LADA (Latent Autoimmune Diabetes of Adulthood):
- nancy dehra
- 12 minutes ago
- 5 min read
The “Invisible” Diabetes Most Adults Are Misdiagnosed With
Most people think diabetes fits neatly into two boxes:
Type 1 (autoimmune, childhood)andType 2 (lifestyle, adulthood).
But there’s a third form that sits quietly in between—and is often missed for years.
It’s called LADA – Latent Autoimmune Diabetes of Adulthood.
Many adults with LADA are told they have Type 2 diabetes, placed on oral medications, advised to “lose weight,” and blamed for something that is not purely lifestyle-driven.
As a functional practitioner, this is one of the most under-recognized metabolic conditions I see.
What Exactly Is LADA?
LADA is an autoimmune condition, like Type 1 diabetes, but it develops slowly and appears in adulthood—usually after age 30.
The immune system gradually attacks the insulin-producing beta cells of the pancreas, but unlike classic Type 1 diabetes:
The destruction is progressive and slow
Insulin dependence may not appear for months or years
Blood sugars can look “mildly abnormal” initially
This is why LADA often gets mislabeled as Type 2 diabetes.
Why LADA Is Commonly Missed
From a clinical perspective, LADA hides well because:
The person may not be overweight
They may eat “clean” and exercise regularly
Initial response to oral diabetes medications can occur
Fasting glucose may be only mildly elevated
HbA1c may sit in the “borderline” zone for years
But underneath, autoimmunity is quietly progressing.
Interesting Facts Only an Experienced Functional Practitioner Notices
1. LADA Often Appears After a Major Stressor
Many LADA cases begin after:
Severe emotional stress
Pregnancy or postpartum period
Viral infections
Chronic sleep deprivation
Long-standing gut inflammation
Stress hormones (especially cortisol) can accelerate autoimmune activity, tipping genetically susceptible individuals into disease.
2. These People Often Have “Normal” Insulin Resistance
Unlike Type 2 diabetes:
Muscle insulin resistance may be mild
Liver fat may be normal
Triglycerides are often not very high
The problem isn’t resistance first—it’s insulin deficiency in slow motion.
3. Gut Health Plays a Bigger Role Than Most Doctors Admit
In functional practice, LADA patients often show:
Increased gut permeability (leaky gut)
Food sensitivities (especially gluten and dairy)
Recurrent bloating, gas, or IBS-like symptoms
Past antibiotic overuse
A compromised gut can drive immune dysregulation, worsening autoimmune attack on the pancreas.
4. Blood Sugars Behave “Strangely”
Classic patterns I see:
Fasting sugars may be normal, but post-meal spikes are high
Blood sugar crashes 2–4 hours after eating
Carbohydrates that were once tolerated suddenly aren’t
Exercise sometimes causes unexpected hypoglycemia
This unpredictability is a huge clue.
5. Weight Loss Happens Without Trying
Unlike Type 2 diabetes, people with LADA often report:
Unintentional weight loss
Loss of muscle mass despite adequate protein
Difficulty gaining weight even when eating more
This happens because insulin is a storage and anabolic hormone—when it declines, so does the body’s ability to hold weight.
Day-to-Day Symptoms People Ignore (But Shouldn’t)
LADA doesn’t announce itself loudly. It whispers.
Here’s what people experience in daily life:
Energy & Mood
Sudden fatigue after meals
Brain fog that improves with eating
Irritability when meals are delayed
Anxiety or shakiness without clear cause
Hunger & Cravings
Extreme hunger soon after meals
Sugar cravings despite balanced meals
Feeling “wired but tired”
Exercise Response
Feeling worse after workouts instead of better
Dizziness during cardio
Poor recovery despite adequate nutrition
Body Signals
Frequent urination at night
Excessive thirst
Dry mouth or dry skin
Blurred vision that comes and goes
Weight Changes
Weight loss without effort
Difficulty maintaining muscle
Clothes fitting looser despite no dieting
Why Treating LADA Like Type 2 Is a Problem
When LADA is treated as Type 2 diabetes:
Insulin-producing cells are stressed further
Autoimmune progression accelerates
Insulin therapy is delayed unnecessarily
Blood sugar control worsens over time
Early identification allows for:
Beta-cell preservation strategies
Better nutritional planning
Timely insulin support (when needed)
Reduced long-term complications
When Should Someone Suspect LADA?
