|Diabetes Types |
Key characteristics of type 1, LADA (latent autoimmune diabetes in adults), and type 2.
|Type 1||LADA||Type 2|
|Typical age of onset||Youth or adult||Adult||Adult|
|Progression to insulin dependence||Rapid (days/weeks)||Latent (months/years)||Slow (years)|
|Presence of autoantibodies*||Yes||Yes||No|
|Insulin dependence||At diagnosis||Within 6 years||Over time, if at all|
As part of their study, the researchers also looked for the same auto antibodies in the general population and in people with type 2 diabetes (which is not an autoimmune disease). The proteins were virtually absent in the general population, but they showed up, to the scientists’ surprise, in about 10 percent of people diagnosed with type 2. This suggested that there was a subcategory of people who could now be diagnosed as having LADA instead, even though there was no obvious difference in their symptoms from those of people with type 2.
While not everyone has settled on calling the condition LADA (some prefer “type 1.5”), or even whether it’s distinct from type 1, researchers are working on a set of criteria for its diagnosis: 1) the presence of autoantibodies in the blood, 2) adult age at onset, and 3) no need for insulin treatment in the first six months after diagnosis. This definition would distinguish LADA from type 1—because people diagnosed with type 1 typically need to start insulin immediately—and from type 2, because of the presence of auto antibodies in the blood.
1. You are diagnosed with Type 2 diabetes while at a normal weight.
2. Whatever your weight, either you or a member of your family has some other autoimmune disease such as thyroid disease, rheumatoid arthritis, lupus, or multiple sclerosis.
3. You lower your carbohydrate intake shortly after diagnosis to no more than 15 grams a meal and still have a fasting blood sugar over 110 mg/dl and blood sugars that rise 40 mg/dl or more after each meal.
4. No matter what your weight, you do not see a dramatic drop in your blood sugar when you take metformin, Avandia, Actos, Januvia or Byetta in combination with a lowered carbohydrate intake.
5. Your blood sugar deteriorates significantly over the period of a year despite treatment with oral drugs and carbohydrate restriction.
If you think you have LADA ask your doctor for:
1. A fasting C-peptide test. If the value is low, it is suggestive of LADA.
2. GAD and Islets antibody tests. High levels of these antibodies are diagnostic of LADA especially in combination with lowered C-peptide.