In fact, the only professional diabetes organization that officially recognizes LADA is the Immunology of Diabetes Society, which proposes a definition that boils down to:
But it’s not so simple. For one thing, the hallmark slow onset of LADA is also sometimes seen in people younger than 30 years old. And some patients over 30 years old can go longer without insulin than “typical” type 1s but still end up needing it in less than 6 months.
In short, the lines are fuzzy here. Many experts believe LADA is a different disease from T1D, while others say it’s just another flavor of the same condition; yet others still think the LADA label should be thrown out altogether.
Italian Drs. Paolo Pozzilli and Umberto Di Mario, writing an early commentary on LADA in the journal Diabetes Care, said: “This term has been largely used in the last few years when referring to autoimmune forms of diabetes not requiring insulin initially. Now it is clear that diabetes in these patients is not latent and is not limited to adults.”
Yet other researchers have been calling for a refined definition, or a different one, including ADASP, which stands for “autoimmune diabetes in adults with slowly progressive beta-cell failure.” That’s a mouthful.
In addition to this scientific wrangling over LADA, the term creates a significant problem for clinicians and, more importantly, for patients. Since LADA doesn’t fit neatly into a shoebox, many patients with LADA (or whatever you call it) are misdiagnosed and wrongly treated.
Because this flavor of autoimmune diabetes generally strikes older people, who are sometimes heavier, develops more slowly than traditional T1D, and often responds initially to oral medications, it is frequently mistaken for type 2 diabetes — leading to inappropriate therapy, especially a delayed start of insulin.
That begs the questions: Just how is LADA diagnosed? And what do people on the receiving end of a diabetes diagnosis need to know?
This content was originally published here.