Latent autoimmune diabetes in adults (LADA)

Latent autoimmune diabetes in adults (LADA)

Metabolic Diseases

For many years, it was thought that autoimmune diabetes only occurs in children and adolescents. Meanwhile, the increasing access to research has allowed for the distinction of LADA type diabetes. It is characterized by high resemblance to type 1 diabetes but it mainly affects adults. Find out how to recognize and treat it properly.

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What is LADA?

LADA (latent autoimmune diabetes in adults) is late-onset autoimmune diabetes, as is the case in type 1 diabetes, except that it occurs in adults. The cause of the disease is the destruction of the insulin-producing beta cells of the pancreas through its own immune system. The disease develops slowly, therefore hyperglycemia gradually increases, similar to that in type 2 diabetes. However, when most of the pancreatic beta cells are already destroyed, the patient must start therapy with insulin. Due to the similarities both to type 1 and 2 diabetes, LADA is very often diagnosed late. It is estimated that the disease affects 5 to 10% of people who were misdiagnosed with type 2 diabetes.

How is LADA different from type 1 diabetes?

What are the similarities between LADA and type 2 diabetes?

How can we distinguish between LADA and type 2 diabetes?

Symptoms of LADA

The symptoms of LADA are similar to those of type 2 diabetes and include:

LADA is a form of diabetes which develops slowly, and therefore the symptoms may initially go unnoticed.

Diagnostics of LADA

In the diagnosis of LADA, basic research is used at the beginning to determine whether or not blood glucose levels are elevated. Research is likely to include:

After this, you should be able to exclude the possibility of an incorrect diagnosis of type 2 diabetes. Some studies show that LADA may remain undiagnosed even in more than 50% of people who have type 2 diabetes not related to obesity (although it is worth remembering that not everyone with LADA is slim). All adults who are not obese and who have been diagnosed with diabetes should consider:

Criteria for the diagnosis of LADA

LADA is defined and thus distinguished from other types of diabetes thanks to the following features:

Treatment of LADA

Due to the fact that the LADA form of diabetes develops slowly, patients are initially advised to eat a diabetic diet, do moderate exercise and take oral diabetic medications. This usually allows for proper control of the disease, in the first phase of the disease.

Unfortunately, as a result of the disease, the cells of the pancreas responsible for secretion of insulin are constantly destroyed and at some point the patient's body no longer produces its own insulin. It is then necessary to switch from oral antidiabetic drugs to insulin. In order to be able to capture this moment early, regular visits to the diabetes clinic are necessary.

Recent research shows that the implementation of insulin therapy in a patient right after diagnosing LADA can slow down the process of pancreatic beta cell destruction. This would allow for longer insulin secretion by pancreatic cells, and therefore it would also be easier to obtain metabolic compensation for diabetes. Doing so would avoid acute complications such as ketoacidosis.

However, be aware that this type of therapy is still in the research phase. There is still a lack of data on the long-term effects of early or delayed onset of insulin therapy in the treatment of LADA-type diabetes.

Bibliography:
  1. Interna Szczeklika 2018 Handbook of Internal Diseases, Authors: Piotr Gajewski, Andrzej Szczeklik Publisher: Medycyna Praktyczna
  2. Collective work, Carbohydrate metabolism disorders [in:] Andrzej Wojtczak (ed.), Internal diseases, ed. II amended, Warsaw: PZWL Medical Publishing, 1995
  3. http://www.mp.pl
  4. https://www.mp.pl/pacjent/
  5. https://apteline.pl/cukrzyca/artykuly/cukrzyca-typu-lada/
  6. M. Landin-Olsson, Latent autoimmune diabetes in adults, "Annals of the New York Academy of Sciences", 958, 2002
  7. Diabetes mellitus. A guide to patient care, Lippincott Williams & Wilkins
  8. https://journals.viamedica.pl/clinical_diabetology/article/viewFile/8441/7202
  9. https://www.mp.pl/cukrzyca/cukrzyca/typ1/65896,cukrzyca-typu-1-lada
  10. http://www.czytelniamedyczna.pl/4369,cukrzyca-typu-lada-to-znaczy.html
  11. https://diabetyk24.pl/blog-section/cukrzyca-typu-LADA-co-ja-odroznia-od-cukrzycy-typu-1-i-2
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