LADA: Understanding Latent Autoimmune Diabetes in Adults

LADA, or Latent Autoimmune Diabetes in Adults, often appears similar to Type 2 diabetes but is actually a form of Type 1 diabetes that develops slowly.

If a middle-aged person suddenly develops diabetes, experiences weight loss, and despite taking oral medications their HbA1c levels do not improve, it could be LADA.

When to suspect LADA? 1. Weight loss occurs but blood sugar does not decrease. 2. No benefit from oral medications; HbA1c remains high despite lifestyle changes. 3. History of other autoimmune diseases such as thyroid disorders, vitiligo, rheumatoid arthritis. 4. Need for insulin arises within months after diagnosis. 5. Poor blood sugar control despite treatment for presumed Type 2 diabetes.

How to confirm? Tests include: 1. GAD antibody test: Positive result suggests autoimmune Type 1 diabetes. 2. C-peptide test: Indicates whether the body is producing insulin. 3. Fasting and postprandial blood sugars along with HbA1c to monitor trends. 4. In some cases, IA2 and ZnT8 antibody tests are also performed.

Main treatment approach is not just lifestyle changes but coaching plus insulin therapy.

- Starting insulin at the right time helps prevent complications. - Delay in insulin therapy can affect retina, kidneys, and nerves. - Diabetes coaching is essential for diet management, mental health, and emotional acceptance.

LADA is a slowly progressing Type 1 diabetes where oral medications fail to control blood sugar and insulin becomes necessary.

Early diagnosis leads to appropriate treatment and a peaceful life.

If you struggle with blood sugar control despite best efforts, ask your doctor if it could be LADA.

Dr. Ravindra L. Kulkarni, MD, DNB, FSCAI (Cardiology) Just For Hearts