What is LADA? (continued)
The Mystery Continues
Researchers still don't know whether autoimmune diabetes in adults is due to the same underlying disease process as type 1 diabetes in children, and there are many LADA questions that still need answers. In attempt to standardize the definition of LADA, the Immunology of Diabetes Society has recently proposed the following criteria: patients should be at least 30 years of age, positive for at least one of four antibodies commonly present in type 1 diabetic patients, and not treated with insulin within the first six month of diagnosis. (1)
No one can predict exactly how long a LADA patient will continue to produce insulin. For me, the slow process of beta-cell destruction has probably been ongoing for close to a decade. The crucial task for the physician is not to miss a LADA diagnosis. And once LADA is diagnosed, the physician should recognize that some LADA patients require insulin, and will respond best to a basal-bolus (or pump) approach. "Although given that LADA patients may have features of type 2 as well," says Dr. Bloomgarden, "they may benefit from concurrent treatment with various oral medicines."
Regardless of your age, if you are labeled as having type 2 diabetes but have no family history of diabetes and are not overweight, you may have in fact have LADA. Your doctor can check for this with a blood test for autoantibodies and c-peptide levels, which indicate the amount of insulin you are producing (a low c-peptide level suggests LADA). When deciding how to treat LADA, says Dr. Bloomgarden, ultimately, it's not the measurement of insulin, c-peptide, or antibodies that matters but rather the physician and patient both understanding when insulin is warranted. If it is, it's not a reason to panic. The sooner you are receiving the correct treatment, the better you should feel.
 Journal of Clinical Endocrinology and Metabolism December 2009, 94. jcem.endojournals.org
Reviewed by Joy Pape, RN, BSN, CDE, WOCN, CFNC. 2/13
Apfelkuchen Salmon, Tortellini, and Artichoke Salad Boxty Pancakes Smothered Green Bean Saute Black Bean Salsa Marmalade Poached Chicken Blue Cheese Sauce Grilled Red Potato Hash Mediterranean Stock with Fennel Pork Fu Yung in a pan
Glucagon is one of those things that hasn't changed much in the diabetes world, in terms of packaging, dosing, method of delivery, since the time of my diagnosis in 1982. It's also one of those items that you buy in the same vein as say a generator. You might never use it, but it sure as heck is handy to have should your lights go out. The first time I was given glucagon was on the front lawn of my childhood home. What I remember of that night was going to bed after a...