Sometimes referred to as type 1.5, Slow onset type 1, LADA - latent autoimmune diabetes in adults or Slowly Progressive Diabetes (SPIDDM).
The name LADA can be confusing to some, as typified by a foreign lady and her doctor who were definitely at cross purposes.
He told her she possible had LADA and they would do some tests to confirm it. She heard larder and went home to check her dictionary, to discover it meant a place for storing food. Being a conscientious housewife she was very upset at the thought that her well stocked pantry was making her ill!
Usually diagnosed in people 35 or older it is often confused as Type 2 and treated as such.
One could query why a patient who presents as slender and has little insulin resistance could be diagnosed as type 2 but the same person also does not have the rapid unexplained weight loss of a person who was not overweight to start with and ketoacidosis (increased acid levels in the blood and urine) normally found in Type1s.
No wonder the doctors are confused. Also, their aim is to get the blood glucose down as fast as possible and when diet, exercise and oral meds work why would they think to look further.
And the Type 2 treatment may work well for a period of time, often years, until the time comes when the blood glucose levels deteriorate to the point where insulin is needed.
It is at this point that testing for c-peptide levels will give a clue as to why - if your levels are near the bottom of the normal range it is possible you have LADA.
To confirm, a test for pancreas antibodies is often done, and if GAD - glutamic acid decarboxylase antibodies are found, which are the markers for autoimmune diabetes, then you have LADA.
Although LADA appears to follow the same path as type 1, in that the immune system kills off the beta cells, their slow destruction as compared to the very fast destruction of type 1s would suggest that the immune system is acting somehow in a different way, which is why the term LADA is preferred to the older term of slow onset type 1 and it is now being recognised as yet another type of diabetes.
The fact that this type of diabetes is so often misdiagnosed, is thought to be not that serious, health wise, as the treatment would be the same anyway.
As yet there is no treatment to halt the immune systems destruction of beta cells.
However if LADA patients were diagnosed early and put on insulin straight away it is possible that some of their beta cells might be preserved for longer and it is known that type 1 is easier to control if you still have a little beta cell activity left.
Also, to a diabetic struggling to understand why his or her blood glucose levels are steadily rising, despite all their efforts to control them, it would be immensely reassuring to know that it was not their fault but that of their muddled immune system.
To give people that peace of mind it would perhaps be best if the don't fit the profile type 2s were routinely tested for antibodies.
As it stands at the moment it is believed that 15%-20% of people diagnosed with type 2 actually have LADA.