Latent Autoimmune Diabetes Of Adults
Latent autoimmune diabetes of adults (LADA) is a form of diabetes mellitus type 1 that occurs in adulthood, often with a slower course of onset than type 1 diabetes diagnosed in juveniles.[3] Adults with LADA may initially be diagnosed incorrectly as having type 2 diabetes based on their age, particularly if they have risk factors for type 2 diabetes such as a strong family history or obesity. The diagnosis is typically based on the finding of hyperglycemia together with the clinical impression that islet failure rather than insulin resistance is the main cause; detection of a low C-peptide and raised antibodies against the islets of Langerhans support the diagnosis. It can only be treated with the usual oral treatments for type 2 diabetes for a certain period of time,[4][5] after which insulin treatment is usually necessary, as well as long-term monitoring for complications. The concept of LADA was first introduced in 1993,[6] though The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus does not recognize the term, instead including it under the standard definition of diabetes mellitus type 1.[7] Signs and symptoms[edit] The symptoms of latent autoimmune diabetes of adults are similar to those of other forms of diabetes: polydipsia (excessive thirst and drinking), polyuria (excessive urination), and often blurred vision.[8] Compared to juvenile type 1 diabetes, the symptoms develop comparatively slowly, over a period of at least six months.[9] Diagnosis[edit] It is estimated that more than 50% of persons diagnosed as having non-obesity-related type 2 diabetes may actually have LADA. Glutamic acid decarboxylase autoantibody (GADA), islet cell autoantibody (ICA), insulinoma-associated (IA-2) autoantibody, and zinc transporter autoantibody (ZnT8) t Continue reading >>
Clarifying Lada (type 1 Diabetes In Adults)
When I met fellow D-writer Catherine Price for coffee recently, I immediately gushed about everything we had in common: two brunette journalist-types living in the SF Bay Area, both diagnosed a few years ago with LADA (or so I thought). Catherine gave me a sideways look, and then began grilling me about the formal definition of LADA. I had to admit, it's pretty fuzzy. Today, I gratefully present you with the results of her investigation into this mysterious acronym: A Guest Post by Catherine Price, of ASweetLife Having had Type 1 diabetes for nearly ten years now, I can handle most diabetic terms and acronyms thrown my way. Hemoglobin A1c? Got it. Carb ratios? Insulin sensitivity? No problem. But one term has continued to confuse me: LADA. Short for Latent Autoimmune Diabetes in Adults, it's also known as Slow-Onset Type 1 Diabetes, Type 1.5 Diabetes or, occasionally, Late-Onset Autoimmune Diabetes of Adulthood. Four names for the same thing? That's never a good sign. Until recently, the most common definition I'd heard for LADA was that it was a Type 1-like form of diabetes diagnosed in adulthood. But I didn't understand the details. Does being diagnosed with Type 1 diabetes as an adult automatically mean you have LADA? Is there a difference between LADA and the classical definition of Type 1? To answer these questions, I spoke with Marie Nierras, the program officer of the genetics programs at Juvenile Diabetes Research Foundation. She cut right to the chase. "There is a lot of confusion about LADA," she told me, "but Type 1 diabetes and LADA are not the same thing." Here, to get us started, is how JDRF's Adults With Type 1 toolkit defines LADA: "Type 1 diabetes diagnosed in adults over 30 may be Latent Autoimmune Diabetes in Adults (LADA), sometimes known as Type 1.5 Continue reading >>
Management Of Type 1 Diabetes In Older Adults
Abstract In Brief Older adults with type 1 diabetes are at high risk for severe hypoglycemia and may have serious comorbid conditions. Problems with cognition, mobility, dexterity, vision, hearing, depression, and chronic pain interfere with the ability to follow complex insulin regimens. With the development of geriatric syndromes, unpredictable eating, and frailty, treatment regimens must be modified with the goal of minimizing hypoglycemia and severe hyperglycemia and maximizing quality of life. Challenges in the Management of Type 1 Diabetes in Older Adults There is a paucity of data related to glycemic management and control of type 1 diabetes later in life. The