Authors: Dr. V. Mohan, Chairman & Chief Diabetologist | Ms. Umasakthy, Registered Dietitian

Latent autoimmune diabetes of adults (LADA) is a form of diabetes that typically develops in adulthood and shares characteristics with both type 1 and type 2 diabetes.

Unlike classical type 1 diabetes, LADA progresses more slowly, with the body gradually losing its ability to produce insulin. This slow progression can make it difficult to diagnose LADA initially, leading most individuals to be misdiagnosed as type 2 diabetes. GAD Antibodies (GADA) is the most commonly tested antibody.

One key feature of LADA is the presence of autoantibodies in the blood, which indicates an autoimmune response targeting the insulin-producing cells in the pancreas. These autoantibodies are similar to those found in type 1 diabetes but are usually present at lower levels.

People with LADA may initially be able to manage their blood sugar levels without insulin therapy for up to six months after diagnosis. However, as the condition progresses and insulin production declines further, most individuals will eventually require insulin treatment for glycemic control.

The exact causes of LADA are not yet fully understood but probably involve a combination of genetic and environmental factors. Certain genes related to immune function may play a role in susceptibility to developing LADA.

Symptoms of LADA include increased thirst, unexplained weight loss, blurred vision or frequent infections such as yeast infections or urinary tract infections. Numbness or tingling in the hands or feet may occur due to nerve damage caused by prolonged high blood sugar levels.

It’s important not to ignore these symptoms, as early detection and treatment can help manage LADA effectively. If you notice any of these symptoms persisting for an extended period of time, consult a diabetologist for proper diagnosis and seek guidance on managing your condition.

Diagnosis of LADA can sometimes be challenging due to its similarities with other forms of diabetes. However, there are certain tests that can help healthcare professionals differentiate LADA from other types of diabetes. One common test used in the diagnosis of LADA is the measurement of autoantibodies associated with autoimmune diabetes.

These antibodies, such as GAD and IA-2, are often present in individuals with LADA. Detecting these antibodies can provide valuable information for diagnosing this specific form of diabetes. In addition to antibody testing, blood glucose levels and insulin production (c-peptide assay) are also assessed during the diagnostic process. People with LADA ultimately have grossly elevated blood sugar levels and poor c-peptide secretion which gives the clue that it may not be type 2 diabetes.

Treatment options for LADA may vary depending on the individual and their specific needs. Since LADA is a form of diabetes that initially does not require insulin for glycemic control, they may be successfully treated with oral medications for a few months but soon need insulin for control.

Close monitoring of blood sugar levels through self-monitoring at home or continuous glucose monitoring or regular check-ups with healthcare providers is crucial in managing LADA effectively. Regular follow-up visits with a diabetes specialist can help ensure appropriate adjustments are made to treatment plans as needed. It’s important for individuals diagnosed with LADA to work closely with their healthcare team to determine the best course of action based on their unique circumstances. Treatment options should always be tailored to meet the specific needs of each individual living with this condition.

Prevention strategies for LADA are currently unknown since the exact cause remains unclear.

Remember that managing LADA requires comprehensive care involving:

• Regular monitoring
• Regular appointments with the diabetologists/ diabetes center
• Dietary modifications
• Physical activity
• Education about self-care strategies
• Insulin as needed
• Screening for complications of diabetes

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