LADA Diabetes

Latent autoimmune diabetes in adults: causes, treatment & symptoms.

Latent autoimmune diabetes in adults (LADA) is also known as type 1.5 diabetes. LADA has characteristics of both type 1 diabetes and type 2 diabetes. Type 1 diabetes is an autoimmune disease that requires insulin for the rest of your life. Type 2 diabetes is a metabolic disease caused by insulin resistance or insufficient insulin production.

Roughly 10% of the total diabetes population has LADA

LADA is often misdiagnosed as type 2 diabetes and, as a result, is often mistreated for years until the mistake is realized. This is because insulin is usually not needed to keep blood sugar under control at the onset of the disease. LADA more closely mimics type 2 diabetes in the early stages, where diet, sleep, stress, exercise, and other health factors help control your blood sugar levels without needing medication or insulin.

However, keep in mind that LADA is still an autoimmune disease, just like type 1 diabetes. The difference between type 1 and LADA is that type 1 progresses very quickly. LADA can take years to progress to the same level as type 1 diabetes.

What Is LADA?

Latent autoimmune diabetes in adults (LADA) is an autoimmune disease. It is caused by your immune system attacking the beta cells in your pancreas, which are responsible for producing insulin. Over time, as more and more of your beta cells are damaged and destroyed, your body’s natural insulin production decreases.

LADA is a slow-progressing form of type 1 diabetes, which is also an autoimmune disease. With type 1 diabetes, the progression of the autoimmune disease is rapid. This causes life-threatening conditions, often within days or weeks. LADA’s slower progression can often take months or years to get to the point of requiring insulin for survival.

LADA is most often diagnosed in individuals over 30 years of age and in people with a lower Body Mass Index (BMI) than those typically diagnosed with type 2 diabetes.

How is LADA Different From Type 1 Diabetes and Type 2 Diabetes?

Type 1 diabetes

Type 1 diabetes is an autoimmune disease that results from your immune system attacking and destroying pancreatic beta cells. People with type 1 diabetes either do not make any insulin or make a minimal amount. The lack of insulin causes high blood sugar. There is no cure for type 1 diabetes; this form of diabetes requires injected insulin for the rest of your life.

Type 2 diabetes

Type 2 diabetes is a metabolic disease that primarily results from insulin resistance. Your pancreas produces insulin in this type of diabetes, but your cells cannot effectively use insulin. This results in high blood sugar. Insulin resistance is thought to be caused by both genetic and environmental factors. A diet high in sugar and simple carbohydrates is the most significant factor contributing to insulin resistance. While there is no cure, type 2 diabetes can be reversed through diet and lifestyle changes. By making diet and lifestyle changes, many people with type 2 diabetes are able to successfully manage their blood sugar without needing medications or insulin.

Chart showing the differences between the a healthy person, someone with type 1 diabetes and type 2 diabetes


LADA is an autoimmune disease that results from your body producing antibodies against your beta cells, the same as type 1 diabetes. Similar to type 1 diabetes, there is a genetic component to developing LADA.

When first diagnosed with LADA, most people are still producing some insulin. This means that you’ll likely be able to manage your blood sugar through diet and lifestyle changes for some time. It may also be possible to slow the progression of LADA by making changes early on. If you’ve been diagnosed with LADA, check out our free guide to learn how to naturally control and lower your blood sugar.

Causes of LADA

Because LADA is an autoimmune disease, there is a genetic predisposition to the disease. In short, your body has a genetic sequence that either allows LADA or doesn’t allow LADA to be a condition that you may experience. However, just having a genetic predisposition for LADA doesn’t mean that you will acquire the disease. It usually takes an event to trigger the disease. This could be a divorce, traumatic experience, or even a night job that over time affects your sleep and stress levels. This event or series of events then triggers the LADA into action.

Signs and Symptoms of LADA

The signs and symptoms of diabetes are similar between type 1 diabetes, type 2 diabetes, and LADA.

Early symptoms of LADA include:

  • Feeling tired all the time, especially after eating
  • Feeling foggy, having a hard time concentrating
  • Feeling hungry soon after eating

As LADA progresses, later symptoms include:

  • Increased thirst
  • Frequent urination
  • Headaches
  • Blurred vision
  • Extreme hunger
  • Tingling in your hands or feet
  • Fatigue or feeling weak
  • Unintentional weight loss
  • Frequent yeast infections
  • Irritability or changes in mood

Illustration showing different symptoms of diabetes

If you have one or more of the above symptoms, please contact your doctor.

Diagnosing LADA

The Immunology of Diabetes Society (IDS) has proposed three criteria to diagnose LADA. 

  1. The patient is 35 years or older.
  2. The patient tests positive for at least one of the four autoantibodies. 
  3. The patient doesn’t require insulin within the first six months.

If a person has symptoms of diabetes but also meets the above criteria, it is very likely they have LADA and not type 1 or type 2 diabetes.

