Updated April 29, 2005
What on
earth is a LADA?
Have you
ever been confused about whether you have type 1 or 2 diabetes? Don’t
worry because many doctors, including the doctors at this Research
Centre, have found it difficult to be certain in some people.
Why does such confusion exist? Part of the confusion is related to the
fact that both types can occur in the one individual.
Diabetes
or a high blood sugar results from a lack of insulin production or a
lack of insulin action in the body’s tissues. We know that type
1 diabetes is a condition in which the immune system reacts against
the insulin-producing beta cells in the pancreas, a process known as
autoimmune destruction. Autoimmune destruction of the beta cells eventually
results in a lack of insulin. Type 2 diabetes is a different process
whereby initially insulin production in the beta cells is sufficient
but the insulin does not work as well at distant sites in the body due
to insulin resistance. It is easy to see that in extremes of either
case diabetes can occur. One can also see that a combination of both
processes could also lead to diabetes.
In the last
ten years it has become evident from research that there are many people
who have both type 1 and 2 diabetes processes. The largest study to
show this was the United Kingdom Prospective Diabetes Study published
in 1997. They identified that one in 10 adults (age 25 – 65) with
presumed type 2 diabetes had glutamic acid decarboxylase antibody (GAD
Ab), a highly specific marker of autoimmune destruction of the beta
cells, ie. evidence of a type 1 diabetes process. Many other studies
have identified a similar number of people, approximately 1 in 10 adults
who have GAD Ab and are presumed to have type 2 diabetes. This condition
is also known as latent autoimmune diabetes in adults (LADA). These
people are different from children with type 1 diabetes because they
clinically present as someone with type 2 diabetes, they do not require
insulin for at least 6 to 12 months after diagnosis of their diabetes
and may be overweight.
Why
is it important to identify LADA in adults?
Because
adults with diabetes and GAD Ab :
have a high probability of requiring insulin injections within 6 years
of diagnosis
have significant insulin
deficiency and may be at risk of future ketoacidosis
may also be eligible
to participate in INIT III, an immunoprevention trial that
we are conducting.
Where
can I find out more about LADA?
Because our
understanding of LADA is relatively recent, there are few, if any, websites
devoted to this particular subgroup of diabetes. Sites that may be of
use to you include:
