not in type 2 diabetes. LADA does not affect children and is uncommon in young adults (age 25–30). It is most often diagnosed after age 35.
  • Antibodies: Persons with type 1 diabetes and LADA usually test positive for certain (same) antibodies that are not present in type 2 diabetes.
  • GAD antibodies: Persons with LADA usually test positive for GAD antibodies, whereas in type 1 diabetes these antibodies are more commonly seen in adults rather than in children.
  • Insulin sensitivity: Persons with LADA are not insulin resistant (and may be insulin sensitive) as in the case of type 2 diabetes and prediabetes.
  • Lifestyle and excess weight: Type 2 diabetes may onset as a result of a sedentary lifestyle and excess body weight (especially when excess weight is carried about the center, or in those with an "apple" shaped body). These factors are not thought of as contributing factors to the onset of type 1 diabetes or LADA. Persons with LADA are often normal body weight or thin and are not insulin resistant. Persons with type 2 diabetes are often insulin resistant and overweight.
  • Prognosis: About 80% of all persons initially diagnosed with type 2, who also have GAD antibodies, will become insulin dependent within six years. Those with both GAD and IA2 antibodies will become insulin dependent sooner. LADA occurs slowly, but progresses towards insulin dependency.
  • Treatment: Although LADA may appear to initially respond to similar treatment (lifestyle and medications) as type 2 diabetes, it will not halt or slow the progression of beta cell destruction. People with LADA will eventually become insulin dependent.

Prognosis

According to one study "Similar as in prediabetic relatives of type 1 diabetic patients the risk for beta cell failure in adult "type 2 diabetic" patients increases with the number of antibodies positive."

Eventually, LADA patients will become dependent upon insulin in order to maintain glucose control. They will require daily injection of insulin and need to be diligent in following their diabetes care plan provided by their physician.

Diabetes, including latent autoimmune diabetes is a chronic illness that can have devastating complications. However, it is possible for most persons with diabetes to actively participate in their daily health care needs and dramatically reduce the risk of diabetes complications.

Patient education, motivation, and state of mental health all play an important role in how well a person with LADA will be able to manage their disease.

source: Wikipedia.org