What Is LADA, Anyway?

When I said I was going to learn about LADA/type-1.5 diabetes and post about it this week, I had in my mind that I probably have this disease, as compared to “plain” type-1 diabetes. I was going based on the various, nebulous definitions that use these criteria:

  • Do you make your own insulin? No.
  • Does anyone in your family have a history of type-2 diabetes? No.
  • Were you over 20, 25, or 30 at diagnosis? I was almost 25.
  • Were you obese? Not after I lost those 50 pounds in six weeks from ketosis.
  • Did your diabetes come on quickly? Define quickly. One day I felt fine. Then I felt off. Then a week or two later I felt really bad but thought it would pass. Then I got scared and didn’t want to learn that I had a disease. Then I could barely function. Then I was in the hospital and feeling like I had been brought back from the brink. So is that a quick onset with a longer period of denial? Or is it a slow onset, since I didn’t end up in the hospital in a coma after a week or two?
  • Alright then, were you on insulin within a year of diagnosis or did you have several years of successful type-2 treatment? Oh no. I was shooting insulin before I left the hospital. Of course, we never tried any T2 pills or diet/exercise-only changes. . . .

So it’s still fuzzy in my mind: LADA v. T1. I get that LADA looks a whole lot like T1, and I understand that one of the big reasons for LADA Awareness Week is to help the LADA folks who have been misdiagnosed as T2 and really should be on insulin. But is there an actual difference?

Yes, says Amy Nierras of the JDRF in a DiabetesMine article:

According to Nierras, the key difference between Type 1 diabetes and LADA is not the age of the person when they’re diagnosed, but the gradual way the disease progresses. Whereas people with classical Type 1 diabetes tend to be completely insulin-dependent within twelve months after diagnosis (usually less), people with LADA can often survive without artificial insulin for years.

Clearly these LADA folks, the ones who can survive for years without adding insulin, do not sound like me.

Unless. . . .

I hadn’t had a physical involving blood work and a health questionnaire in the several years before I was diagnosed. I was young. I was mostly in good health (except for the pressure in my eyes). For about a year I didn’t have health insurance, and for a couple years after I finally got insured, money was tight. Since I hadn’t had an A1c taken in many years, it’s possible that I had been living with impaired beta cells for some time. After all, on those rare occasions when I would eat candy in college, I would get that cranky feeling that I have nowadays when my BG is high.

But, as they say, “When you hear hoofbeats, think horses, not zebras.” It’s possible but probably unprovable. For now I’m going to go back to calling myself a person with late-blooming type-1 diabetes. Type-1.25, perhaps?

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One Response to What Is LADA, Anyway?

  1. Sara says:

    I mentioned at Simonpalooza that we are both in our own odd “Type” club. I was diagnosed at 22, but other than that do not fit any of the characteristic signs of LADA.

    I finally convinced my doctor to check for antibodies and anything else that would signal LADA. She says I have “typical autoimmune Type 1″. Whatever that means!

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