Latent autoimmune diabetes of adulthood (LADA) can be vexing to physicians unfamiliar with this form of diabetes – and even to those who know it well. For example, LADA patients rarely display the classic symptoms of type 1 diabetes, such as rapid unexplained weight loss or a tendency to develop diabetic ketoacidosis (a dangerous condition involving  excess waste products called ketones in the blood).

With standard type 1 diabetes, the loss of insulin production is typically rapid. With LADA, the pancreas loses the ability to make insulin much more slowly than in standard type 1 but faster than is usual in type 2 diabetes. LADA patients, like those with type 1, have in their bloodstream abnormal antibodies (autoantibodies) to the insulin-making beta cells, which means that their immune system attacks these cells.

In type 1, the cells are killed quickly, but LADA is a much slower process. Some physicians believe that this indicates that LADA is separate from type 1 and type 2 diabetes and that a different immune reaction is at work.

Also, people with type 2 diabetes are commonly overweight or obese, whereas people with LADA usually have a normal or lean build. LADA patients often lack the common related traits including metabolic syndrome, high triglyceride levels, low HDL (“good”) cholesterol or high blood pressure.

Considering the high number of LADA patients erroneously believed to have type 2 diabetes, LADA should be considered if the patient who is being diagnosed:

• Is between 30 and 50 years old. This is the typical age range, though younger or older adults have also been diagnosed with LADA.
  
  
• Has a lean build or normal to low body mass index .
  
  
• Has not had a significant unexplained weight loss.
  
  
• Does not present with ketoacidosis.
  
  
• Has no known relatives with type 2 diabetes.
  
  
• Has low c-peptide levels, an indicator of insulin levels in the blood.