Red flags include:
Diabetes diagnosis after age 30
Lean or normal body weight
Poor response to oral diabetes medications
Family history of autoimmune disease
Fluctuating blood sugars despite “doing everything right”
If this resonates, deeper evaluation is warranted.
How to Test for LADA (Latent Autoimmune Diabetes of Adulthood)
LADA cannot be diagnosed with routine sugar tests alone.
That’s the biggest reason it gets missed.
A correct diagnosis requires looking at three layers:
Blood sugar status
Insulin production capacity
Autoimmune activity
Let’s break this down properly.
Step 1: Basic Blood Sugar Tests (NOT enough on their own)
These tests often trigger suspicion but do not confirm LADA.
Tests:
Fasting Blood Glucose
Post-meal (2-hour) Blood Glucose
HbA1c
What you might see in LADA:
Mildly elevated fasting or post-meal sugars
HbA1c in prediabetes or early diabetes range
Blood sugars that fluctuate unpredictably
⚠️ Important:
These results look similar to Type 2 diabetes → this is where misdiagnosis happens.
Step 2: C-Peptide Test (MOST IMPORTANT FUNCTIONAL CLUE)
What is C-peptide?
C-peptide tells you how much insulin your pancreas is actually producing.
Type 2 diabetes → normal or high C-peptide (insulin resistance)
LADA → low or low-normal C-peptide
Type 1 diabetes → very low or absent C-peptide
How to test it properly:
Fasting C-peptide
OR Stimulated C-peptide (after glucose or meal)
Red flag for LADA:
Normal sugars + low C-peptide
Or rising sugars with declining C-peptide over time
This is a huge clue that insulin production is failing.
Step 3: Autoimmune Antibody Tests (CONFIRMATORY)
LADA is an autoimmune disease, so antibodies must be checked.
Key antibodies to test:
GAD-65 antibodies
Most common and most important
Positive in the majority of LADA cases
IA-2 antibodies
Indicates more aggressive autoimmunity
ZnT8 antibodies
Helpful when GAD is negative but suspicion remains
Islet Cell Antibodies (ICA)
Older test but still relevant
👉 Even ONE positive antibody = autoimmune diabetes
Many doctors only test GAD.
Functional practitioners often testa full antibody panelif possible.
Step 4: Insulin Levels (Helpful but Secondary)
Fasting insulin
Post-meal insulin
In LADA:
Insulin levels may be low or inappropriately normal
They do not rise adequately after meals
This explains:
Post-meal sugar spikes
Crashes a few hours later
Step 5: Look for Associated Autoimmune Clues (Experienced Practitioner Insight)
People with LADA often have other autoimmune markers, such as:
Thyroid autoimmunity (Hashimoto’s)
Vitiligo
Celiac disease
Family history of autoimmune disorders
Testing may include:
Thyroid antibodies
Vitamin B12 (often low)
Vitamin D (often low)
Inflammatory markers
These don’t diagnose LADA—but they strengthen clinical suspicion.
When Should Someone Specifically Ask for LADA Testing?
A person should push for testing if they have:
Diabetes or prediabetes diagnosed after age 30
Normal or lean body weight
Poor response to oral diabetes medications
Increasing sugars despite “doing everything right”
Frequent hypoglycemia episodes
Family history of autoimmune disease
👉 In these cases, C-peptide + GAD antibodies are non-negotiable.
The Gold-Standard Testing Combination
If I had to choose only three tests to strongly identify LADA:
C-peptide
GAD-65 antibodies
HbA1c (baseline context)
This combination alone catches most cases.
A Very Important Truth (No Sugar-Coating)
If someone has:
Low C-peptide
Positive antibodies
👉 This is NOT Type 2 diabetes, no matter the age.
Delaying correct diagnosis:
Accelerates beta-cell loss
Worsens long-term complications
Creates unnecessary frustration and guilt
Early identification changes outcomes.
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