Do you have LADA? Introduce yourself here!

Welcome, Mike. There may be more than you think; you might try posting in the Canada group. Many people don't use the term LADA. After awhile, our Diabetes is pretty identical to any other Type 1.

Hi Zoe

Actually, around Edmonton there aren't many, according to my Endo, and he is one of the leading Endos in Canada & in charge of the University of Alberta Endocrinology dept and a PhD. After 11 years, my lada behaves a lot differently than Type 1.....a lot of the time. Of course it is exacerbated by the psych illnesses and psych meds. LADA is distinctly different from Type 1 or 2, and is not true Type 1, possesses characteristics of 1 & 2, but is in a category of it's own. One unique characteristic of LADA is that one must possess " GAD " antibodies to be LADA. LADA also has a responsivity problem, as we still produce our own pancreatic insulin ( I still do after 11 years ) but it doesn't get released as required. Type 1's produce 0 insulin and have 0 insulin resistance. LADA's have insulin resistance similar to type 2 or higher...mine is higher due to being on antipsychotic drugs. LADA is definitely in it's own category for a reason. Many ( most ) people haven't heard of LADA because it is quite uncommon versus 1 and particularily 2,( which is about 95% of diabetics. )

I'm sorry Mike, but there are a few inaccuracies in your post. LADA is Type 1; it is just a slower onset form. It has no connection to Type 2 at all. Most LADA's do not have insulin resistance; it is not a characteristic feature of Type 1, though it can be developed later on for various reasons (usually related to high carb, high insulin use and weight gain) and it sounds like in your case, the medication you take may have contributed. The chief evidence of lack of insulin resistance is that we take very low doses of insulin the same as any other Type 1 (in comparison to type 2's who take high doses due to IR).. The amount of insulin LADA's still produce varies, as does the amount of insulin produced by any Type 1; many type 1's still produce a small amount of insulin even after years, even decades.
Ultimately, for most LADA's our management after a few years is virtually indistinguishable from other Type 1's. You say that your LADA behaves very differently from regular Type 1; we are all different, but for most of us that is not the case. I don't even believe there is a diagnostic code for LADA,(I could be wrong about that, maybe it has been developed now) so we are all classed as Type 1; we have an autoimmune type of diabetes.

Oh, and by the way, Type 2, when you count all the ones who were misdiagnosed LADA's is only about 75% of the total Diabetes population.

Please don't be offended, I just think it's really important to put out accurate information for those who might be new and still learning.

Hi Zoe --

As you pointed out to Mike, it's dangerous to generalize because every case is different. Now, I have one to point out to you . . . not all T2s are highly IR. I am a "classic" T2 with some (but not much) beta cell function remaining, and my typical bolus is about 4 units of regular; much more than that and I risk a serious low. We're all individuals. :)

Hi, Mike. I was dxed with the low c-peptide and high GAD antibodies three years ago. I had an Endo for another condition, so when I developed symptoms of diabetes, I got tested earlier than most of you. I went ultra low carb immediatedly and have always exercised more than most. I really play games to keep my A1c at 5.1-5.2, but I've been able to do this without insulin. There was a theory going at the time of my dx that you may preserve function if you could rest your pancreas. I thought it was worth the gamble, but I was used to not eating certain foods because of food allergies. So, the food allergy thing helped! Right now, I'm icing my poor knees, so this isnt' for everyone.

Cute cat, David! You are absolutely right that there is an enormous variation in Diabetics, and I also admit to knowing more about Type 1 than Type 2, but since Insulin Resistance is the very definition of Type 2, are you sure you are not in fact, LADA? Back when you were diagnosed (and a lot more recently than that) many people were automatically diagnosed as Type 2 if they were over a certain age.

Hi Zoe,

Yes, I'm certain.

(1) I don't use any basal insulin. Don't need it. If I don't eat, my BG stays in the 80s. It's only food that causes problems.

(2) C-pep (tested quite recently) says I have some remaining beta cell function. Just not enough.

