What is Latent Autoimmune Diabetes in Adults (LADA)?
Latent autoimmune diabetes in adults, also known as LADA, describes a form of diabetes that develops over many years and shares similarities with both type 1 and type 2 diabetes1. LADA is sometimes referred to as “type 1.5 diabetes” because it’s an autoimmune condition like type 1 diabetes (T1D), but it’s diagnosed later in adulthood, which is typically associated with type 2 diabetes (T2D).
LADA is a nuanced condition, and its treatment will vary by person and their symptoms. Understanding what makes it
different from T1D and T2D can help provide a little clarity about what’s going on in your body so you can have a productive conversation with your doctor about what you’re experiencing when seeking a diagnosis and developing a treatment plan.
What makes LADA different from type 1 and type 2 diabetes?
LADA sometimes appears to be T2D at first, but it ultimately has the same underlying cause as T1D. Like T1D, LADA is caused by an autoimmune event that destroys the cells in the pancreas, called beta cells, that produce insulin2. Insulin is the hormone in the body that regulates how glucose, or sugar, is used for energy in the body. Without beta cells, the pancreas can’t produce the insulin the body needs so it can absorb and use glucose from food.
T1D is most often diagnosed in children and adolescents, with peaks in diagnosis typically occurring between the ages of 4 and 7 or between 10 and 14.3 Those who experience LADA are usually around or over the age of 30.4
On the other hand, in T2D, the pancreas can still produce insulin, but it is unable to make enough insulin to effectively regulate glucose or the body isn’t able to use the insulin that’s available, which is known as insulin resistance.5,6 T2D is not an autoimmune condition. A variety of factors contribute to the development of T2D and, similar to LADA, it progresses over time, which is one of the reasons why people with LADA might be diagnosed with T2D at first.6
When individuals are diagnosed with LADA, they have the same autoimmune response as in T1D, but they usually do not yet require insulin treatment when they are diagnosed, a circumstance that’s more common with people diagnosed with T2D.6 Individuals living with LADA typically need to start depending on insulin about six months after their initial diagnosis as their beta cells are depleted.7 A healthcare provider must test for the antibodies (the proteins in the immune system that protect the body8) that destroy beta cells to confirm whether an individual is experiencing LADA or T2D.6,7
Common Latent Autoimmune Diabetes in Adults (LADA) Symptoms
The first symptoms of LADA can include:9
- Feeling more fatigued than usual, especially after eating
- Getting hungry soon after eating
- Brain fog
As insulin production slows down, you might experience other symptoms that look more like undiagnosed T1D. These symptoms may include:
- Feeling very thirsty and being unable to quench your thirst
- Urinating frequently
- Experiencing blurred vision
- Experiencing tingling nerves
- Losing weight
A doctor might also look at whether you or your family has a history of other autoimmune conditions to diagnose LADA.
How do you know if you have LADA and not T2D?
Everyone living with diabetes experiences it differently. If you’ve been recently diagnosed with T2D, you’re likely adapting to your treatment plan and shifts in your lifestyle. It’s a good idea to keep checking in with yourself and your doctor about whether your treatment is working for you and whether you’re feeling better than before you started treatment.
It’s critical to continue to communicate with your doctor about your symptoms even if you have been diagnosed with T2D because the treatments that work for T2D (such as diet or lifestyle changes) will not be effective if your pancreas is not producing insulin anymore. If you have developed LADA, getting treatment with insulin in addition to lifestyle changes may be a vital part of maintaining your health.7
The Immunology for Diabetes Society (IDS) has three specific criteria that can help healthcare providers determine whether someone is experiencing LADA.1
- The individual is in their 30s
- They are positive for the antibodies that attack beta cells
- They did not need to depend on insulin for at least 6 months after the initial diagnosis of T2D
Discussing your symptoms and talking to your doctor about being tested for T1D-related antibodies can help you get an accurate diagnosis so that you and your doctor can determine the right treatment options.
Taking the first steps on your diabetes journey
Receiving a LADA diagnosis may come as a complete shock, especially because it’s diagnosed later in life. Living with diabetes requires lifestyle changes and it’s important to acknowledge that
it can be stressful to implement those changes. However, there are plenty of tools and resources that you can lean on to empower you to take control of the way you manage diabetes.
Your doctor is your guide and will collaborate with you to develop
a diabetes management plan that will address your unique needs. They can provide you with more information about diabetes and
help you understand how to support yourself through your
diabetes journey.
In addition to your doctor, you can build a network of care that
might include a dietitian that specializes in diabetes as well as
other healthcare professionals who can help you manage both
the physical and emotional aspects of living with diabetes.
There is also a thriving community of other individuals living with diabetes, including our Dexcom Warriors, and plenty of diabetes education resources online that can light the path along the way. A few great educational resources to get started with include:
Managing Glucose When Living with LADA
A major part of living with any type of diabetes is regulating your glucose levels and making sure that you limit the amount of time you experience hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar). There are many factors that influence changes in blood sugar, and they include diet, activity, and sleep. You and your doctor will work together to determine your ideal glucose levels, which is known as your target glucose range (generally defined as being between 70–180 milligrams of glucose per deciliter of blood, or mg/dL).
