Really, what is LADA?

Hi All!

When I was diagnosed with diabetes at the age of 21, the doctor (internal medicine) told me that I had “type 1.5” diabetes. When I went to see the endocrinologist, she said that no such thing exists and that I have type 1 diabetes. From that day on, I considered myself a type 1 diabetic-- today is the first day that I heard the term “LADA”.

When I was diagnosed, I started on insulin immediately- 4-6 shots a day- and a few months later my insulin needs increased dramatically, representing the end of my “honeymoon”.

Other than being diagnosed at a later age, is there some more significant difference between type 1 diabetics and LADAs? How do you draw the line between the two? Is someone diagnosed at 16 or 18 a LADA? Just wondering about this concept…

Thanks!
Kristin

I am still learning about LADA as I’ve had it for a year now. My PCP (primary care physician) thought I would be a type 1. My endo is the one that diagnosed me as a LADA. I must still be honeymooning because my insulin levels are still low and hope to keep it that way! From my understanding is type 1s do not produce any insulin at all whereas LADA produces and sometimes wont. I found <a href=“http://www.google.com/search?hl=en&q=related:www.diabetesmonitor.com/lada.htm”>This list of websites that explains what LADA is. So perhaps it can give a clarity of the difference between the two :)…hopefully it does

This is taken direct from wiki.

In its early stages LADA typically presents as type 2 diabetes and is often misdiagnosed as such. However, LADA more closely resembles type 1 diabetes and shares common physiological characteristics of type 1 for metabolic dysfunction, genetics, and autoimmune features, but LADA does not affect children and is classified distinctly as being separate from juvenile diabetes.

There is also a comparison listing here

Hi Amy-
I was diagnosed at age 35 with diabetes. At diagnosis, my Blood Glucose was 780, and my A1c was over 15. My Primary Care Doc winged a Type-2 diagnosis and put me on Glyburide pills which cause whatever was left of my Beta cells to work overtime producing as much insulin as possible. For awhile, coupled with walking hard or running after every meal, I was able to get my A1c down to under 9 ( Whooo Hoooo — NOT !). At the time, I was a thin guy who was riding a bicycle over 150 miles per week and riding hard until the diabetic symptoms began messing up my electrolyte balance so badly that I was getting leg cramps on 10-mile rides. Anyway, I was not the typical Type-2. This whole Type 1.5 or LADA thing seems arbitrary to me. The truth is, Type 1 and “Type 1.5 or LADA” are both autoimmune conditions in which the body attacks itself, specifically the insulin-producing Beta Cells of the pancreas. Sooner or later, all those guys will be gone, and some form of insulin injection is the only possible treatment. In my opinion, having been through the full experience, it would be much better if the medical community looked first for the autoimmune markers, and if found, immediately began treating every such patient as the Type-1 they really are. There would have to be allowances for the fact that the autoimmune process is sometimes rapid, and sometimes prolonged, but as far as I’m concerned the only difference between Type-1 and LADA is the rate of Beta Cell destruction, not the fact that it is occurring. Type-2 is not caused by Beta Cell destruction, and is a whole different condition. My diabetic symptoms came on within a period of weeks, accompanied by severe weight loss, dehydration and all the usual poly symptoms. The only thing missing was ketoacidotic coma, and that was probably hours or days away at the time of diagnosis. I suspect that as research goes on, the details of the autoimmune response and the factors that can suppress it will show more clearly the close relationship between Type-1 and “LADA”. Maybe the process that causes LADA folk to lose their Beta cells more slowly could offer researchers a clue into how to slow or stop Type-1 altogether. But I’m no researcher, just a veteran of the progression. Sorry to ramble, but after 15 years, its something I’ve thought about a lot!

So how would you know if you have this? I’m getting more and more confused by what I read. When I was first told I was Type 2, I had lost almost 100 lbs in about 6 months, had all the thirst issues, A1c over 15. Dr. said my condition was “rare” for a type 2. My mother suspected I was really a type 1. Now I’m told that I’m actually Type 1 and taking 2 kinds of Insulin daily. Still having a first of the day reading of over 220.

My c-peptides were at 0.3 which is the basis of the type 1 according to my Endo.

Am I losing my mind as well as everything else?
-Carla

Hi Carla-
Your experience sounds similar to mine. The fact of c-peptides being low means that you are not making much insulin at this time, but still you are making some. I’m guessing your injected insulin quantity is still fairly small. My experience over the years was that my body’s natural insulin production eventually declined to zero, and correspondingly, the quantity of injected insulin needed to rise to overcome that natural deficit. If you mind your meter numbers and stay on top of it, you’ll be fine. This LADA thing is kind of a mixed blessing. We get a chance to adjust to taking insulin injections more gradually than classic Type-1s do, but there always is the lingering hope that maybe we can get control of it without having to take insulin. The reality is that our bodies are gradually losing their insulin production factory, and eventually all of it will have to come from injections or a pump. The best attitude to have is vigilance, and the realization that your situation is very dynamic. That’s the frustrating part. Just when you think you have the numbers dialed in, you lose more beta cells, and you have to recalibrate the whole process. Keep in touch. You can do this.
-Tom

One of the biggest problems is that many doctors assume that since we are adults, we are Type 2, all because of type 1 being classified as “juvenile diabetes.” Slowly but surely many doctors are waking up to the fact that even adults can contract the autoimmune response for type 1. Normally its a slower progression that childhood onset, but adjustments to insulin regimen and doses will always be a constant. Discuss any changes you make with your endo/internist.

sounds alot like what i was told and same loss of weight. i am 1.5 my body don’t make insulin.i got it 3 years ago i was 43 then.

