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What Is Latent Autoimmune Disease in Adults (LADA)?

What Is Latent Autoimmune Disease in Adults (LADA)?
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Published on March 26, 2025
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Latent autoimmune diabetes in adults (LADA) is a type of diabetes that occurs when the body mistakenly attacks the cells in your pancreas that make insulin (a hormone that regulates blood sugar). LADA is also casually known as type 1.5 diabetes, since it has characteristics of both type 1 and type 2 diabetes. This condition often resembles type 2 diabetes at first, because it develops slowly in adults, but it should eventually come to resemble type 1 diabetes, requiring regular insulin injections.

While there’s currently no cure for LADA, it is treatable with medication and lifestyle changes.

Signs and Symptoms of LADA

Like other forms of diabetes, LADA causes high blood sugar levels (hyperglycemia), and therefore shares many of the same symptoms as type 1 and type 2 diabetes, including:

  • Blurred vision
  • Unexpected weight loss
  • Frequent urination
  • Extreme thirst
  • Fatigue
  • Itchy, dry skin
LADA is frequently misdiagnosed as type 2 diabetes, because its early progression can closely resemble that of type 2 diabetes, with symptoms developing gradually over time. LADA affects adults over the age of 30, and during its first months or years, type 2 diabetes medications such as metformin may be enough to keep blood sugar levels in a healthy range.

 At this stage, it may require additional testing of autoantibodies or C-peptide levels (a measure of insulin production) to distinguish between LADA and type 2 diabetes.
Sometimes LADA is diagnosed only years after an initial diagnosis of type 2 diabetes, after the standard type 2 diabetes treatment has ceased to be effective. With LADA, your pancreas stops making insulin gradually, and you will eventually need treatment with insulin.

Graphic titled, what you should know about LADA, illustrated points include affects adults, cannot be reversed, often mistaken for type 2 diabetes, is an autoimmune disorder, eventually requires insulin, develops slowly. Everyday Health logo bottom left.

Causes and Risk Factors of LADA

Like type 1 diabetes, LADA is autoimmune in nature. LADA has a genetic component, so you may be more likely to have it if a family member does, but it can also strike randomly in individuals with no family history of autoimmune disorders.

Some studies suggest there may also be environmental and lifestyle factors at play, including obesity, being sedentary, and smoking. It is possible that healthy habits can delay or even prevent LADA.

How Is LADA Diagnosed?

To determine if you have LADA, your healthcare provider will give you an antibody test, which is a blood test for the autoantibodies that cause the disease.

 If the blood test reveals autoantibodies, you may have LADA.
Your provider may also recommend a C-peptide test to confirm the diagnosis.

 C-peptide is a by-product of the insulin-making process, and this measurement shows how much insulin your pancreas produces.
LADA is often misdiagnosed as type 2 diabetes because the two conditions share many similarities.

 If you were diagnosed with type 2 diabetes but haven’t seen improvements in blood sugar after using medication, your healthcare provider may check for LADA.

Latent Autoimmune Diabetes in Adults (LADA) Is Sometimes Called Type 1.5 Diabetes

LADA
Type 1 Diabetes
Type 2 Diabetes
Cause
Autoimmune attack
Autoimmune attack
Varies, including insulin resistance and lifestyle factors
Onset
Develops gradually
Can develop very rapidly
Develops gradually
Age at onset
Only affects adults older than 30
Any age, but often affects children
Any age, but usually affects adults
Time to insulin treatment
Will eventually require insulin treatment, months or years after onset
Requires insulin treatment immediately
May never require insulin treatment
Is it reversible?
No
No
Maybe; some can achieve type 2 diabetes remission

Treatment and Medication Options for LADA

When first diagnosed with diabetes, people with LADA may not yet need insulin injections. At this stage, your treatment will concentrate on improving your blood sugar control, which may help preserve your natural ability to secrete insulin. To achieve this, your doctor may use type 2 diabetes drugs such as metformin or GLP-1 receptor agonists, which can help improve insulin sensitivity. Lifestyle adjustments, such as a wholesome diet and enhanced physical activity, could also extend this period before insulin treatment becomes necessary.

Eventually, however, everyone with LADA will need insulin. Some doctors may choose to prescribe insulin relatively soon after diagnosis, while others may prefer to wait until it is no longer possible to control blood sugar levels without it.

