What is LADA?
LADA (Latent Autoimmune Diabetes in Adults) is an autoimmune condition where the immune system mistakenly attacks the insulin-producing beta cells in the pancreas, leading to reduced insulin production. Unlike people with type 1 diabetes who need insulin from the start, those with LADA may still produce some insulin at diagnosis. The need for insulin therapy varies from person to person, making LADA similar to type 2 diabetes in this regard.
How is LADA Different from Type 2 Diabetes?
In type 2 diabetes, insulin resistance prevents the body from using insulin properly, and the pancreas can’t produce enough insulin to compensate. This type of diabetes becomes more common as people age. LADA is often misdiagnosed as type 2, especially in older adults or those who are overweight, as initial treatments like lifestyle changes and medication can be effective, much like in type 2 diabetes.
LADA Classification
In 2019, the WHO reclassified LADA as “Slowly Evolving Immune-Mediated Diabetes” (SEIMD). This change doesn’t impact the way LADA is diagnosed or treated, and it’s still widely referred to as LADA.
What are the Features of LADA?
LADA shares characteristics with both type 1 and type 2 diabetes. It usually develops after the age of 30 and can affect people who are overweight (like type 2 diabetes) or lean (like type 1 diabetes). Initially, LADA can be managed with diet and exercise, but most people will need medication sooner than those with type 2 diabetes. This blend of features is why it’s sometimes called “type 1.5” diabetes.
How is LADA Diagnosed?
LADA is diagnosed through a combination of medical history, blood tests, and checking for autoantibodies (proteins that show the immune system is attacking the pancreas). A C-peptide test, which shows how much insulin the body is making, can also help determine when to start insulin therapy. People with LADA may also have other autoimmune conditions like thyroid disease.
How is LADA Treated?
People with LADA typically need insulin therapy over time, although lifestyle changes and other medications may help initially. Treatment must be personalised, as people with LADA can vary greatly in their needs.
Education for People with LADA
Education in managing blood glucose, diet, exercise, and medication is important. Many people with LADA eventually need the same insulin therapy as those with type 1 diabetes. Those requiring multiple insulin injections per day may be referred to structured diabetes education programs, such as OzDAFNE or insulin pump therapy.
Complication Screening
Regular health checks are important to monitor for diabetes complications. Like type 1 diabetes, people with LADA should be screened for other autoimmune conditions, such as thyroid disease or celiac disease.
Ongoing Research
There is still much to learn about LADA. Ongoing research will help improve diagnosis and management of the condition.
Treatment and management of LADA
LADA requires careful management, and as the condition progresses, daily care becomes essential.
Dr. Imran’s practice specialises in the diagnosis, treatment, and ongoing management of LADA. With support from our dedicated clinical team, we will assist
you in managing your diabetes through:
- Insulin therapy, including injections or the use of an insulin pump
- Regular monitoring of blood glucose levels
- Guidance on a healthy diet and eating plan
- The creation of a personalised exercise program