(3) I've been using insulin for less than a year. And here is a direct quote from something you wrote during a discussion we had last summer: "IMHO, it is highly unlikely you are Type 1. The typical length of time for LADA's to manage without insulin is anywhere from a few months to about 4 years; some people have gone a bit longer, but a 17-year onset of type 1 (needing insulin) seems very unlikely. It is however, a typical period of time before Type 2's go on to need insulin."

Here's what it amounts to. There are different T2 patterns. Some have high BG because they have high IR. Others, because they have very little insulin of their own. Still others suffer from both. I am in the second category.

I will just add, as a personal and highly subjective postscript, that using insulin has given me a degree of control I was never able to achieve before, diet and exercise notwithstanding. I wish I had done this years ago.

P.S. Her name is Lilah and she is about 15 years old.

The type of diabetes in which insulin isn't released as required is MODY, not LADA. It is a genetic disorder.

It's hard to say how long people with LADA are able to survive before going on insulin since many of us aren't diagnosed until we start showing signs (weight loss, thirst, peeing often) and then we are often misdiagnosed as Type 2 and told we must be lying or not trying hard enough. Even once we are diagnosed correctly, many healthcare personnel still insist we must be overweight Type 2s and that LADA doesnt' exist. It is also confused with Type 1.5, which is a Type 1 with insulin resistance. I have LADA and am very sensitive to insulin.

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Hi Zoe

I just had a medical exam & report done by my Endo, a PhD and a leading researcher on Endocrine medicine in North America, and head of Endocrinology at the University of Alberta here in Edmonton. In his report to the Alberta Government for medical reinstatement of my Driver's licence he stated LADA is NOT true Type 1. I do NOT make up information to mislead anyone, having learned about LADA through living with it for over a decade, researching it and working with my Dr. When they were trying to diagnose me in January 2002.....all they could come up with was " Type 1.5 ? " Much has been learned since about it since then and it is officially named LADA diabetes for a reason and hence is in it's own category.
Do research on the net, there is a lot of good information and make sure to check the sources.
I have had high insulin resistance from the get go....typical of Type 2 & I am not type 2. I have had major reversals in c-peptide that the Dr. could NOT explain. We are all different. I have exacerbating factors with the psych stuff of course. Someone mentioned Type 1's still produce trace insulin years later, maybe so but not what the Dr's told me.
Once again, diabetes is an ever changing situation. I sometimes need NO insulin and just use metformin because of insulin resistance. How many type ones can do that ? So I am a true Type 1 ?....don't think so !

There are many different scenarios out there, I did not mean to generalize ? I am getting alab soon....oughtta be interesting to see if I have had another " unexplained reversal in c-peptide !

Oh no, being quoted back to myself!! Sorry, David, that I forgot we had that discussion! I probably told you Lilah was cute then too! Btw my brand new little boy, Dulce, is on my page.

For awhile people were using the term 1.5 interchangeably with LADA which I really disliked, as it implies we are halfway between Type 1 and Type 2, which we are not. Mary, did you mean "Healthcare personnel still insist we must be thin type 2's?"

I did plenty of research, Mike, when I was diagnosed. I saw Natalie was going to post a link to Melitta's blogs on LADA which are very well researched and accurate, but somehow never did so. I'm sure anyone who wants to can access them easily enough. But you are right, there are exceptions to every rule. And there are relatively rare variations such as Mody which Mary mentioned which I know nothing about.

Here are links to a couple of Melitta's blogs, hope one is the one you guys meant!
http://www.tudiabetes.org/profiles/blogs/we-need-a-detective-in-the
http://www.tudiabetes.org/profiles/blogs/a-field-guide-to-identifying

You can find more on her profile page.

