Most people have heard of type 1 and type 2 diabetes. Many do not know, however, that there is an “intermediate” form of this disease, latent autoimmune diabetes of adulthood (LADA), which shares characteristics of both type 1 and type 2 diabetes and which is often misdiagnosed because of these similarities. To understand LADA, it is important to first understand the differences between type 1 and type 2 diabetes.
Type 1 Diabetes
In type 1 diabetes, a person’s immune system attacks and eventually kills the cells that produce a hormone called insulin. Insulin is a crucial hormone that allows the body’s cells to use sugars as energy. If the body can’t use sugar as energy, it will quickly become fatigued, dehydrated, and unable to function. Without treatment, a person with type 1 diabetes will eventually die. The amount of time it takes for the immune system to destroy the insulin-producing cells varies from person to person, but it can happen in infants and is most commonly diagnosed before the age of 30.The only current treatment for type 1 diabetes is to take insulin injections to provide the insulin the body cannot make.
Type 2 Diabetes
In type 2 diabetes, a person’s body produces insulin, just not enough. Additionally, the insulin receptors on the cells stop responding properly, so the body has a difficult time using the insulin it does have. This results in very high blood sugar levels, which over time, can lead to greater risk for problems with the heart and circulatory system, strokes, and blindness. Most people with type 2 diabetes are diagnosed after the age of 45. Common treatments for type 2 diabetes include dietary changes, weight loss, and insulin injections or prescriptions for other drugs that can help the body properly use insulin.
Latent Autoimmune Diabetes of Adulthood
LADA is a form of diabetes that, like type 2 diabetes, occurs later in life (usually over the age of 35). However, at its root, LADA is like type 1 diabetes: the body’s immune system attacks and kills off insulin-producing cells.
Because LADA is diagnosed so much later in life than type 1 diabetes, it is often misdiagnosed as type 2 diabetes. The problem with this is that the common treatments for type 2 diabetes, such as drug therapy and weight loss, will not help produce insulin, which is what that person’s body desperately needs.
Doors Open for a New Test to Help Diagnose LADA
With any form of diabetes, getting an accurate diagnosis and managing the disease as soon as possible is crucial in preventing the long-term issues it can have on the body. Currently, diagnosing LADA usually involves an expensive test that screens the body for the antibodies that attack insulin-producing cells.
But a research team led by Children’s Hospital of Philadelphia has discovered a genetic difference between type 1 diabetes and LADA that may pave the way for better testing. The team looked at the set of genes that help the immune system recognize “friendly” vs. “enemy” cells. The team already knew about variations in this set of genes that are associated with type 1 diabetes. They discovered that all of those variations were not present in patients with LADA. This means that they might have found a genetic characteristic in LADA that would allow it to be diagnosed through genetic testing.
The Future of Diagnosing LADA
There is still more research needed to follow up on the findings of this study. Hopefully, recognizing the genetic difference between type 1 diabetes and LADA will open the door to finding better ways to test for LADA genetically, rather than through expensive antibody screening tests. This can greatly improve the quality of diagnosis for adults who develop LADA late in life.
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Check out the original study here.