2LADA is often misdiagnosed as type; 2 diabetes.
“Most diabetes, in general, is type 2,”
McCallum says. 90–95 percent of people
with diabetes in the United States have
type; 2, according to the Centers for Disease
Control and Prevention (CDC). Most adults
with elevated blood glucose are part of the
majority that has type 2.
But people with LADA typically don’t
;t the type 2 pro;le. “We’re clinically
suspicious in individuals who are younger
than 50, who are lean, and who often don’t
have a family history with type 2 diabetes,”
McCallum says. But not all health care
providers act on these suspicions, leaving
some patients with an inaccurate diagnosis.
3LADA is treated like type 1 and type 2.
LADA is an autoimmune disease—the body
attacks itself by destroying beta cells, which
produce insulin in the pancreas. But unlike
people with type 1, people with LADA often
don’t need insulin right away. “It’s an immune
process that is not as quick as it is with
type 1,” says Sally Pinkstaff, M.D., Ph.D., an
endocrinologist at Sinai Hospital in Baltimore.
“Patients [with LADA] may have some insulin
resistance, but they still may have beta cells
in the pancreas. They can start treatment with
oral medication like a person with type; 2.”
Slowly, antibody cells destroy more beta cells,
insulin levels dwindle, and insulin therapy
becomes a must.
4Misdiagnosis isn’t the end of the world.
“I feel like I relate to both type 1s and type 2s. Not because
I know what having diabetes as a child feels like, but because
I’ve been on both pills and insulin.” —Cherise
Eventually, people with LADA stop producing
insulin. The honeymoon phase—the period
when blood sugars can be controlled without
insulin therapy—can last for a year or much
longer. Cherise, for example, took oral meds for
three years before she started insulin. “I have
patients I’ve followed for many years who are
still making insulin, even though I know they
have LADA,” Pinkstaff says.
After the honeymoon phase, people with
LADA usually see a spike in glucose levels,
despite their efforts to control them with diet,
exercise, and non-insulin medications. The
antibodies destroy too many insulin-producing
beta cells, so doctors prescribe insulin to bring
glucose levels closer to normal.
42 Diabetic Living FALL 2010