Male scientist lab tech looking through a microscope at blood samples.The four different antibodies commonly found in patients with type 1 diabetes are:

  • Islet cell autoantibodies (ICA)
  • Anti-glutamic acid decarboxylase (anti-GAD)
  • Insulinoma-associated protein-2 antibodies (IA-2A)
  • Insulin autoantibodies (IAA)

The process of diagnosing LADA is similar to diagnosing other forms of diabetes and will likely include:

  • HbA1C – tests your average blood sugar over the last two to three months
  • Fasting plasma glucose (FPB) – tests your blood sugar after fasting overnight
  • Oral glucose tolerance test (OGTT) – tests your blood sugar before and 2 hours after drinking a sugary drink
  • Random plasma glucose test – tests blood sugar at any time
  • Pancreatic autoantibody test – tests for the four common antibodies that attack the beta cells in your pancreas
  • C-peptide test – tests how much insulin your body is making

Other signs that a patient may have LADA instead of type 2 diabetes include:

  • Lack of other metabolic disorders such as obesity, high blood pressure, and high cholesterol
  • High blood sugar despite taking oral diabetes medications
  • Other autoimmune diseases such as Grave’s disease and Anemia

This chart published by the American Diabetes Association is very helpful in comparing the differences and similarities between type 1 diabetes, type 2 diabetes, and LADA.

Chart comparing the characteristics of type 1 diabetes, type 2 diabetes, and LADA

Why is LADA Often Misdiagnosed?

LADA’s slow progression leads to it commonly being misdiagnosed as type 2 diabetes. Many of the symptoms of diabetes are the same or similar between type 1 and type 2 diabetes. Usually, when a patient visits their doctor with symptoms of diabetes, the doctor will order blood tests. If the blood tests show high blood sugar and the patient is a teenager or older, many doctors are quick to diagnose type 2 diabetes.

Misdiagnosis can be dangerous. Because of LADA’s slow progression, patients usually don’t require medications or insulin in the beginning. Blood sugar levels during this period can often be managed by diet and exercise, which is similar to many people with type 2 diabetes.

However, over time your immune system destroys more and more of your beta cells. As this happens, your insulin production decreases. For LADA, this is often very gradual and can take anywhere from 6 months to years before a patient with LADA requires insulin. 

The misdiagnosis mistake is often caught several years after the diagnosis when the patient notices their blood sugar levels become higher and more uncontrolled despite following a healthy diet that controlled their blood sugar early on. Unfortunately, some doctors still don’t realize their mistake and instead prescribe insulin but continue to treat the patient as if they have type 2 diabetes.

If you or someone you love has been diagnosed with type 2 diabetes and are between 20-40, we STRONGLY urge you to ask your doctor to run additional blood tests. A blood test looking at pancreatic autoantibodies and a C-peptide test can be used to determine if you have LADA instead of type 2 diabetes.

Treatment of LADA

Initially, you will likely be able to manage LADA with diet and lifestyle changes alone. Over time you may need oral medications as your insulin production decreases.

Diabetes medications, pills and insulin, also glucometer and other diabetes testing suppliesEventually, you will require insulin for the rest of your life. People with LADA often require insulin within the first five years from diagnosis. There are many different types of insulin and insulin regimens. Your doctor will help determine the best regime for you. Once LADA has progressed to requiring insulin, you essentially have type 1 diabetes; it just progressed much slower.

Closely monitoring your blood sugar is important for people with LADA. Like type 1 diabetes, if uncontrolled, LADA can result in hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar) and can be deadly if untreated. Many people with LADA find a continuous glucose monitor (CGM) especially helpful for managing blood sugar.

Complications of LADA

Diabetes attacks every cell in your body. Uncontrolled high blood sugar for extended periods will damage and destroy all of your organs and body systems. Some of the complications from diabetes include:

Blindness – Retinopathy in your eyes can lead to blindness.
Stroke – Diabetes can more than double your chances of stroke.
Heart attack – Heart disease is one of the most common complications of diabetes.
Alzheimer’s – There is a strong link between Alzheimer’s and diabetes.
Cancer – The survival rate for cancer with diabetes is much worse than for someone without diabetes.
Amputation – Neuropathy damages nerves and joints, which can lead to infections and amputation.
Kidney transplant – Nephropathy can lead to daily dialysis or a kidney transplant.
Infections – Skin, foot, and yeast infections are common, along with common infections like the flu and pneumonia. 
Erectile Dysfunction – Poor blood circulation and damaged blood vessels from high blood sugar can lead to erectile dysfunction (ED).
Polycystic Ovarian Syndrome – For women, ovarian cysts can develop as a result of hormonal imbalance.

Specific to people with LADA, thyroid disease is more prevalent with LADA than with type 2 diabetes. Therefore, if you have LADA, your doctor will want to check your thyroid levels yearly to watch for any signs of thyroid disease.

Learn more about complications of diabetes:

The Bottom Line

Because LADA starts by closely resembling type 2 diabetes but then progresses to a form of type 1 diabetes, you must educate yourself on both types of diabetes. In addition, it is important to understand what you can do to help potentially delay the disease’s progression and help reduce the amount of insulin required to maintain the disease.

A LADA diagnosis can be overwhelming. It is vitally important to make sure you have a correct diagnosis. If you suspect you may have LADA, ask your doctor to run an autoantibody blood test. This test will help you know for sure which type of diabetes you have. Proper diagnosis should result in appropriate treatment and management, leave you feeling better, and help you avoid potential complications from diabetes.

Learn more about type 1 diabetes:

Learn more about type 2 diabetes: