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What Is LADA or Diabetes 1.5?

Understanding How LADA Differs from Types 1 and 2 Diabetes


Updated July 01, 2011

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What Is LADA or Diabetes 1.5?

Type 1 diabetes can begin in childhood or adulthood, while LADA begins only in adulthood.

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Latent autoimmune diabetes in adults, or simply LADA, is a relatively new type of diabetes that is just becoming known. Conventional thought has been that there are two main types of diabetes:

  • Type 1 (where your pancreas stops making insulin almost immediately)
  • Type 2 (where your pancreas still makes insulin but not enough or your body can’t use it effectively)

There is also gestational diabetes, which can occur during a woman’s pregnancy. Blood sugar is elevated during pregnancy but usually returns to normal after delivery if prenatal care is good.

So What Is LADA?

LADA takes on characteristics of both types 1 and 2 diabetes and is sometimes referred to as type 1.5 diabetes. LADA is often initially diagnosed as type 2 diabetes because the typical symptoms of type 1 diabetes are not present. The reason: the pancreas is still producing insulin so the body does not dramatically respond to an insulin deficiency as do those with type 1.

The main difference between LADA and type 2 is that there is an autoimmune response present with LADA that is similar to that of type 1. This means that your body’s immune system sees the beta cell production from the pancreas as a "threat" and launches an attack on these insulin-producing cells, eventually destroying most of them. But the attack is a slow, progressive one with LADA, compared to the swift and aggressive assault that is waged on the beta cells in type 1 diabetes. These same proteins that launch the autoimmune attack in LADA and type 1 are virtually absent in those with type 2 diabetes.

See the chart below for the distinguishing characteristics of LADA, compared to type 1 and type 2 diabetes

So, a person with LADA might not even know they have diabetes for quite some time, despite the fact that they may be showing some symptoms typical of type 2 diabetes. This is especially true with older adults because some symptoms of type 2 diabetes are routinely seen as symptoms of aging and are not discussed with a doctor. It isn’t until the symptoms become progressively worse that help is sought. By then the health consequences of diabetes may already be causing damage.

Researchers estimate that approximately 10% of people diagnosed with type 2 diabetes actually have LADA. This means that those people will eventually need to be on insulin in order to manage their blood sugar because LADA leads to a slow but progressive shut-down of beta cell insulin-production.

Early diagnosis of LADA is helpful

Although not always possible, early diagnosis of LADA is optimal. There is some evidence that early insulin treatment may preserve beta cell production of insulin for a longer period of time. But more research needs to be done to confirm this. Also, a misdiagnosis of type 2 may result in a person being placed on one or more oral medications, which may be ineffective or unnecessary. In addition, knowing that you have LADA when your symptoms start to become evident can help you to better manage your blood sugar and reduce the risk of health problems associated with diabetes.

The only way to know for certain whether a person has type 2 diabetes or LADA is to test for the presence of protein antibodies. This can be set up with your doctor, preferably with an endocrinologist (one who specializes in treating diabetes).

Treatment for LADA

Because LADA is more closely aligned with type 1 diabetes, treatment is essentially the same as for type 1. Insulin therapy will eventually be needed, and it may be beneficial to start insulin before it is actually needed to preserve beta cell function for as long as possible.


American Diabetes Association." The Other Diabetes: LADA or Type 1.5." Diabetes Forecast, May 2010

Type 1 LADA Type 2
Age of onset Child or adult Adult Adult
Progression to insulin dependence Rapid (days or weeks) Delayed (months to years) Very slow
Presence of autoantibodies Yes Yes No
When the person becomes insulin dependent At diagnosis Usually within 6 years Over time, if at all
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