Most people with new-onset Type 1 diabetes are adults. LADA is an unofficial term that refers to slow-onset Type 1 diabetes, but it is simply Type 1 diabetes. I always say I have Type 1 diabetes, because there was nothing latent about the onset of diabetes in me (I was in DKA, age 35). So no, if you are diagnosed with Type 1 as an adult you are not automatically considered LADA. If any one antibody is positive, it’s Type 1 autoimmune diabetes, whether you are 1 month old or 91. Some people with Type 1 diabetes, both children and adults, develop insulin resistance–they still have T1 but it’s sometimes referred to as “double diabetes.”
Unfortunately, Jenny’s website is really inaccurate and archaic regarding LADA, and the sources she quotes are certainly not the best science or by leading researchers studying slow-onset T1/LADA. Many people with Type 1 diabetes, both children and adults, have the genes for Type 2. It is not exclusive to LADAs.
My simple story : diagnosed at 42 plus with diabetes , Jan 1983 ; meds to bring BG down …lab tests weekly ( no finger pokes in those days ) ; numbers did not come down and I asked Doc to put me on insulin . Mid March of 1983 I was hospitalized to learn , how to give insulin and I suppose to check also how much insulin I required daily . …I still had diabetes ; never was concerned , what it was called, as long as the treatment was right for me …just knew, that I needed insulin to survive for a long time !! …never had the tests done, you describe , other than c-peptide …I am still here at age over 70 and today’s official name is type 1…most times I say I have diabetes and wear an insulin pump !
We are all unique with OUR stories and diagnosis
I wonder what the incidence of Type 2 insulin-resistance is in the Type 1 population. Anyone know?
I was Dx’ed at age 55 with T-1. Nothing else was ever mentioned to me. My BS was 500 and A1c was 14. I had lost 15 lbs. in about 10 days and felt like cr*p. After these 12 years I take Humalog and Lantus, but not a lot each day. My TDD is 20-23 units. I have always thought of myself as a T-1 and not considered LADA.
This might sound off topic, but how the heck would I know that I was insulin resistant? I almost never had an elevated fasting blood sugar these days, but I can spike to 175 over less than 20 grams of carbs and then shoot back down to normal in about two hours or even subnormal levels if I was exercising a lot. I suspect this is not realy insulin resistant. What would my numbers look like if it is resistant? Elevated for several hours after each meal?
Insulin resistance is usually indicated by high cholesterol, high blood pressure, and belly fat. Plus a higher than average insulin dose, if you’re on insulin.
Spiking to 175 says that you have an impaired first-phase insulin response, and then coming back down in 2 hours says you have a normal or near normal second phase response. This has nothing to do with insulin resistance, but a lot to do with pancreatic function. Type 2 can differ in that some people have a lot of insulin resistance but very little pancreatic dysfunction, or little to no insulin resistance but a lot of pancreatic dysfunction that is not autoimmune. Or a lot of both. And everything in between. Which is why Type 2’s vary so much.
You may very well NOT be insulin resistant, but you still have diabetes, unfortunately!
Thanks, Natalie! very informative.
I wish they would get read of the designation "Type 1.5" as it's misleading and sounds like software.The software I work with is called TYPO3. :-) You are so right.
it’s basically type 1. i say “basically” because there is some evidence that indicates that LADA, especially if caught early, can end up being a bit more mild (either due to the “legacy effect”, the fact that it’s often easier to control blood sugars as a healthy adult than as a child, or due to some sort of protective factor we haven’t yet isolated) and that some LADA will have small amount of c-peptide even years after diagnosis, whereas this is highly unusual among those diagnosed when young.
A recent study that looked at insulin production (c-peptide) in people with Type 1 diabetes for over 50 years (yes, fifty years) found that most still had antibodies and were making some insulin. These were people diagnosed as children, so in no way is it unusual to have some c-peptide when diagnosed as a child. People want to pretend that autoimmune diabetes diagnosed in adulthood is somehow different than autoimmune diabetes diagnosed in childhood, but the diagnosis is based on etiology not age.
