LADA stands for Latent autoimmune diabetes in adults It is by definition an autoimmune condition so is a subset of t1. It that develops a bit more slowly than is usual in younger people (although there are researchers to have described LADY latent autoimmune diabetes of the young in children)
If diagnosed early people with LADA achieve control with diet or non-insulin antidiabetic medication for at least 3-6 months whereas the diagnosis of type 1 diabetes normally requires immediate treatment with insulin. However, the autoimmune 'attack' on the beta cells continues until the person needs insulin to prevent DKA. Eighty per cent of people with LADA have been found to need insulin within 5 years of first presentation.
The most common antibody is antiGAD and most people with LADA test positive for that but there are a number of other antibodies that have been found. People with high amounts of the antibodies tend to need insulin quicker than others.
It's hard for a GP to differentiate between a person with LADA and with T2, particularly if they are thin.
One group of researchers found this short list to be helpful (though it hasn't been tested outside Australia.
- manifestation of diabetes below age 50 years;
- Acute symptoms at diagnosis;
- Body mass index <25kg/m2;
- Positive personal history of autoimmune disease;
- Positive family history for autoimmune diseases.
If 2 or more of these criteria were satisfied they found that the person had LADA in 71% of cases. (so some had T2) However, they found no cases of LADA in those that had 1 or less of the criteria.
Recently gene sequencing has found that people with LADA have similar gene sequences in the region associated with 'normal/ T1 but this field is in it's infancy
Lastly there are probably far more people in Europe with LADA than with 'traditional' T1.(90% of people with D have T2 but in Europe 10% of them may have LADA) Outside Europe the figures (as far as they go) differ from 0% in Alaska and Papua New Guinea to 20% in Indonesia..