Internal Medicine Specialist Assoc. Dr. Mustafa Temizel stated that within the scope of diabetes awareness, the society generally knows about type 1 and type 2 diabetes, but LADA type diabetes, defined as ‘hidden autoimmune diabetes of adults’, is also an important health issue.
LADA type diabetes accounts for 3 to 12 percent of diabetes cases in adults. Assoc. Dr. Temizel said, “It is also referred to as ‘type 1.5 diabetes’ in the medical literature. It neither progresses as quickly as type 1, nor can it be explained only by insulin resistance, like type 2. For this reason, it is quite difficult to diagnose.”
“SYMPTOMS ARE SIMILAR, DIAGNOSIS IS DIFFERENT”
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Assoc. Prof. stated that regardless of the type of diabetes, patients’ complaints are generally similar. Dr. Mustafa Temizel said that it may be accompanied by symptoms such as dry mouth, drinking too much water, frequent urination, fatigue, weight loss, numbness in hands and feet, delayed healing of wounds, and blurred vision.
Assoc. Dr. Temizel continued his explanations as follows: “Due to this similarity, it may not be noticed that some type 2 diabetes patients actually have LADA. Research shows that approximately 14 percent of individuals diagnosed with type 2 diabetes have LADA type diabetes. The autoimmune mechanism in LADA is similar to type 1, but the disease progresses slowly and usually occurs over the age of 30. For this reason, it is called ‘latent’ diabetes.”
“EARLY INSULIN TREATMENT REDUCES THE RISK OF COMPLICATIONS”
Assoc. Prof. stated that the treatment process in type 2 diabetes usually begins with long-term oral medications. Dr. Temizel said, “The situation is different in LADA. Tablet treatment can be applied initially in LADA patients, but this treatment becomes insufficient within a few months. In fact, these patients need insulin treatment in the early period. When a LADA patient is mistakenly evaluated as type 2, the beta cell reserve may be rapidly depleted due to inappropriate treatment and the risk of complications increases. Studies show that LADA patients are more prone to the development of neuropathy than people with type 2 diabetes. However, with correct diagnosis and early insulin treatment, the risk of microvascular disease can be significantly reduced.”
LADA IS MORE COMMON IN THIN ADULTS
Underlining that one of the most important criteria in the diagnosis of LADA is autoantibody tests, Assoc. Dr. Temizel said, “The presence of antibodies such as anti-GAD, IAA and ICA indicates autoimmune diabetes. Being positive for at least one antibody is a warning sign for diagnosis. In addition, the insulin production capacity of the pancreas can be evaluated by C-peptide measurement. In LADA patients, this value decreases over time, which indicates the need to start insulin. The person’s body type, cholesterol levels and metabolic profile can also be guiding about the possibility of LADA. LADA is more common, especially in thin-bodied adults.”
“THE PURPOSE OF TREATMENT IS TO PROTECT BETA CELLS”
“Although there is no definitive treatment algorithm for LADA type diabetes yet, the main goal is to control blood sugar and protect the beta cell reserve in the pancreas,” said Assoc. Dr. Temizel concluded his words as follows: “In this process, early diagnosis, regular follow-up and personalized treatment planning are of great importance. The aim of the treatment is not only to normalize blood sugar levels, but also to slow down the progression of the disease and preserve the remaining insulin production capacity of the pancreas. This is possible by checking patients at regular intervals, adapting to nutrition and exercise programs, and switching to insulin treatment on time when necessary.”
