If you’ve been diagnosed with latent autoimmune diabetes in adults (LADA), you know that managing blood sugar can be a challenge. You may have heard different things about treatment options, such as making lifestyle changes, taking medications, or using insulin.

If you have questions about whether LADA can be cured or reversed, here’s what you need to know. You and your doctor can then talk about what options might work for you and what steps might help you manage LADA while maintaining your quality of life and sense of well-being.

What’s Latent Autoimmune Diabetes in Adults?

LADA is a type of diabetes that isn’t as well known as type 1 diabetes or type 2 diabetes. Symptoms usually start in people over 30 years old. In LADA, the pancreas stops making insulin because of an autoimmune reaction. This means your immune system attacks the cells in your pancreas as if they were invaders. These attacks damage or destroy the cells that produce insulin, slowing or eventually stopping insulin production. Although people with LADA may not need to use insulin at first, most will ultimately need insulin to manage the condition.

The destruction of insulin-producing cells in the pancreas is a relatively slow process, so most people diagnosed with LADA don’t need to use insulin until they’ve been living with the condition for a while.

Scientists have different opinions about how to classify LADA. Some see it as separate from type 1 diabetes, while others think it’s simply how type 1 diabetes appears in adults. To make things even more complicated, LADA can look different from person to person. Researchers are still studying LADA to better understand whether it’s a separate condition from type 1 diabetes, whether there are different LADA subtypes, and what might be the best treatment plan for the condition.

LADA Compared to Other Types of Diabetes

LADA can be confused with type 1 or type 2 diabetes, especially when someone is first diagnosed.

LADA involves the immune system, just like type 1 diabetes, although the process seems to happen more slowly in LADA. Since type 1 diabetes usually develops in children, the age when symptoms first appear can help you and your healthcare provider figure out which type of diabetes you may have.

There are also specific immune system markers your doctor can test for to help tell the difference between LADA and other forms of diabetes. Additionally, the presence of certain immune system markers can help distinguish LADA from type 1 and type 2 diabetes.

Type 2 diabetes shares some risk factors with LADA. People may have a higher chance of developing both conditions if they have a higher body weight, smoke, drink sugary beverages regularly, were born at a low birth weight, or have a high waist-to-hip ratio.

In addition, because people with type 1 diabetes are diagnosed during childhood, adults who develop diabetes are often assumed to have type 2 diabetes rather than LADA. And since people with LADA usually don't need insulin when they’re first diagnosed, this also makes it seem more similar to type 2 diabetes early on.

One of the most useful tests for distinguishing LADA from type 2 diabetes is the C-peptide test. The body releases this peptide when it makes insulin, so it can be used to measure how much insulin your body is producing. People with type 2 diabetes tend to have higher C-peptide levels than those with LADA. C-peptide levels usually need to be tested more than once. This is because people with LADA can have normal levels at first, but these often drop over time.

Another helpful test for LADA is the glutamic acid decarboxylase (GAD) antibodies test. GAD antibodies are found in people with type 1 diabetes. If someone who has controlled diabetes without needing insulin treatment has a relatively normal C-peptide value, this is a strong sign of LADA.

Additionally, people with LADA may notice that typical lifestyle changes don’t improve their blood sugar as expected. If your provider assumes you have type 2 diabetes and you make changes but don’t see improvement, they may decide to test you for LADA. Similarly, if you’re taking medications commonly used for type 2 diabetes but your diabetes is poorly controlled, mention it to your doctor.

Can LADA Be Cured or Reversed?

Right now, there’s no way to stop the body from attacking the cells in your liver that produce insulin, so LADA cannot be cured or reversed. Lifestyle changes may help slow its progression, but once these cells are damaged, they cannot be healed, and further damage is likely to keep happening.

However, there are ways to treat LADA. Working closely with your doctor to find personalized ways to manage it may help you avoid insulin for longer and lower your risk of complications associated with diabetes.

Treating LADA

When you’re first diagnosed with LADA, your endocrinology team will usually check your C-peptide level. This result will play a significant factor in figuring out the best treatment option for you. Most people won’t need insulin right away, though insulin may be recommended sooner if your C-peptides are very high.

If your body is still making enough insulin, your endocrinologist may recommend lifestyle changes before any other treatment. These usually involve following a diabetes-friendly diet plan and increasing physical activity. They may also encourage weight loss, quitting smoking, or other goals. These strategies, similar to those used in type 2 diabetes care, are intended to help avoid high blood sugar levels and reduce the risk of long-term or serious complications such as diabetic retinopathy.

Over time, though, these lifestyle changes won’t be enough to help you stay healthy. If you’re following your care plan but still struggling to keep your blood glucose levels under control — even when you’re consistent with your lifestyle changes — your doctor may repeat a C-peptide test and adjust your treatment plan.

If you need additional treatments, there are a number of medications that may help with blood sugar control. There is limited research on how many of these medications, such as metformin (Glumetza), work when it comes to treating LADA, so you’ll need to work closely with your endocrinologist to try different options and monitor how well they work. This may require regular testing and follow-up appointments until you figure out what works.

Eventually, most people with LADA will need insulin to manage their blood sugar. Your doctor will help determine the best type of insulin treatment for you, how and when to take it, how often to check your blood sugar, what signs mean you need insulin, and how to give yourself injections if needed.

Talk to Your Doctor

If you think you may have LADA and you’ve been misdiagnosed, or if you have questions about living with LADA, your endocrinology team is the best source of guidance. They can help you figure out what sort of diabetes care works best for your body so you can receive the most effective treatment at every stage.

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