LADA/ Type 1.5 Diabetes

Understanding LADA/ type 1.5 diabetes

Type 1.5 diabetes, also known as latent autoimmune diabetes in adults (LADA), is a disorder that combines elements of type 1 and type 2 diabetes.

LADA is diagnosed in adulthood and, like type 2 diabetes, it develops gradually. However, unlike type 2 diabetes, LADA is an autoimmune illness that cannot be reversed with dietary and lifestyle modifications.

If you have type 1.5 diabetes, your beta cells quit working considerably faster than if you have type 2. It is believed that 10% of patients with diabetes have LADA.

What research says:

In 2020, an international expert group released a consensus declaration on LADA in the journal Diabetes. According to this consensus statement, patients with LADA have a "slowly progressing type of autoimmune diabetes with blood indicators of T1D but not needing insulin at diagnosis." According to the scientists, LADA accounts for 2% to 12% of all diabetes patients. In addition, there are no clear protocols for LADA management.


What are the symptoms of type 1.5 diabetes?

  • Recurring thirst
  • Increased appetite
  • Fatigue
  • Hazy vision
  • Tingling in the feet or hands
  • Loss of weight
  • Infections that recur, like yeast infections
  • More urination, especially during night
  • Unaccounted-for weight loss
  • Eyesight haze and tingling nerves

The causes of 1.5 diabetes( LADA):

To understand what causes type 1.5 diabetes, it is necessary to first grasp the distinctions between the other major forms of diabetes.

Type 1 diabetes is classified as an autoimmune disease since it is caused by your body's destruction of pancreatic beta cells. These cells assist your body in producing insulin, the hormone that permits you to store glucose (sugar) in your body. People with type 1 diabetes must inject insulin into their bodies in order to survive.

Type 2 diabetes is defined largely by your body's resistance to the effects of insulin. Insulin resistance is induced by a combination of genetic and environmental factors, including a high-carbohydrate diet, inactivity, and obesity. Type 2 diabetes can be treated by lifestyle changes and oral medication, but many people will require insulin to keep their blood sugar under control.

Type 1.5 diabetes can be caused by pancreatic injury caused by antibodies against insulin-producing cells. A family history of autoimmune disorders, for example, may also play a role. When the pancreas is injured in type 1.5 diabetes, the body kills pancreatic beta cells, just as it does in type 1. Insulin resistance may be evident in people with type 1.5 diabetes who are also overweight or obese.


How is LADA diagnosed?

Diagnosis of LADA can be challenging and time-consuming since many persons with LADA are initially diagnosed with type 2 diabetes. According to an article published in the journal Endocrinology and Metabolism in 2018, the Immunology of Diabetes Society has developed three primary criteria for diagnosing LADA:

  1. Age of adulthood (over the age of 30)
  2. Any islet cell antibody present (people with type 2 diabetes do not have these antibodies)
  3. Absence of insulin need for at least 6 months following diagnosis

The following tests can be used to identify any kind of diabetes:

  • A fasting plasma glucose test, which is performed on a blood sample following an eight-hour fast
  • An oral glucose tolerance test performed on a blood sample after an eight-hour fast and two hours after consuming a high-glucose beverage
  • A random plasma glucose test performed on a blood sample that examines your blood sugar without regard to when you last ate.

LADA patients may have a personal or familial history of autoimmune illness, such as celiac disease, Grave's disease, or Hashimoto's thyroiditis. Body weight (meaning the person is neither overweight or obese), the absence of high blood pressure or high cholesterol, and no family history of type 2 diabetes are all indicators that a health care practitioner may evaluate.

How is LADA treated?

LADA patients have the same life expectancy as persons with other kinds of diabetes. Higher blood sugar levels over time can lead to diabetic complications such as Kidney disease, cardiovascular difficulties, eye disease, and neuropathy, all of which can have a poor effect on prognosis. However, with proper blood sugar control, many of these issues may be avoided.

Some patients with LADA are able to regulate their blood sugars, at least initially, via lifestyle changes such as carbohydrate restriction and increased physical exercise. Diabetes tablets and non-insulin injectable treatments can also be useful early on. These may include:

  • Metformin
  • DPP-4 inhibitors, such as Januvia (sitagliptin) and Onglyza (saxagliptin)
  • GLP-1 agonists such as Ozempic (semaglutide), Trulicity (dulaglutide), and Byetta (exenatide)
  • Thiazolidinediones, such as pioglitazone

Some specialists believe that starting insulin treatment very away after being diagnosed can assist preserve beta cell function. If that's the case, receiving a precise diagnosis as quickly as possible is critical.

Thyroid disease is more common in persons with LADA than in those with type 2 diabetes in terms of problems that may affect prognosis. People with poorly controlled diabetes recover from wounds more slowly and are more prone to get infections.

Over time, lifestyle changes and the usage of the above medications are often insufficient to control blood sugar levels. At this moment, insulin must be administered. If you are prescribed insulin, your doctor may also advise you to continue taking any other diabetic medications you are currently on.