Patient education: Latent autoimmune diabetes in adults (The Basics)

What is latent autoimmune diabetes in adults? — Latent autoimmune diabetes in adults, or "LADA," is a type of diabetes. "Latent" means that it shows up later, usually in people who are at least 30 years old. "Autoimmune" means that it is caused by the immune system attacking the body's own cells.

Diabetes is a disorder that disrupts the way the body uses sugar. All of the cells in the body need sugar to work normally. Sugar gets into cells with the help of a hormone called insulin. Insulin is made by the pancreas, an organ in the belly. If there is not enough insulin, or if cells in the body don't respond normally to insulin, sugar builds up in the blood. That is what happens to people with diabetes.

There are 2 main types of diabetes:

●In type 1 diabetes, the pancreas makes little or no insulin.

●In type 2 diabetes, the pancreas still makes some insulin, but the cells in the body stop responding normally. Eventually, the pancreas cannot make enough insulin to keep up.

LADA is a form of type 1 diabetes, because the pancreas is damaged by the immune system and stops making enough insulin. But unlike in "classic" type 1, this damage happens slowly, over months to years. Because of this, LADA is often mistaken for type 2 diabetes at first. LADA is sometimes called "type 1.5 diabetes."

What are the symptoms of LADA? — Symptoms can happen if blood sugar gets too high. They can include:

●Intense thirst

●Being very tired

●Urinating often

●Losing weight

●Blurred vision

In extreme cases, a person can also have nausea or vomiting, belly pain, and severe loss of energy.

How do I know if I have LADA? — Diabetes is diagnosed based on your symptoms and a blood test. The test checks the level of sugar, or "glucose," in your blood. If it is high, you have diabetes.

If a test shows that you have high blood sugar, your doctor or nurse will then decide which type of diabetes you have. They can often figure this out based on your age, whether anyone else in your family has diabetes, and other factors. Some people might need extra blood tests.

In adults, type 2 diabetes is most common. Sometimes, people with LADA are diagnosed with type 2 diabetes at first. Then, over time, as the pancreas makes less insulin, it becomes less clear which type of diabetes they actually have. Doctors can do blood tests to help confirm LADA. One test looks for specific "autoantibodies." These are proteins that attack a person's own cells in autoimmune disorders.

How is LADA treated? — As with all types of diabetes, the main goal of treatment is to manage your blood sugar. This helps prevent problems that can happen if blood sugar gets too high.

Treatment for LADA includes:

●Medicines – The ones you need depend on how much insulin your pancreas is still making. At first, you might take pills or other medicines that help your body make more insulin or that help insulin do its job. But eventually, you will need to take insulin. Some people give themselves insulin shots every day. Others use an insulin pump.

You will probably also need to check your blood sugar regularly. Your doctor or nurse will explain how to measure your blood sugar, and how often to do it. You can keep track of your blood sugar using a phone app, online "portal," or paper chart (form 1).

●Lifestyle changes – These are important parts of managing diabetes. They include eating healthy foods and getting plenty of physical activity.

If you take insulin, you also need to carefully plan your meals and activity levels. Eating raises blood sugar. Physical activity can raise or lower it, depending on the type of activity. You might need to adjust your insulin dose based on your eating and exercise plans.

●General medical care – It's also important to take care of other areas of your health. This includes:

•Avoiding smoking – If you are having trouble quitting, your doctor or nurse can help.

•Watching your blood pressure and cholesterol levels – People with diabetes have an increased risk of heart disease and stroke. Keeping your blood pressure and cholesterol well managed can help lower these risks.

•Preventing infections – You should get certain vaccines, including vaccines to protect against the flu and COVID-19. Some people also need a vaccine to prevent pneumonia.

If you have LADA, it's important to see your doctor regularly. They will do blood tests, review your treatment plan, and make changes as needed.

What if I want to get pregnant? — Many people with diabetes have healthy pregnancies. If you want to have a baby, talk with your doctor or nurse. They will help make sure that your blood sugar is managed very well before and during pregnancy. This will protect you and your baby from problems.

More on this topic

Patient education: Type 1 diabetes (The Basics)
Patient education: Using insulin (The Basics)
Patient education: Checking your blood sugar at home (The Basics)
Patient education: Keeping track of your blood sugar (The Basics)
Patient education: Low blood sugar in people with diabetes (The Basics)

Patient education: Type 1 diabetes: Overview (Beyond the Basics)
Patient education: Type 1 diabetes: Insulin treatment (Beyond the Basics)
Patient education: Type 1 diabetes and diet (Beyond the Basics)
Patient education: Preventing complications from diabetes (Beyond the Basics)