I'm back. One difficulty in diagnosing diabetes is that there is a very distinctive definition of T1, which is auto-immune. If you have one or more antibodies, you're T1. But then there's everyone else. If you define T2 as antibody-negative, obese and insulin resistant, then you leave a lot of people sitting in neither box. On the other hand, if you restrict the definition to antibody negative, you are going to have people whose diabetes ACTS like T1, but who are classified as T2, and who then may receive inappropriate medical treatment, especially in case of emergency. So, my friend Ann, RN, CDE, PhD says that for practical purposes, anyone who tests as deficient in insulin and is not insulin resistant should be TREATED as T1. Which makes sense, since about 15% of CHILDREN diagnosed in DKA do NOT show antibodies. There is clearly more going on than just the known antibodies.

In addition, there are some T1's who were diagnosed during childhood in DKA, who, as adults develop metabolic syndrome and insulin resistance, and carry their weight in their belly, who then can benefit from T2 drugs in addition to their necessary insulin. Some people call this "double diabetes". Having T1 in NO way protects you from T2.

So what I'm trying to say is that diabetes is not as cut and dried as some people would have you believe. Before I came to the conclusion that what I have is closer to T1 than T2, I used to make jokes about having Type Weird, or Type Square Root of 2 (1.414), because I DIDN'T fit in either the T1 or the T2 box. And I don't have MODY, because I don't fit that definition, either. LADA comes closest to describing my situation, and when people ask, I just say T1, because I don't want to explain my whole story to people whose eyes would just glaze over. And this was corroborated by the CDE who treated me when I had a coma 2 years ago -- at first they were using T2 protocols, and I was not responding, and she had to fight with the hospitalist (and most of them know squat about T1 in adults) to get them to use T1 protocols. Good enough for me -- for safety reasons, I will tell medical professionals that I'm T1. Especially because they don't know what LADA is, anyway.

Hi
Just read some medical information online in an article about Type 1, Type 2 & LADA similarities and differences, etc. It states a shared gene exists between LADA & Type 2, hence there IS a shared characteristic & link with Type 2.

The gene has a long letter and number description ( I will post it later on here. ) I also found that GAD antibodies can be associated with all autoimmune diabetes, but present themselves later in adulthood, hence in LADA.

The more one delves into this the more information and complexity there is.

Hi LADA's !

There are only 320 of us on here ( well, officially diagnosed anyway....many more are supposedly misdiagnosed as Type 2's ! ) Out of the diabetic population here on TuDiabetes, we are a small and special group ! Around Edmonton these past 11 years ( in a month ! ) I have encountered very few medical professionals ( still ! ) who know what LADA is. Seems only some Pharmacists of the newer grad classes and those in the Endocrinology world seem to know.....VERY few G.P's know about it, and the public sure don't. Unfortunately, a lot of research hasn't been allotted to LADA.....I guess because we are somewhat a small population.

This discussion is both informative and useful, but I think it runs the risk of getting a little too involved with the trees and overlooking the forest.

As a Bernstein disciple, I return again and again to one of his basic premises: he isn't much interested in labels or categories. At the end of the day, you have to do what is necessary to achieve control. What you call it doesn't change that. If you need such-and-such a regimen, then you do that. If you need something else to get the desired result, then you do THAT.

Personally I think I'm a fairly "pure" T2. But if you disagree, we have no quarrel. Put me in whichever cubbyhole makes the most sense to you. Fundamentally I just want to have normal blood sugars and I intend to do whatever it takes to get that. Label me however you like. I don't much care.

I think there are probably plenty more LADA's than are in this group, either because they are misdiagnosed, just identify as Type 1, or just don't have time for groups..lol. I, like Natalie, just identify as Type 1. I'm concerned with correct identification of LADA, because I, like many of you was a victim of the "all adults are Type 2" mentality. But at this point in my life, the onset of my Diabetes (latent) is less important than the management which is the same as any other type 1. (with, as we all agree, individual variations) I too just say Type 1 and only bring out the "LADA" if someone is really interested or like my cardiologist, he said "so you were diagnosed as a child?" and the answer mattered for his assessment of risk factors. I started a Type 1 women's group which was a very varied bunch of childhood onset, and adult onset both in DKA and slow onset. We all had so much in common.

Good points, David. I think for some of us the "label" matters more than others (for various reasons) but, yes, what matters is that we get the treatment we need!