Living with one type of diabetes and finding out years later that you have another can take an emotional toll. Initially, healthcare professionals diagnosed Phyllisa Deroze with type 2 diabetes in 2011 to later diagnos she was living with LADA. Read her full story in Diabetes Voice and learn why recognising less common forms of diabetes is essential for timely, accurate care.
Latent autoimmune diabetes in adults (LADA) is a form of autoimmune diabetes that develops in adulthood and progresses more slowly than type 1 diabetes. It shares characteristics with both type 1 and type 2 diabetes and is sometimes referred to as “type 1.5 diabetes”.
In LADA, the immune system mistakenly attacks the insulin-producing beta cells in the pancreas, leading to a gradual decline in insulin production. Many people are initially diagnosed with type 2 diabetes because symptoms often develop gradually and the body may still produce some insulin in the early stages.
Although LADA shares features with both type 1 and type 2 diabetes, it requires a specific approach to diagnosis and management. Over time, most people living with LADA will require insulin therapy.
Early diagnosis and appropriate treatment can help improve blood glucose management and reduce the risk of complications.
What makes LADA different?
LADA has characteristics that distinguish it from both type 1 and type 2 diabetes.
Unlike type 2 diabetes, LADA develops primarily because the immune system attacks the insulin-producing beta cells, rather than because of insulin resistance or lifestyle factors. Unlike type 1 diabetes, it usually develops gradually over months or years rather than suddenly.
LADA, type 1 and type 2 diabetes: key differences
| LADA | Type 1 diabetes | Type 2 diabetes | |
| Age of onset | Usually over 30 | Any age, but commonly in children and young adults | Usually over 40 (but can occur earlier) |
| Cause | Autoimmune | Autoimmune | Insulin resistance |
| Onset | Slow | Sudden | Gradual |
| Autoantibodies present | Yes | Yes | No |
| Insulin required | Often within months or years | Immediately | Sometimes |
Why LADA is often misdiagnosed
LADA is often under-recognised and misdiagnosed because it can resemble type 2 diabetes in the early stages.
An incorrect diagnosis can delay appropriate treatment and may lead to difficulties in managing blood glucose levels over time.
Early identification of LADA is important because:
- Treatment needs may differ from type 2 diabetes
- Insulin therapy may be required earlier than in type 2 diabetes
- Blood glucose levels may become difficult to manage with oral medications alone
- Appropriate care can help protect remaining pancreatic function
- Early support may help reduce the risk of complications
Increasing awareness of LADA can support earlier diagnosis and improve access to appropriate care.
Who is more likely to develop LADA?
LADA typically develops in adults aged 30 or older. Certain factors may increase the likelihood of developing the condition or suggest that a person diagnosed with type 2 diabetes should be assessed for it:
- Personal or family history of autoimmune conditions
- Presence of other autoimmune conditions, such as thyroid disease or coeliac disease
- Diagnosis of type 2 diabetes at a younger adult age, especially under 50
- Normal or lower-than-expected body weight at diagnosis of type 2 diabetes
- Unexpected progression after a type 2 diabetes diagnosis
- Difficulty managing blood glucose levels with oral medications over time
People who do not respond to standard type 2 diabetes treatments as expected may require further assessment for LADA. Symptoms or risk factors alone cannot confirm a LADA diagnosis. Diagnosis usually requires blood tests for diabetes-related autoantibodies and assessment of insulin production, often using C-peptide.
Common Symptoms of LADA
Symptoms of LADA often resemble those of type 1 diabetes, particularly in the beginning. These may include:
- Increased thirst
- Frequent urination
- Tiredness or fatigue
- Blurred vision
- Unexplained weight loss
- Increased hunger
As insulin production declines, symptoms may become more noticeable or difficult to control with standard treatment.
Diagnosing LADA
Diagnosing LADA can be challenging, especially during the early stages when it may appear similar to type 2 diabetes. Two key tests are used:
Autoantibody testing
Most people living with LADA test positive for at least one diabetes-related autoantibody, such as Glutamic Acid Decarboxylase GAD antibodies.
Testing for these antibodies can help distinguish LADA from type 2 diabetes and support a more accurate diagnosis.
C-peptide test
C-peptide tests measure how much insulin the body is still producing.
In people with LADA, insulin production is often low or continues to decline over time.
Why accurate diagnosis matters
An accurate diagnosis enables a management plan that matches the person’s specific needs and the stage of the condition.
Early recognition of LADA can improve blood glucose management and treatment outcomes by supporting timely diagnosis, appropriate management decisions and ongoing care.
Managing LADA
People living with LADA may initially respond to lifestyle changes and oral medications used for type 2 diabetes.
However, because LADA causes a gradual loss of insulin production, most people eventually require insulin therapy.
Starting insulin therapy earlier may help protect remaining pancreatic function and improve blood glucose management.
Living with LADA
Managing LADA involves ongoing monitoring, personalised treatment and support. Over time, the management approach may need to change as insulin production declines.
With the right care and support, people living with LADA can live well and reduce the risk of complications.
Important aspects of managing LADA include:
- Developing an individual care plan with a healthcare team.
- Regularly checking blood glucose levels.
- Receiving nutritional advice.
- Accessing mental and emotional health support.
- Staying informed about the condition and treatment options.
Can LADA be prevented?
Currently, LADA cannot be prevented.
Research into the condition is increasing, but many aspects of LADA are still not fully understood. More research is needed to improve diagnosis, clarify management approaches, and better understand how LADA progresses over time.
Early diagnosis and appropriate management remain the most important strategies for improving long-term outcomes and reducing complications.
