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
Mexican Style Fish and Chips Sweet Potato Cakes & Salad Carrot Spread Chocolate-Drizzled Cream Puffs Shrimp with Wasabi Mayo Chicken, Ham and Vegetable Stew Minestrone Zuppa Banana Yogurt Pancakes Citrus Rice Almond Cookie Cups
I had a work dinner last night with some leadership from my office. I always find diabetes etiquette at these things to be kind of tricky. It was a four course meal, with salad, soup, entree' and dessert and coffee. There was also a selection of gluten free and non-gluten free dinner rolls. I felt way too full of questions for waitress... "Could I get my dressing on the side? How much sugar is in it?" A course later...