Living With LADA Diabetes

There are several different forms of diabetes with the most recognizable and common being type 1 and type 2. Although there are similarities between the different types, symptoms, treatments, and even risks are unique to each. For patients who find themselves diagnosed with one of the less common types of diabetes, the search to find information or even be correctly diagnosed can be challenging. Genteel hopes to provide at least a jumping-off point by examining diabetes through our blogs. This month we are focusing on LADA diabetes. 

What is LADA Diabetes?

Latent autoimmune diabetes in adults (LADA), occurs when the pancreas stops producing enough insulin. It is similar to type 1 diabetes in that the insulin-producing beta cells in the pancreas are slowly attacked and damaged by the immune system. The damage occurs at a much slower rate than in type 1 diabetes patients, but faster than it does in type 2 diabetes patients. 

The National Library of Medicine says that up to 10% of people who have diabetes, have LADA. Because LADA has some similarities to both type 1 and type 2 diabetes, it is sometimes referred to as type 1.5. Type 1.5 diabetes can stem from genetic factors like a family history of autoimmune disease, and through damage to the pancreas. 

LADA can be misdiagnosed because there is still a belief that type 1 diabetes is a childhood disease and any diabetic symptoms in adults must be type 2. In addition, the decline of the pancreas’s ability to produce insulin is slow, so early testing may show that insulin is still being produced as it would be in someone with type 2 diabetes. 

Signs & Symptoms of LADA Diabetes

Most people diagnosed with LADA are over the age of 30 and may carry some risk factors stemming from heredity or lifestyle. A patient with a family history of autoimmune disease, or who carries excess body weight, smokes, or regularly consumes food with a high glycemic index, will have a higher risk of developing LADA diabetes. 

Symptoms of LADA diabetes can include: 

• • Difficulty concentrating
• • Dry, itchy skin
• • Fatigue that can be greater after eating
• • Constant hunger even after eating 

As insulin production decreases, classic type 1 diabetes symptoms can develop that include: 

• • Excessive thirst
• • Frequent urination
• • Changes in your vision
• • Tingling in your hands, feet, legs
• • Fatigue or exhaustion
• • Unexplained weight loss
• • Recurring yeast infections (women) 

Types of Testing for LADA

Because LADA is often misdiagnosed, it is important to be your own health advocate and push for testing. LADA can appear in those who have a low or normal body mass index and normal cholesterol and blood pressure levels, and have no family history of diabetes or autoimmune disease, so it can be a bit sneaky. 

There are certain key factors that indicate LADA:

• • A positive test for at least one out of four types of diabetes-related autoantibodies
• • A potential presence of autoimmune diseases such as celiac or Grave’s disease
• • There is no requirement for insulin immediately following an initial diagnosis of diabetes

To ascertain any of these results and rule out type 2 diabetes requires a blood test. Physicians generally turn to tests that look for autoantibodies that are created through the immune system’s attack on the cells of the pancreas. The most common tests are glutamic acid decarboxylase (GAD) and islet cell antibodies (ICAs). A test will come back positive for autoantibodies if a patient has LADA. 

Other tests that may be performed are similar to regular testing for diabetes and can include: 

• • Hemoglobin A1c test (HbA1c)
• • Fasting plasma glucose test (FPB)
• • Oral glucose tolerance test (OGTT)
• • Random plasma glucose test (RPG)
• • Ketone test (performed through blood or urine)

Getting Diagnosed with LADA

Receiving a correct diagnosis for LADA is just half the battle. Information from the August 2020 issue of Perspectives in Diabetes  indicates that there are no guidelines for managing the disease. Therapeutic options are being continually reviewed with the goal to first find the best means to protect the beta cells and preserve their insulin-producing properties, and as the disease progresses, to administer therapies to bring more insulin to the patient. 

At first diagnosis, the treatment for LADA diabetes starts with controlling blood sugar, and maintaining a healthy weight and active lifestyle. Adopting a diabetes-friendly diet that is low in sugar and high on fresh fruit, vegetables, and whole grains will also be beneficial. As the pancreas cells continue to be damaged, insulin therapy and blood sugar monitoring will eventually be needed but should be an addition to the above-mentioned lifestyle changes. 

The road from not needing insulin to needing it can be long for LADA patients. Research has shown that while some may begin to need insulin therapy within months, for others it can be years. A LADA patient may not see a decrease in insulin that would match someone with type 1 diabetes for 12 years. 

The treatment for LADA diabetes is very similar to treatment for type 1: find the right dose and timing for insulin. The goal is to keep glucose circulating in the blood and absorbed efficiently to keep your body's functions working. Too much glucose (hyperglycemia) or too little glucose (hypoglycemia) in your blood can cause serious complications. With many types of insulin on the market that generally differ in how quickly they work and how long they will last, finding the best brand to use will depend on your insurance, your lifestyle, and your doctor’s recommendations. 

Determining the correct insulin dosing requires regular blood sugar monitoring. There are options for both how to test with a lancing device or continuous monitor, and how to read the results. Your medical team can help guide you but we suggest removing the pain and trepidation of regular blood testing through the use of our Genteel Lancing Device which enables users to benefit from the painless vacuum technology as well as the ability of the device to be used on other areas of the body outside the fingertips. Contact us to learn more and find out about our free trial. 

Along with self-testing, your doctor will also regularly perform an A1c blood test to help see your blood sugar levels over a three-month span and guide your insulin needs. He’ll work with you to determine how different foods, meal schedules, and your amount of exercise affect your glucose levels as well so you’ll know when you need to dose. 

All this testing and monitoring may sound daunting, but it can give you the skills needed to live a healthy and happy life. We remind you that you are not alone and that diabetes is nothing new. Even if you haven’t heard of LADA diabetes, it isn’t new, it is just a finding from the continuous research that goes into diabetes all in the name of helping those with the disease live their best lives.