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© 2018 BY MARY SHOMON / LADA TYPE 1.5 DIABETES GUIDE.8134 Chelaberry Court, Gaithersburg, MD 20879.  919-714-7185

About LADA/Type 1.5 Diabetes

 

Latent autoimmune diabetes of adults (LADA) – also sometimes referred to as type 1.5 diabetes -- is categorized as a form of type 1 diabetes (diabetes mellitus). Unlike type 1 diabetes, however, LADA often develops slowly, and symptoms appear over time, and the condition often appears during adulthood.

 

The condition is sometimes called Type 1.5 because it can initially start with high blood sugar, and diagnosis of type 2 diabetes. Unlike type 2 diabetes however, in LADA, your immune system becomes confused, and starts to attack your own cells or organs—in this case, the beta cells of your pancreas. Over time, this makes you increasingly unable to produce insulin, as is the case in type 1 diabetes. Additionally, C-peptide levels are low, and one or more antibody levels are typically elevated.

 

LADA was recognized in 1993, but it is not yet classified as a separate disease. Instead, LADA is is typically considered a sub-type of type 1 diabetes.

 

Signs and Symptoms of LADA

 

  • Excessive thirst

  • Drinking excessive amounts of liquids

  • Excessive and frequent urination

  • Blurred vision

  • Weight loss

  • Fatigue

  • Numbness/tingling in the extremities

  • Dry skin

  • Feeling very hungry even though you are eating

  • Slow healing of cuts and bruises

  • Elevated blood sugar and/or Hemoglobin A1C (HA1C) with normal weight or underweight

 

LADA should be suspected in anyone who has any of these symptoms, along with another autoimmune disease, including Hashimoto’s thyroiditis, Graves’ disease, rheumatoid arthritis, celiac disease, lupus or a personal or family history of any other autoimmune disease.

 

Diagnosing LADA

 

A diagnosis of diabetes is first made, using blood glucose (blood sugar) and HA1C testing.

 

Blood Sugar/Blood Glucose (Morning fasting glucose level)

  • Normal forperson without diabetes: 70–99 mg/dl

  • Prediabetes/impaired glucose: 100 to 125
  • Diabetes: 126 mg/dL or higher

 

Hemoglobin A1C (HA1C)

  • Normal for person without diabetes: Less than 5.7%

  • Prediabetes: Between 5.7 and 6.4 percent

  • Diabetes: 6.5 percent or higher

 

2 Hour Glucose Tolerance Test

Blood sugar 2 hours after glucose

  • Normal for person without diabetes: Less than 140 mg/dl

  • Prediabetes: 140 to 199 mg/dL

  • Diabetes: 200 mg/dL or higher

 

LADA is confirmed with tests to confirm low C-Peptide levels, along with elevation of at least one of the following types of autoimmune antibodies, including:

 

  • Antibodies to glutamic acid decarboxylase (anti-GAD antibodies or GADAs)

  • Antibodies to Islet Cell Antigens (anti-ICA)

  • Antibodies to tyrosine phosphatase proteins (IA-2s)

  • Antibodies to insulin

 

Is it LADA or Type 2?

 

In general, it’s estimated that at least 10% -- and potentially as many as 50% -- of those diagnosed with type 2 diabetes actually have LADA.

 

  • Specifically, 10% of those over 35 with type 2 diabetes are thought to have LADA

  • 25% of those under 35 with type 2 diabetes are thought to have LADA

  • 50% of those who are normal weight or underweight with type 2 diabetes may actually have LADA

 
Treatment of LADA/Type 1.5 Diabetes

 

Current guidelines recommend that LADA be managed with diet and type 2 diabetes drugs for six months after diagnosis, but experts are now saying that starting insulin treatment as soon as possible reduces the risk of diabetic complications, such as complications such as diabetic ketoacidosis, and damage to vision, nerves,  or kidneys. Over time, most LADA patients become insulin-dependent.

Latest Research

Latent autoimmune diabetes
of the adult: current knowledge
and uncertainty.
Diabetic Medicine.
2015

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Recognizing and Appropriately
Treating Latent Autoimmune
Diabetes in Adults.

Diabetes Spectrum
2016 Nov

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Combined treatment with sitagliptin and vitamin D in a patient with latent autoimmune diabetes in adults
Endocrinol Diabetes Metab Case Rep. May 2016

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