Tom, you said to watch for deterioriating glucose tolerance. I assume you mean 2hr pp but include some 1hr and 3hr checks. On a typical month, I see some cycles of worsening glucose tolerance but then it goes back to better BG results. Dunno why, hormones, the disease itself, etc. (and it’s not the carbs, I didn’t overeat there.) Just because last week I hit 176 doesn’t mean I don’t get it back to normal this week.
Those of you with LADA, would you mind sharing more details? Like dates and BG results at diagnosis of “type 2” , the BG readings you started getting as you got closer to diagnosis of LADA (although I understand doctors aren’t using this term). Any other related info as well such as “LADA got started after I reached my normal weight” What sort of pattern did you guys see?
I was mis-diagnosed Type 2 in July, 2007. I had been 40 pounds overweight but started rapid weight loss before and after diagnosis and about a year after had lost all 40 pounds for a healthy weight. My blood glucose at diagnosis was 325 fasting. For 15 months on oral meds I did fine, with in target fasting and post prandials. In September 2008 my numbers started a slow but steady climb. I probably waited longer than I should have because I was trying to make sense of things, but by the time I started on insulin in February 2009 I was having numbers consistently in the 200s and 300s and even spiking a few times into the 400s. Nobody diagnosed me; I diagnosed myself. When I finally did see an endo, she looked at my list of 5 things I knew made me type 1 and just checked off each one and said “You are type one”. She’d never heard of LADA. The five things were: weight loss at diagnosis, another autoimmune disorder (Graves), insulin sensitive (my doctor started me on type 2 doses of insulin and it was way too much), low c-peptide (.38 and .70 from two different labs) and needing insulin only 15 months after diagnosis.
I don’t know what you mean by “LADA got started…”. I was always LADA. LADA means “latent autoimmune diabetes in adults” and slow onset is the very nature of the syndrome. I was a classic LADA but just didn’t know it.
I was dx’d at 45 in 1991 as a Type 2–quite suddenly, while at a normal weight, on a healthy eating plan, and exercising. Much later I was dx’d with multiple autoimmune illnesses. As a kid, I began having chronic pancreatitis attacks that continued into adulthood. I now think they were autoimmune–connected with the lupus or some other AI feature.
Now, after 20 years, my A1c has been over 11 for a year, as high as 13+, and my bGs are regularly close to 300, creeping to over 500 at times. Since talking with other diabetics online and doing some research, I believe I’m a clear-cut LADA, and TOMORROW I am going to ask my doc for the GAD65 and C-Peptide tests. Is there anything else I should ask?
Hi. You might bring up the possibility of taking insulin. 500 is really, really high, and most likely insulin is the best way to get stable at lower numbers, regardless of type.
Trudy, I have been on insulin for most of the last 16 years. 
I can bring down my bGs with a corrective bolus, but if I am dx’d a LADA, or Type 1, my chances of getting a pump are better, aren’t they? I think that may be the next step. I also am “brittle,” and have bad lows when my bGs are closer to normal. That makes me overeat, as I’m so afraid of the nosedives.
Having constant monitoring would help, I think.
So if you have antibodies, it is definitely Type 1 or LADA?
Yup. Having antibodies is the definition of Type 1.
Thanx. Must tell my dr this ;-). I am still waiting for results of the c-peptide test but antibodies are positive. Dr calls it Type unknown.
Hi Smile: If you are antibody positive (GAD, ICA, and/or IA-2), you have Type 1 autoimmune diabetes, not “type unknown.” According to the World Health Organization and the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus:“Type 1 diabetes results from a cellular-mediated autoimmune destruction of the beta-cells of the pancreas. In Type 1 diabetes, the rate of beta-cell destruction is quite variable, being rapid in some individuals (mainly infants and children) and slow in others (mainly adults)” and “Although the specific etiologies of Type 2 diabetes are not known, autoimmune destruction of beta-cells does not occur.” These quotes come from Diabetes Care. Many doctors are in total denial about the prevalence of new-onset Type 1 diabetes in adults, but we actually make up the vast majority of new-onset T1!