atent Autoimmune Diabetes in Adults (LADA)
is a form of
autoimmune
(type 1 diabetes)
which is diagnosed in individuals who are older than the usual age of
onset of type 1 diabetes (that is, over 30 years of age at diagnosis).
Alternate terms that have been used for "LADA" include
Late-onset Autoimmune Diabetes of Adulthood,
"Slow Onset Type 1" diabetes, and sometimes also
"Type 1.5 [Type one-and-a-half]" diabetes.
Often, patients with LADA are mistakenly thought to have
type 2 diabetes,
based on their age at the time of diagnosis.
Such misdiagnosis is easy to make when the person is older, and initially responds to treatment with diabetes pills.
It is now thought that perhaps twenty percent of patients with apparent Type 2 diabetes really have LADA.
Patients with LADA do not have
insulin resistance,
as do people with Type 2. Also,
positive antibody tests would help make the diagnosis of LADA in a person who might be suspected of having either LADA or Type 2.
Some diabetes specialists feel that once LADA is diagnosed, it is important to
promptly start the patient on insulin therapy (rather than using
sulfonylureas
or other diabetes pills), but
it is unclear whether early treatment with insulin is beneficial for the remaining
beta cells.
Drug therapy to preserve insulin function in patients with LADA
is being investigated.
Characteristics of LADA
- Adult age at diagnosis (usually over 25 years of age)
- Initial presentation masquerades as non-obese type 2 diabetes
(does not present as
diabetic ketoacidosis)
- Initially can be controlled with meal planning with or without diabetes pills
- Insulin dependency gradually occurs, frequently within months
- Positive antibodies
- Low
C-peptide levels.
- Unlikely to have a family history of type 2 diabetes.
Also see
Type 1.5 Diabetes
Latent Autoimmune Diabetes in Adults (PDF file) [PDF help]
Autoimmune diabetes not requiring insulin at diagnosis (latent autoimmune diabetes of the adult): definition, characterization, and potential prevention.
(Abstract at PubMed)
Progress in the characterization of slowly progressive autoimmune diabetes in adult patients (LADA or type 1.5 diabetes).
(Abstract at PubMed)
New Drug Arrests Progression of Type 1 Diabetes