Your doctor will keep an eye on whether your glucose is within a healthy range using a blood test called an A1C test which
measures your average glucose levels over the three previous months. They will work with you to determine an A1C goal to guide your diabetes management plan. For most adults, the American Diabetes Association (ADA) recommends an A1C below 7.0%.10
Part of your A1C goal might be setting a target glucose range you’ll aim to stay within on a daily basis. Spending more time in
range (TIR) is associated with an improvement in A1C levels.11 To increase your TIR, you need to understand what affects your glucose levels throughout the day so that you can make adjustments to your habits and discuss changes to your insulin doses
with your doctor.
One of the ways to measure your glucose levels on your own outside of appointments is with a continuous glucose monitoring (CGM) system. CGM systems use a sensor inserted just below the skin to measure glucose levels in the body on a continuous
basis, day, and night, so you don’t need to perform routine fingersticks to see where your glucose is at.*
*Fingersticks required for diabetes treatment decisions if symptoms or expectations do not match readings.
The Dexcom G7 CGM System makes it easy to view your glucose levels in the palm of your hand on a receiver or compatible smart device using the Dexcom G7 app.† This can be especially helpful when you’re keeping an eye on whether T2D treatments are working to stabilize your glucose levels over time or if you might need to explore the possibility of LADA with your doctor.
To ensure that you’re effectively managing your glucose levels, you can also set up alerts to tell you when you’re outside your target range (both high and low) and be alerted up to 20 minutes before you’re likely to head into serious hypoglycemia (≤55 mg/dL).
Dexcom G7 also has a built-in low alarm that lets you know when you’ve dropped below 55 mg/dL. This can help give you greater peace of mind that you’ll be able to take proactive action to stay in range as often as possible. Using Dexcom G7 is also proven to increase the time you spend in your target range and lower your A1C.12-16
Get started on Dexcom G7
Were you recently diagnosed with Diabetes or are you living with diabetes and not using CGM? Talk to your doctor about Dexcom G7. We can help you get started with a free benefits check. Click the button below to send us some basic information.
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*Fingersticks required for diabetes treatment decisions if symptoms or expectations do not match readings.† For a list of compatible devices, visit www.dexcom.com/compatibility.
1 O’Neal, K. S., Johnson, J. L., & Panak, R. L. (2016, November). Recognizing and appropriately treating latent autoimmune diabetes in adults. Diabetes spectrum : a publication of the American Diabetes Association. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5111528/ 2 Centers for Disease Control and Prevention. (n.d.-b). About type 1 diabetes. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/about/about-type-1-diabetes.html 3 Mayo Foundation for Medical Education and Research. (2024, March 27). Type 1 diabetes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011# 4 Ravikumar, V., Ahmed, A., & Anjankar, A. (2023, October 29). A review on latent autoimmune diabetes in adults. Cureus. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10683931/ 5 U.S. Department of Health and Human Services. (n.d.). Type 2 diabetes - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/type-2-diabetes 6 Understanding insulin resistance. Insulin Resistance and Diabetes | ADA. (n.d.). https://diabetes.org/health-wellness/insulin-resistance 7 Rajkumar V, et al. Latent Autoimmune Diabetes. StatPearls Publishing. Updated June 21, 2022. https://www.ncbi.nlm.nih.gov/books/NBK557897/ 8 Antibodies. Cleveland Clinic. Updated May 6, 2022. https://my.clevelandclinic.org/health/body/22971-antibodies 9 Diabetes LADA. Diabetes.co.uk. Updated June 10, 2022. https://www.diabetes.co.uk/diabetes_lada.html 10 What is the A1C test?. Understanding A1C Test | ADA. (n.d.).https://diabetes.org/about-diabetes/a1c 11 Vigersky RA, et al. The Relationship of Hemoglobin A1C to Time-in-Range in Patients with Diabetes. Diabetes Technology & Therapeutics. 2019;21(2):81-85. doi: 10.1089/dia.2018.0310 12 Beck RW, et al. JAMA. 2017;317(4):371-378. 13 Beck RW, et al. Ann Intern Med. 2017;167(6):365-374. 14 Martens T, et al. JAMA. 2021;325(22):2262-2272. 15 Laffel LM, et al. JAMA. 2020;323(23):2388-2396. 16 Welsh JB, et al. J Diabetes Sci Technol. 2024;18(1):143-7
BRIEF SAFETY STATEMENT: Failure to use the Dexcom Continuous Glucose Monitoring System and its components according to the instructions for use provided with your device and available at https://www.dexcom.com/safety-information and to properly consider all indications, contraindications, warnings, precautions, and cautions in those instructions for use may result in you missing a severe hypoglycemia (low blood glucose) or hyperglycemia (high blood glucose) occurrence and/or making a treatment decision that may result in injury. If your glucose alerts and readings from the Dexcom CGM do not match symptoms, use a blood glucose meter to make diabetes treatment decisions. Seek medical advice and attention when appropriate, including for any medical emergency.