Living with one type of diabetes and finding out years later that you have another can take an emotional toll. Phyllisa Deroze was diagnosed with type 2 diabetes in 2011 and later discovered 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. LADA shares characteristics with both type 1 diabetes and type 2 diabetes. It is sometimes referred to as “type 1.5 diabetes” because, like type 1, it is caused by an autoimmune reaction. However, it develops more gradually and usually appears later in life.
In LADA, the immune system mistakenly attacks the pancreatic beta cells that produce insulin. This leads to a progressive decline in insulin production over time.
Although LADA shares features with both type 1 and type 2 diabetes, it requires a specific approach to diagnosis and management. With early recognition, ongoing care and tailored treatment, people living with LADA can lead healthy and fulfilling lives.
Who is at risk?
LADA typically develops in adults aged 30 or older. A person may be more likely to develop LADA if they:
- Have a personal or family history of autoimmune conditions
- Were diagnosed with type 2 diabetes but have a normal or lower-than-expected body weight
- Do not respond well to oral diabetes medications
- Have blood glucose levels that are difficult to manage despite treatment
Common symptoms of LADA
The 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
As the condition progresses and insulin production declines, symptoms may become more noticeable or difficult to control with standard treatment.
Causes of LADA
An autoimmune response causes LADA. This means the body’s immune system targets its own insulin-producing beta cells in the pancreas. The exact cause is not fully understood, but a combination of genetic and environmental factors is thought to contribute.
Because the progression is slow, LADA is often mistaken for type 2 diabetes during the early stages of the condition.
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 GAD (glutamic acid decarboxylase) antibodies.
- C-peptide test: This measures how much insulin the body is still producing. In people with LADA, levels are often low or continue to decline.
Correct diagnosis enables a treatment plan that matches the person’s specific needs and the stage of the condition.
Treating LADA
People living with LADA may initially respond to lifestyle changes and oral medications used for type 2 diabetes. However, because LADA is characterised by a gradual loss of beta-cell function, most people will eventually require insulin therapy.
Unlike type 2 diabetes, where insulin resistance is the main issue, LADA is driven by a lack of insulin. Starting insulin earlier may help preserve remaining pancreatic function and improve blood glucose management.
Living with LADA
Managing LADA involves ongoing monitoring, personalised treatment and support. Over time, the treatment approach may need to change as insulin production declines.
Important aspects of managing the condition 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.
With the right care, people living with LADA can live well and reduce the risk of complications.
LADA, type 1 and type 2 diabetes: key differences
| LADA | Type 1 diabetes | Type 2 diabetes | |
| Age of onset | Usually over 30 | Usually over 30 | 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 |
