Diabetes Research Centre

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Latent Autoimmune Diabetes of Adulthood (LADA)

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:

Diabetes Australia (Victoria) - this site contains research and clinical news on type 1 and type 2 diabetes with diet and lifestyle tips and is the home of one of the major Australian diabetes support groups.

The International Diabetes Institute - this site contains a wealth of information about type 1 diabetes, including current research, living with diabetes, diet and clinical information.

The American Diabetes Association - this is an overseas website, which focuses on living with diabetes, with information on weight loss and diet, sections for parents, children and doctors, and even recipes (but beware - all recipes are in Imperial measurements, so make sure you have a converter when baking).

Or read a brief article on LADA written by Dr Spiros Fourlanos and Assoc. Prof Peter Colman at the Diabetes Research Centre (article reproduced here with the kind permission of Diabetes Australia and the Diabetes Management Journal)

OR... visit the INIT III page, to find out about our diabetes trial just for people with LADA...

 

PS - these are the best websites we could find for you. If you have found a really good LADA website, we'd love to hear from you - email Catherine with the details.

 

Type 1 Diabetes
Type 2 Diabetes
Gestational Diabetes
Diabetes Research Centre

Last updated 19 December, 2007. For further information about this website, please contact Catherine McLean