Type 1 Diabetes (T1D) Exchange clinic registry reported characteristics of older adults with type 1 diabetes who are followed in diabetes centers across the United States.17 Of those ages 50 to < 65 years (n = 2,066), mean A1C was 7.7% (27% had an A1C < 7.0%, 46% had an A1C < 7.5%, and 11% had an A1C ≥ 9.0%), and mean self-reported blood glucose testing was 5.5 times daily. Of those ≥ 65 years of age (n = 683), mean A1C was 7.4% (34% had an A1C < 7.0%, 52% had an A1C < 7.5%, and 8% had an A1C ≥ 9.0%) and mean self-reported blood glucose testing was 5.6 times daily. Greater frequency of self-monitoring of blood glucose (SMBG) was associated with lower A1C levels in both those who used an insulin pump and those who administered insulin via injections.18 Diabetic ketoacidosis (DKA) was lower with increasing age and was not associated with duration of diabetes.19 DKA was more likely in those with higher A1C levels and lower socioeconomic status. No relationship was found between DKA and pump versus injection use. Longstanding diabetes in older adults has been associated with increased risks of severe hypo Continue reading >>
Type 1 Diabetes
Print Overview Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin. Insulin is a hormone needed to allow sugar (glucose) to enter cells to produce energy. Different factors, including genetics and some viruses, may contribute to type 1 diabetes. Although type 1 diabetes usually appears during childhood or adolescence, it can develop in adults. Despite active research, type 1 diabetes has no cure. Treatment focuses on managing blood sugar levels with insulin, diet and lifestyle to prevent complications. Symptoms Type 1 diabetes signs and symptoms can appear relatively suddenly and may include: Increased thirst Frequent urination Bed-wetting in children who previously didn't wet the bed during the night Extreme hunger Unintended weight loss Irritability and other mood changes Fatigue and weakness Blurred vision When to see a doctor Consult your doctor if you notice any of the above signs and symptoms in you or your child. Causes The exact cause of type 1 diabetes is unknown. Usually, the body's own immune system — which normally fights harmful bacteria and viruses — mistakenly destroys the insulin-producing (islet, or islets of Langerhans) cells in the pancreas. Other possible causes include: Genetics Exposure to viruses and other environmental factors The role of insulin Once a significant number of islet cells are destroyed, you'll produce little or no insulin. Insulin is a hormone that comes from a gland situated behind and below the stomach (pancreas). The pancreas secretes insulin into the bloodstream. Insulin circulates, allowing sugar to enter your cells. Insulin lowers the amount of sugar in your bloodstream. As your blood sugar level drops, so does the secre Continue reading >>
Type 1 Diabetes In Adults
For years, distinguishing between the various types of diabetes was pretty straightforward: “Juvenile diabetes,” an autoimmune disease, was diagnosed primarily in children and teenagers when their own body’s immune system destroyed the insulin-producing (beta) cells in their pancreas. “Adult-onset diabetes” occurred in adults and was generally associated with insulin resistance and often with overweight. And “gestational diabetes” occurred in pregnant women and disappeared once the pregnancy was over. In the past 25 years, however, determining what type of diabetes a person has has become more of a challenge. In large part, that’s because more and more children and teenagers are now being diagnosed with Type 2 diabetes — the type that occurred predominantly in adults in generations past. Most of these children and teens are overweight. At the same time, it’s becoming clearer that Type 1 diabetes can occur at any age and sometimes occurs in people who are overweight. In addition, another type of diabetes, called latent autoimmune diabetes in adults, or LADA, that shares some characteristics with both Type 1 and Type 2 diabetes, has been recognized. Muddying the water further is the realization that diabetic ketoacidosis, an acute, life-threatening complication of diabetes that is caused by a lack of insulin, can occur in people with Type 2 diabetes — not just in people with Type 1, as was previously thought. And while gestational diabetes is still diagnosed only in pregnant women, it is sometimes discovered that what is thought to be gestational diabetes is really Type 1 or Type 2 diabetes that happens to start during pregnancy. The incidence of diabetes has increased so greatly around the world in the past 25 years that health organizations and med Continue reading >>
