The Pending Epidemic That No One's Heard About: LADA Diabetes

Blog post   •   Jul 01, 2013 13:14 BST

What Is LADA Diabetes and Why is it Being Called a Pending Epidemic?

For 1500 years, from about 400-500AD to the very recent past, diabetes has fit neatly into one of two categories. Type 1 was associated with childhood, insulin-dependence, and (eventually) with autoimmune disorders. Type 2, on the other hand, was something that you got in adulthood, didn’t always need to constantly take insulin for, and could generally be controlled with diet and exercise. Of course, there were other types of diabetes during that time too: gestational diabetes, which affects women during pregnancy and often disappears completely after childbirth, along with many other sub-types and specific cases. And for a long time, it was thought that these sub-types made up a tiny percentage of all diabetes cases worldwide. Then along came LADA.

LADA, or Latent Autoimmune Diabetes in Adults, is a very special subtype of diabetes. For one thing, it affect a shockingly high amount of people – some estimates put it at 10% of all diabetes cases (or more than Type 1). For another thing, it shares enough qualities with both Type 1 and Type 2 diabetes that diagnosing it becomes a little bit of a challenge. So much so that many in the diabetes research community have taken to calling it Type 1.5 instead of using the ‘official’ name. Like Type 1 diabetes, LADA Diabetes is increasingly thought of as an autoimmune disorder, largely because of the presence of autoimmune antibodies in the blood of those with the disease. These antibodies, proteins that are left over after the immune system attacks what it perceives to be a threat, are a clear sign that like Type 1, Type 1.5 diabetes is caused by the body getting confused and attacking itself. Unlike Type 1, LADA is diagnosed mostly in adults. It also does not cause immediate dependence on insulin, and shows some signs of insulin resistance like Type 2 does.

The Trouble With Type 1.5

For most of our readers, these technical distinctions between types 1, 1.5, and 2 may seem trivial. Does it really matter how each one works, so long as your doctor diagnoses it and gives you the right treatment? Well, that’s the main problem with LADA – it can be very hard to diagnose by a physician who hasn’t seen it before, and the treatment it requires is quite different from Type 1 OR Type 2.

The biggest problem is that Type 1.5 diabetes most often presents itself later in life. Unfortunately, when many physicians see new cases of diabetes in adults, they often chalk it up to Type 2 without running tests for the autoantibodies that would clearly show it to be Type 1 or LADA Diabetes. The patient gets their Type 2 diabetes diagnosis, and goes on a standard diabetes fitness and dietary regimen, which helps control blood sugar levels for a little while. When their blood sugar gets out of control again, they are given Lantus insulin, a typical treatment for people with Type 2 who require insulin. Still, the blood sugar continues to rise, and finally, after a long struggle and many frustrations, the patient is placed on the full basal/bolus regimen like those with Type 1 diabetes.

While that in and of itself doesn’t sound terrible, there are several studies coming out showing that starting patients with LADA on insulin early can prevent the full failure of their beta-cells for a longer period of time, giving them more time until the onset of full Type 1 diabetes. A misdiagnosis early can do irreparable damage and speed up the onset of insulin-dependence and full-on symptoms.

So what can you do about this?

Read the full article here.