What is Type 1.5 diabetes, symptoms of this hard-to-diagnose diabetes, and tips to manage it

Type 1.5 diabetes, commonly known as Latent Autoimmune Diabetes in Adults (LADA), represents a unique and often misdiagnosed form of diabetes that blends features of both Type 1 and Type 2 diabetes. (Image: Canva)

Type 1.5 diabetes, commonly known as Latent autoimmune diabetes in Adults (LADA), represents a unique and often misdiagnosed form of diabetes that blends features of both Type 1 and Type 2 diabetes. Unlike classic Type 1 diabetes, which is typically diagnosed in childhood or adolescence, LADA emerges in adulthood and is frequently mistaken for Type 2 diabetes due to its age of onset.

LADA is characterised by the autoimmune destruction of insulin-producing beta cells in the pancreas, similar to Type 1 diabetes, but it progresses more gradually. At the same time, individuals with LADA may experience insulin resistance, a hallmark of type 2 diabetes. This dual nature makes LADA challenging to diagnose and manage, says Vinayak Hospital’s endocrinologist, Sabyasachi Sharma.

Recognising the subtle signs and understanding their distinct features are crucial for effective treatment, which often involves a combination of lifestyle modifications, oral medications, and insulin therapy.

What is Type 1.5 diabetes?

LADA is a type of autoimmune diabetes that occurs in adults, often being misdiagnosed as Type 2 diabetes initially due to its age of onset. It has features of Type 1 diabetes (autoimmune destruction of insulin-producing beta cells in the pancreas) and Type 2 diabetes (insulin resistance).

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Causes

Autoimmune reaction: LADA involves the immune system attacking the insulin-producing beta cells in the pancreas, similar to Type 1 diabetes. This autoimmune destruction is slower than in classic Type 1 diabetes.

Genetic factors: Genetics may play a role, as with both Type 1 and Type 2 diabetes, although the exact genetic triggers are less understood.

Environmental triggers: Factors such as viral infections or other environmental factors might trigger the autoimmune process.

Symptoms

Gradual onset: Symptoms often develop more gradually compared to Type 1 diabetes. They can include increased thirst, frequent urination, unexplained weight loss, and fatigue.

Insulin dependence: Unlike Type 2 diabetes, individuals with LADA often require insulin therapy sooner or later, as their insulin production decreases over time.

Blood sugar levels: Blood sugar levels can be harder to control than in Type 2 diabetes and may require more intensive management.

Diagnosis and management

Diagnosis: LADA can be challenging to diagnose due to its overlap with Type 2 diabetes. It is often identified through antibody testing (such as GAD antibodies) and a clinical assessment of insulin dependence.

Management: Treatment typically involves a combination of lifestyle changes, oral medications, and eventually insulin therapy. Monitoring blood glucose levels regularly is crucial.

If you suspect you might have LADA or are experiencing symptoms, it’s best to consult a doctor for an accurate diagnosis and personalised management.