Type 1 Diabetes
Type 1 diabetes is an auto-immune condition in which the immune system is activated to destroy the cells in the pancreas which produce insulin. We do not know what causes this auto-immune reaction. Type 1 diabetes is not linked to modifiable lifestyle factors. There is no cure and it cannot be prevented. Type 1 diabetes: Occurs when the pancreas does not produce insulin Represents around 10% of all cases of diabetes and is one of the most common chronic childhood conditions Onset is usually abrupt and the symptoms obvious Symptoms can include excessive thirst and urination, unexplained weight loss, weakness and fatigue and blurred vision Is managed with insulin injections several times a day or the use of an insulin pump. What happens to the pancreas? In type 1 diabetes, the pancreas, a large gland behind the stomach, stops making insulin because the cells that make the insulin have been destroyed by the body’s immune system. Without insulin, the body’s cells cannot turn glucose (sugar), into energy. People with type 1 diabetes depend on insulin every day of their lives to replace the insulin the body cannot produce. They must test their blood glucose levels several times throughout the day. The onset of type 1 diabetes occurs most frequently in people under 30 years, however new research suggests almost half of all people who develop the condition are diagnosed over the age of 30. About 10-15% of all cases of diabetes are type 1. What happens if people with type 1 diabetes don’t receive insulin? Without insulin the body burns its own fats as a substitute which releases chemical substances in the blood. Without ongoing injections of insulin, the dangerous chemical substances will accumulate and can be life threatening if it is not treated. This is a condition call Continue reading >>
Type 1 Diabetes In Children
Overview Type 1 diabetes in children is a condition in which your child's body no longer produces an important hormone (insulin). Your child needs insulin to survive, so you'll have to replace the missing insulin. Type 1 diabetes in children used to be known as juvenile diabetes or insulin-dependent diabetes. The diagnosis of type 1 diabetes in children can be overwhelming at first. Suddenly you and your child — depending on his or her age — must learn how to give injections, count carbohydrates and monitor blood sugar. Type 1 diabetes in children requires consistent care. But advances in blood sugar monitoring and insulin delivery have improved the daily management of the condition. Symptoms The signs and symptoms of type 1 diabetes in children usually develop quickly, over a period of weeks. These signs and symptoms include: Increased thirst and frequent urination. Excess sugar building up in your child's bloodstream pulls fluid from tissues. As a result your child might be thirsty — and drink and urinate more than usual. A young, toilet-trained child might suddenly experience bed-wetting. Extreme hunger. Without enough insulin to move sugar into your child's cells, your child's muscles and organs lack energy. This triggers intense hunger. Weight loss. Despite eating more than usual to relieve hunger, your child may lose weight — sometimes rapidly. Without the energy sugar supplies, muscle tissues and fat stores simply shrink. Unexplained weight loss is often the first sign of type 1 diabetes to be noticed in children. Fatigue. Lack of sugar in your child's cells might make him or her tired and lethargic. Irritability or behavior changes. In addition to mood problems, your child might suddenly have a decline in performance at school. Fruity-smelling breath. Bu Continue reading >>
Diagnosed With Type 1 Diabetes As An Adult: The Day That Changed My Life Forever