I was also told that my body is producing insulin but will eventually stop. I was told I had thyroid issues also. They had put me on 20 units of Levemir before bed and 5 units of Novolog before every meal with a sliding scale for correction. I am also on a thyroid pill every morning (.5 mcg). My glucose was over 650 when I was diagnosed. I tried to make all kinds of excuses that I had lots of stress. Married end of May(Memorial day weekend). Drove to Saint Louis that week & started a new job June 2nd. Flew back to NJ mid July and packed all my remaining stuff in a POD and flew back to St. Louis. Since Moving here We bought a house and were moving from an apartment to a house. I was diagnosed a week later when I was drinking everything in sight. My first appointment since my diagnosis is in just over a month and I it too about 2 weeks for my numbers to come completely in a healthy range. What I do remember is them throwing all kinds of terms at me like 1.5 and LADA as well as Hasimodo’s and a variety of other things. This site has been amazing and the knowledge sharing here had been very helpful and informative. I was told that although I am 38 and 10 years ago would have been called type 2 off the bat that now this is becoming more and more of a popular group that many people fall into and I am more a type 1 or sometime called type 1.5. Do not worry your numbers will come down.

Hi Kristin,
I am 18 years old and have Type “1.5” diabetes. I was diagnosed in August of 2006. I just found out today that there is such a thing and I am curious to know more about LADA. What do you know about this type of diabetes?
Brittany

Hmmm…I’m 32 and at in the January 2008 they said I’m diabetic…they didn’t know which type for months…I was between the stage having diabetis or not having, disturbance in organism or something…they gave me my diabetic ID, next time they took it from me…but from the first moment I was on diet and didn’t eat sweets at all (just to keep my pancreas working as long as I can), even in a times when they said its not diabetes…My doc said I’m very lucky to be there on time and that I might get diabetes in 5-10-15-20 years…in a meantime I came to diabetic clinic for checks…every time I came was different, high glu, in the middle of the June they said type 2, later tablets…after I start to use them I lost on weight, and they gave me new tablets…then in October we had daily hospital & education on diabetic clinic, at that time I knew a lot of things about diabetes, coz I red and searched on the net all the time, I was totaly obsessed with idea I have to do something to stop that cells self destruction…but on the other hand, what can you do? Sometimes I think I would be happier if she would told me 1st minute I was there to get on insuline, this was a way to see a whole proces of dying and kind of funeral. At the end of 5 days education my doc said its type 1. My level of insulin was much decreased in few months. Last few days I had high levels of sugars, 2 days ago was 17 ( I don’t know your measurement overthere, but here we use this units, to 6 they tolerate as little higher), I lost on weight again and my doc said next year I go to insuline…Well I already knew that…Yesterday most of the day I cried…It made me so mad and said, again I can’t do anything to help myself, then to barry…Beside that, my immunity sucks, I’m sick all the time and get some colds which last for weeks, last one was more then 5 weeks…I’m really tired of being cold, sick, always something…Just for case I bought Colostrum with Beta glucan…just for case…But I see where its going, no return back…I’m just wondering now for this LADA, does it change anything…type 1 or 1,5 or 2 its not good anyway…Next time I go to the clinic they will grab their heads with the new data I have now…sure I’ll ask for LADA… ;-))

In a 1994 scientific article, Paul Zimmet coined the term “latent autoimmune diabetes in adults” (LADA). However, the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus does not recognize LADA, but the Expert Committee’s definition of Type 1 diabetes clearly encompasses all autoimmune diabetes including LADA: “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).” From my perspective, the medical community (very unscientifically) has a mental block against acknowledging the prevalence of adult-onset Type 1 diabetes (LADA, Type 1.5) and continues to preach the myth that it is a disease of childhood. Hence so many of us are misdiagnosed as having Type 2 diabetes. Yet the knowledge that new-onset Type 1 diabetes is far more frequent in adults than in children is nothing new—I have a book published in 1958 (“How to Live With Diabetes” by Henry Dolger, M.D. and Bernard Seeman) that states that “[Type 1] diabetes is almost three times more frequent among young adults than among youngsters” and “the acute onset typical of childhood is not as common.” That was stated in 1958. Today, with antibody testing, the same statement is true. A new book, “Type 1 Diabetes in Adults: Principles and Practice” (Informa Healthcare, 2008) says that adult-onset autoimmune diabetes is two to three times more common than classic childhood onset autoimmune diabetes (p. 27).

Hi Brittany! Sorry that I didn’t repond earlier. Here is a good site explaining LADA. If you have questions-- ask them here or in the LADA group, we have lots of people with LADA on this site!