What Is Diabetes Type 1.5?

By Gretchen Scalpi

October 18, 2010 marked a special day for the diabetes community.  It was the first day of the first annual LADA Awareness Week.  What is LADA?  Often referred to as type 1.5 diabetes, LADA is an abbreviation for latent autoimmune diabetes in adults.  It is often misunderstood, frequently misdiagnosed and there are many physicians unfamiliar with it altogether.

LADA (or type 1.5 diabetes) generally affects adults in the age range of 35-50.  This person usually has some of the signs and symptoms found in type 1 diabetes, but because of their age, they are diagnosed with type 2 diabetes.  About 10% of the diabetic population has LADA, and it may be somewhat more common than type 1 diabetes.  Among those diagnosed with type 2 diabetes, up to 15-20% may have been misdiagnosed, and actually have LADA.

Here are some facts that distinguish LADA (type 1.5 diabetes) from type 2 diabetes:

• The person with LADA is usually not overweight and there is little evidence of insulin resistance.  In contrast, someone with type 2 diabetes is often overweight and has insulin resistance.

• Insulin may not be required right away, but within a short period of time the person demonstrates a poor response to oral medications.  Certain oral medications that treat insulin resistance (such as Actos or Avandia) are ineffective for LADA.

• Medications that stimulate the pancreas to produce insulin (such as Glyburide), or reduce excess glucose production by the liver (such as Metformin) can be helpful in delaying the need for insulin in this type of diabetes.

• In general, the need to start insulin occurs much sooner for someone with LADA.  Insulin is required within approximately four years of diagnosis as compared to 6 or more years in those with type 2 diabetes.

• When special lab tests are done, people with LADA are found to have certain antibodies, such as GAD65 antibodies that attack the beta cells of the pancreas.  Destruction of pancreatic beta cells hastens the decline in insulin production.  This helps to explain why insulin is required much sooner.

• Metabolic syndrome (obesity, high triglycerides, low HDL cholesterol or high blood pressure) typically found in type 2 diabetes is often not seen in LADA, making this population less at risk for cardiovascular disease.

• Although the medication and/or insulin regime may differ for the treatment of LADA, having a healthy diet and a routine exercise plan remain vital components of the overall treatment plan.

No matter what type of diabetes you have, knowing your type will give you a better understanding of the most appropriate kind of treatment needed, as well as how your disease may progress over time. 

If you have been diagnosed with type 2 diabetes, but lack the typical characteristics of type 2, discuss the possibility of LADA with your doctor.  It's a good idea to add a Registered Dietitian and/or a Certified Diabetes Educator to your treatment team.  They can help you learn about the many aspects of your treatment including an appropriate eating plan, exercise, glucose monitoring and medications.

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