Diagnosed with Type 1 Diabetes as an Adult: The Day That Changed My Life Forever By: Valerie Abner I’m approaching my 2nd Type 1 Diabetes birthday and just turned 41. Yes, I’m one that was fortunate enough to be diagnosed at 39. I’m the mom who was saved by my mom and my son’s broken leg. July 6, 2015 . . . it’s the day that my life changed forever. It’s the day that I now like to call my birthday. It all began with what I thought was a stomach virus on July 4th. I was on the couch all day. The next day was a Sunday and just as anyone recovering from a virus, I was weak, but feeling better. We went to a nearby park for the afternoon. My son was playing on the playground and fell from the fireman’s pole, fracturing his leg in two places. After leaving the hospital we had to get pain medication and when we arrived back at home, I was sick all over again. I vaguely remember falling asleep on the bathroom floor. Monday morning came and again I was weak, but feeling some better. My husband had to go for a meeting and my mother came to stay with us, mostly to care for my son. The symptoms were just the same. I thought maybe I was dehydrated and began drinking Gatorade, and lots of it. It was just after lunch when I lost control of myself. I was dizzy, confused, lethargic and completely out of my mind. I could not catch my breath. I somehow got back in the bed when my mom found me and called for an ambulance. I knew nothing. Not even enough to know that I was in serious danger. At the age of 39… Who would have ever thought that I would be diagnosed with Type 1 Diabetes as an adult? I spent the next week in ICU being treated for diabetic ketoacidosis or DKA. If it wasn’t for my son’s broken leg, my mother probably would not have been at our house. Today, I Continue reading >>
Understanding Adult-onset Type 1 Diabetes
When then 34-year-old Rebecca Gill was pregnant with her second child in 2004, high blood sugar levels led to a diagnosis of gestational diabetes, an often-temporary form of diabetes that can occur in pregnant women. After Gill’s son was born, her blood sugar levels returned to normal, and her doctors assumed that the diabetes was gone. But another blood test given several weeks after she gave birth showed that her diabetes problems had returned. She was referred to an endocrinologist who ran tests and eventually diagnosed her with latent autoimmune diabetes in adults, or LADA. “Thankfully, I was one of the lucky ones whose endocrinologist had experience with LADA,” says Gill, an internet marketing consultant in Commerce, Mich. LADA, also known as type 1.5 diabetes or double diabetes, is a form of diabetes in which an adult’s immune system destroys beta cells in the pancreas, cells that produce insulin. Insulin is a hormone that converts the body’s blood sugar to energy. Without enough insulin, blood sugar levels can become too high, resulting in nerve damage, blindness, and other problems if untreated. LADA is similar to type 1 diabetes in that both forms are caused by the immune system mistakenly attacking beta cells. However, most diabetics with LADA are diagnosed after age 30, while the most common form of type 1 diabetes usually develops in children or adolescents. LADA: A Different Diabetes Because LADA appears in adulthood, it may be initially mistaken for type 2 diabetes, but it is different. People who have LADA are often initially misdiagnosed with type 2 diabetes, says Priscilla Hollander, MD, PhD, an endocrinologist at Baylor University Medical Center in Dallas. “Many people with LADA present symptoms a little like type 2s,” Dr. Hollander expla Continue reading >>
Type 1 Diabetes
Type 1 diabetes is much less common than type 2 diabetes and typically affects younger individuals. Type 1 diabetes usually begins before age 40, although there have been people diagnosed at an older age. In the United States, the peak age at diagnosis is around 14. Type 1 diabetes is associated with deficiency (or lack) of insulin. It is not known why, but the pancreatic islet cells quit producing insulin in the quantities needed to maintain a normal blood glucose level. Without sufficient insulin, the blood glucose rises to levels which can cause some of the common symptoms of hyperglycemia. These individuals seek medical help when these symptoms arise, but they often will experience weight loss developing over several days associated with the onset of their diabetes. The onset of these first symptoms may be fairly abrupt or more gradual. To learn more about type 1 diabetes basics, see our type 1 diabetes slideshow. It has been estimated that the yearly incidence of type 1 diabetes developing is 3.7 to 20 per 100,000. More than 700,000 Americans have this type of diabetes. This is about 10% of all Americans diagnosed with diabetes; the other 90% have type 2 diabetes. What You Need to Know about Type 1 Diabetes Type 1 Diabetes Causes Type 1 diabetes usually develops due to an autoimmune disorder. This is when the body's immune system behaves inappropriately and starts seeing one of its own tissues as foreign. In the case of type 1 diabetes, the islet cells of the pancreas that produce insulin are seen as the "enemy" by mistake. The body then creates antibodies to fight the "foreign" tissue and destroys the islet cells' ability to produce insulin. The lack of sufficient insulin thereby results in diabetes. It is unknown why this autoimmune diabetes develops. Most often Continue reading >>