Initially you may be prescribed a long-acting “basal” insulin. This is a once or twice-daily injection that provides a constant steady stream of insulin. When you begin taking insulin, you may also need to increase the frequency with which you test your blood sugar, partially to help reduce the risk of low blood sugar (hypoglycemia). Some doctors will encourage you to use a continuous glucose monitor (CGM), a device that measures your blood sugar constantly around the clock and sends data to a smartphone app or a separate receiver.

Finally, you will probably need to start using a rapid-acting insulin before every meal you eat. At this stage in LADA’s progression, treatment is essentially identical to the treatment of type 1 diabetes. Intensive treatment is very complex and occasionally frustrating, and many people with LADA will rely heavily on their healthcare teams to help them navigate this new challenge.

No other medication is specifically approved to treat LADA.

Prevention of LADA

LADA probably cannot be prevented. Like type 1 diabetes, LADA is an autoimmune disorder that is influenced by genetics but can also strike people without any family history of the condition.

On the other hand, some research suggests that people who make healthy lifestyle decisions — including maintaining a healthy weight, not smoking, staying physically active, limiting their intake of sweetened beverages and processed red meat, and eating high amounts of fatty fish — are less likely to develop LADA. Researchers have speculated that these healthy habits could reduce the risk.

Lifestyle Changes for LADA

Lifestyle changes are essential for the optimal treatment of every form of diabetes, including LADA. But doctors may suspect a patient has LADA if they are lean, have already made healthy lifestyle changes, yet still have persistent or worsening hyperglycemia.

The goal of LADA treatment is blood sugar management, and if they haven’t already, people with the condition should consider making the same healthy changes that help other people with diabetes keep their blood sugar in a safe range.

Make Healthy Changes to Your Diet

What, when, and how much you eat significantly impacts your blood sugar levels. To keep your blood sugar stable, prioritize nonstarchy vegetables (such as leafy greens, carrots, or peppers), high-fiber carbohydrates (such as brown rice, whole grains, and fruits), and lean protein sources (such as fish, dairy, tofu, and skinless chicken breast). Keep foods high in saturated fat, sodium, and added sugar to a minimum. Sugar and refined carbohydrates cause rapid blood sugar rises, and require larger doses of insulin, both factors that make blood sugar management more challenging.

You may find it useful to consult a registered dietitian who specializes in diabetes. They can help you create a diabetes-friendly meal plan that works with your lifestyle.

Get Regular Exercise

Consistent physical activity is a drug-free method for lowering blood sugar in both the short- and long-term. It also burns calories, which may aid weight loss or maintenance; people who can maintain a healthy weight tend to have better insulin sensitivity, which makes managing insulin treatment easier.

Try to move more and sit less throughout the day. Aim to get a minimum of 150 minutes of moderate-intensity aerobic exercise and two full-body strength workouts each week, as recommended by many health authorities.

LADA Prognosis

LADA is a lifelong condition with no cure. People with LADA will need to manage their condition for the rest of their lives.

LADA does not necessarily lead to a lower life expectancy, but the complications of LADA are associated with a risk of early death, cardiovascular disease, and other long-term health issues, such as diabetic retinopathy.

For example, chronic high blood sugar levels can lead to heart disease.

Complications of LADA

Like other forms of diabetes, LADA can lead to complications because of the damage done by chronic high blood sugar. Major potential health complications include:

  • Cardiovascular disease
  • Kidney damage
  • Neuropathy (nerve damage)
  • Retinopathy (damage to the blood vessels of the tissue at the back of the eye)

High blood sugar can lead to many other less dangerous complications, too, such as skin problems, gum disease, and yeast infections.

Like type 1 diabetes, LADA also entails a risk of two dangerous short-term complications:

  • Diabetic ketoacidosis (DKA), a life-threatening emergency complication that occurs when people with diabetes do not have enough insulin in their bodies. DKA typically happens when blood sugar levels are severely elevated, often when illness makes it difficult to eat, drink, or use insulin normally.
  • Severe low blood sugar (hypoglycemia), a potential side effect of insulin usage, which can lead to diabetic seizures and other emergency outcomes

Insulin and lifestyle choices recommended by your healthcare team should keep your blood sugar in range and greatly reduce the risk of these complications.

How Many People Have LADA?

LADA is often misdiagnosed as type 2 diabetes, making it difficult to pinpoint how many people have it. It’s estimated that LADA accounts for up to 9 percent of all diabetes cases.

 Approximately 38.4 million people of all ages (about 11.6 percent of the population) have diabetes in the United States.

 Therefore, LADA may affect several million Americans.