1 In 5 Cases Of Type 1 Diabetes Diagnosed In The Over-40s
Save for later More than one in five cases of Type 1 diabetes are diagnosed in people aged over 40, according to new figures announced today at Diabetes UK’s annual Diabetes Professional Conference. The figures, which are based on analysis from the National Diabetes Audit data, shows that in the year 2011–12, 8,952 people were diagnosed with Type 1 diabetes. This included 2,035 people who were aged over 40 at the time of their diagnosis, of who more than 500 were aged over 69. The research confirms what Diabetes UK has always said that, though most cases are commonly diagnosed between the ages of 10–14, Type 1 diabetes can occur at any age. The charity pointed to Home Secretary Theresa May’s Type 1 diagnosis last year as a high profile example of this. The charity’s announcement comes as new research from the Royal Gwent Hospital in Wales suggests that lack of awareness about late onset Type 1 diabetes is leading to some people not being diagnosed early enough and in some cases people can become seriously ill before the condition is identified. Signs and symptoms This research highlights the need for healthcare professionals not to rule out Type 1 diabetes just because a patient is older. It is also important for the public to be aware of the main signs and symptoms of Type 1 diabetes, which include being tired, thirsty, losing weight and going to the toilet a lot, especially at night. People also need to understand that they should contact their GP if they have any of these symptoms. Simon O’Neill, Director for Health Intelligence and Professional Liaison for Diabetes UK, said, "This study highlights that Type 1 diabetes is not just a condition that strikes the young. We hear of reports where people who develop the condition later in life are only diagnosed Continue reading >>
Adults Can Get Type 1 Diabetes, Too
David Lazarus had just moved to Los Angeles to start a new job as a business and consumer columnist for the Los Angeles Times when he suddenly developed some of the classic signs of diabetes: extreme thirst, fatigue and weight loss. He dropped close to 15 pounds in two weeks. Lazarus was in his early 40s. "The weight loss was the first big red flag. It happened really fast," he says. He consulted a physician, who diagnosed him with Type 2 diabetes and recommended a "monastic" low-carb, macrobiotic diet. When he continued to feel lousy a few days later, Lazarus spoke with another physician. That doctor suggested that Lazarus might have Type 1 diabetes, an autoimmune condition in which the insulin-making cells in the pancreas are attacked and destroyed. But that physician didn't take insurance. Finally Lazarus made his way to the diabetes center at the University of California, Los Angeles. There, an endocrinologist diagnosed him with Type 1 diabetes and immediately put him on the correct treatment, insulin. Without insulin injections or infusion via a pump, people with Type 1 diabetes typically fall into a coma and die within days to weeks, although sometimes adults may have a small amount of reserve insulin that keeps them going longer. Still, eventually all people with Type 1 diabetes must receive insulin. Lazarus' story is not uncommon. It has long been thought that Type 1 diabetes arises primarily in childhood or adolescence and only rarely in adulthood. In fact, Type 1 diabetes was formerly called "juvenile" diabetes, and that term is still widely used, even though the terminology was officially changed in 1997. Across the ages Now, it looks as if not only can Type 1 diabetes occur in adults, it's just as likely to appear in adulthood as in childhood or adolescence. Continue reading >>
Type 1 Diabetes Diagnoses Can Happen Well Into Adulthood.