The Takeaway

  • Latent autoimmune diabetes in adults (LADA) happens when the body mistakenly attacks insulin-making cells in your pancreas.
  • Also known as type 1.5 diabetes, LADA has elements of both type 1 and type 2 diabetes.
  • LADA develops slowly in adults older than 30. Eventually, after months or years, it leads to dependence on insulin treatment.
  • LADA cannot be prevented or cured, but it can be managed with medications and lifestyle changes.

Common Questions & Answers

What are the symptoms of latent autoimmune diabetes (LADA) in adults?
The initial symptoms of LADA are similar to those of types 1 and type 2 diabetes. They include blurred vision, unexpected weight loss, frequent urination, extreme thirst, fatigue, and dry, itchy skin. These symptoms often appear gradually.
The word “latent” means emerging or concealed, and people with LADA may not require insulin initially and can be misdiagnosed with type 2 diabetes because the disease progresses slowly.
Both types of diabetes result in chronically high blood sugar levels. But the two types have different causes. LADA is caused by an autoimmune condition, while type 2 diabetes is caused by a variety of risk factors, sometimes including modifiable factors such as poor diet, lack of exercise, or excess body fat.
Similar to other types of diabetes, complications can include cardiovascular problems, nerve damage, vision issues, and kidney disease, especially if blood glucose levels are not well managed.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Latent Autoimmune Diabetes in Adults (LADA): What Is It? Mayo Clinic. June 14, 2023.
  2. Latent Autoimmune Diabetes in Adults (LADA). Cleveland Clinic. October 14, 2024.
  3. Is There a Gray Area Between Type 1 and Type 2 Diabetes? UCHealth. February 21, 2024.
  4. Rajkumar V et al. Latent Autoimmune Diabetes. StatPearls. March 1, 2024.
  5. Carlsson S. Etiology and Pathogenesis of Latent Autoimmune Diabetes in Adults (LADA) Compared to Type 2 Diabetes. Frontiers in Physiology. March 2019.
  6. Wang D et al. Glutamic Acid Decarboxylase Antibodies in Neurocritical Patients: A Culprit or a Bystander? Neurological Sciences. June 2020.
  7. C-Peptide Test. Cleveland Clinic. October 3, 2022.
  8. Buzzetti R et al. Management of Latent Autoimmune Diabetes in Adults: A Consensus Statement From an International Expert Panel. Diabetes. August 26, 2020.
  9. Carlsson S. Lifestyle or Environmental Influences and Their Interaction With Genetic Susceptibility on the Risk of LADA. Frontiers in Endocrinology. June 2022.
  10. Healthy Living With Diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. October 2023.
  11. Type 2 Diabetes. Cleveland Clinic. November 8, 2023.
  12. Physical Activity Guidelines for Americans, 2nd edition. U.S. Department of Health and Human Services. 2018.
  13. Wei Y et al. All-Cause Mortality and Cardiovascular and Microvascular Diseases in Latent Autoimmune Diabetes in Adults. Diabetes Care. August 28, 2023.
  14. Diabetes, Heart Disease, & Stroke. National Institute of Diabetes and Digestive and Kidney Diseases. April 2021.
  15. Li W et al. Is Diabetic Retinopathy Affected By Diabetes Type? A Retrospective Study Using Electronic Medical Record Data From Patients With Latent Autoimmune Diabetes in Adults, Type 1 Diabetes, and Type 2 Diabetes. Acta Diabetologica. June 2021.
  16. Zhou Z et al. Prognosis and Outcome of Latent Autoimmune Diabetes in Adults: T1DM or T2DM? Diabetology & Metabolic Syndrome. October 7, 2024.
  17. Ramu D et al. The Worldwide Prevalence of Latent Autoimmune Diabetes of Adults Among Adult-Onset Diabetic Individuals: A Systematic Review and Meta-Analysis. Endocrine. July 20, 2023.
  18. National Diabetes Statistics Report. Centers for Disease Control and Prevention.
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Anna L. Goldman, MD

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Anna L. Goldman, MD, is a board-certified endocrinologist. She teaches first year medical students at Harvard Medical School and practices general endocrinology in Boston.

Dr. Goldman attended college at Wesleyan University and then completed her residency at Icahn School of Medicine at Mount Sinai Hospital in New York City, where she was also a chief resident. She moved to Boston to do her fellowship in endocrinology at Brigham and Women's Hospital. She joined the faculty after graduation and served as the associate program director for the fellowship program for a number of years.

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