A patient receives a test for diabetes during a Care Harbor L.A. free medical clinic in Los Angeles on Sept. 11, 2014. Jocelyns bathroom breaks were becoming a cause for concern. The first-year teacher found she was increasingly asking colleagues to cover for her as she nipped out to the restroom. Suspecting that something was up, the 22-year-old asked her mother, a nurse, to check her blood sugar. She thought I was crazy, said Jocelyn, until the blood-glucose meter bleeped its reply: Her blood sugar levels were too high for the machine to even read them. (Editors note: We are withholding Jocelyns last name due to the sensitive medical information given in this article.) There must have been a mistake. There was no history of diabetes in the family, and 22-year-old Jocelyn was lean, a former competitive gymnast. Maybe the meter was broken, or perhaps she still had traces of sugar on her fingers from something shes eaten earlier. Jocelyns mom sent her home with the glucometer and told her to check again in the morning. Each year, somewhere between tens and hundreds of thousands of patients are likely misdiagnosed with Type 2 diabetes when they in fact have Type1. Before breakfast the next day, Jocelyns blood sugar levels were four times what they should have been for a healthy adult. I wouldnt let myself eat because I was so paranoid, she said. Later that day in the hospital, she was diagnosed with Type 2 diabetes, a condition associated with adults who are older and overweight. While the nurses at the hospital seemed unsurprised by the diagnosis, Jocelyn was upset, wondering how this could have happened, as she put it. After a week of rumination, Jocelyn went to see an endocrinologist who ran additional blood tests, and eventually diagnosed her with latent autoimmune d Continue reading >>
Type 1 Diabetes: Causes, Symptoms, And Diagnosis
In type 1 diabetes, your body does not produce insulin, which is the hormone necessary for processing glucose. Glucose is used by cells in your body as an energy source, and without insulin, glucose can’t get into those cells. It stays in the blood, and when you have too much glucose in your blood, it can damage your organs and other parts of your body. Therefore, people with type 1 diabetes must take insulin in order to manage their blood glucose levels and make sure their bodies get the energy they need. Type 1 diabetes used to be called juvenile diabetes or insulin-dependent diabetes, and you may still hear those names used. Type 1 Diabetes Causes Type 1 diabetes is an autoimmune disorder, which means that the immune system turns against your body. Instead of protecting the body, the immune system in people with type 1 diabetes starts to destroy beta cells—and those are the cells that are in charge of making insulin. The medical community isn’t sure what causes the immune system to start destroying the beta cells. Some thoughts are: a genetic susceptibility to developing type 1 diabetes certain viruses (for example, German measles or mumps) environmental factors Regardless of what triggers the immune system to turn against the beta cells, the end result is the same in type 1 diabetes: gradually, all beta cells are destroyed and the body is no longer able to produce insulin. Type 1 Diabetes Symptoms Type 1 diabetes develops gradually, but the symptoms come on suddenly. As soon as the body is no longer making insulin, blood glucose levels rise quickly, so the following type 1 diabetes warning signs can develop: extreme weakness extreme tiredness rapid weight loss increased appetite extreme thirst increased urination nausea and/or vomiting fruity breath wounds tha Continue reading >>
Symptoms Of Diabetes Type 1 In Adults
Symptoms of type 1 diabetes in adults may occur suddenly It’s important to realize that early signs of type 1 diabetes in adults often develop quickly and may sometimes be brushed off—or mistaken for illness. Here’s what you should look out for: Frequent Urination: If you’re constantly running to the bathroom, your kidneys may be trying to rid your blood of excess sugar, resulting in an increased need to urinate. Extreme thirst: Increased urination can then result in dehydration, which will leave you feeling more thirsty than normal. Increased appetite: If you’re suddenly hungry all the time it may be because your body isn’t able to get proper energy from the food you eat. Unexpected weight loss: Along the same lines, if your body is losing sugar in your urine instead of absorbing it, you may lose weight without trying. Other symptoms of type 1 diabetes in adults Other diabetic symptoms in adults include feeling drowsy or lethargic; sudden vision changes; fruity or sweet-smelling breath; heavy or labored breathing; and stupor or unconsciousness. If you do have high blood sugar and it goes untreated, it could develop into diabetic ketoacidosis—a life-threatening condition. So please see your doctor immediately if you are exhibiting these warning signs. So what are the low blood sugar symptoms you should look out for? It’s important to realize that the signs of… The reality is that signs of type 1 diabetes usually develop suddenly. And, that’s why it can be… Continue reading >>
