NSYNC’s Lance Bass Diagnosed with Type 1.5 Diabetes: What Is It?

Type 1.5 diabetes, also called latent autoimmune diabetes in adults (LADA), is a form of diabetes that begins during adulthood and slowly worsens over time.

LADA has some similarities to type 2 diabetes — both develop gradually and are diagnosed when someone is an adult.

As a result, LADA is often incorrectly diagnosed as type 2 diabetes. In fact, between 4% and 12% of people with type 2 diabetes may have LADA.

Unlike type 2 diabetes, though, LADA is an autoimmune disease, so it can’t be reversed with changes in diet and lifestyle — although these can help a person manage their disease.

LADA happens when the immune system mistakenly attacks and destroys insulin-producing cells in the pancreas, which causes the pancreas to stop making insulin.

“[This] destruction of beta cells occurs very slowly over many years,” said Saleh Adi, MD, a pediatric endocrinologist and vice president of medical affairs at Willow Laboratories, developer of the Nutu app, which helps people prevent or delay the development of type 2 diabetes.

“This results in a gradual loss of insulin secretion and an increase in blood glucose levels,” he told Healthline. “Patients with LADA remain asymptomatic for years until there is significant loss of beta cells, or there is an increase in insulin resistance.”

This kind of damage to pancreatic beta cells also occurs in type 1 diabetes, a form of diabetes that begins in childhood or adolescence. Damage to the beta cells occurs more slowly in LADA than in type 1 diabetes.

LADA is also more genetically similar to type 1 diabetes than to type 2 diabetes. People who have a close family member with LADA, type 1 diabetes, or an autoimmune disease may have a higher risk of developing LADA.

“Many diabetes organizations, including the American Diabetes Association, consider LADA to be simply a sub-type of type 1 diabetes that develops very slowly due to some differences in the autoimmune processes that attack the beta cells,” said Adi.

People usually develop symptoms of LADA after the age of 30. Symptoms may be vague in the beginning. Some people have no symptoms at first.

As with all types of diabetes, the symptoms of LADA are related to high blood glucose, said Adi. They include:

• increased urination
• frequent thirst
• unexplained weight loss
• fatigue
• blurred vision
• tingling in the feet

Because damage to the pancreatic beta cells occurs slowly, people with LADA may not require insulin to help control their blood sugar (glucose) level in the first 6 months or more after diagnosis.

Because LADA occurs later in life and often has mild symptoms without much weight loss, many patients are mistakenly diagnosed with type 2 diabetes and treated with oral medications, said Adi.

“However, their symptoms do not improve because what they really need is a replacement of insulin,” he said. “It is therefore critical to distinguish LADA from type 2 diabetes.”

He said certain clinical clues indicate a person may have LADA:

• They have another autoimmune condition or a close family member with an autoimmune condition.
• Their blood glucose level doesn’t improve even when taking medications for treating type 2 diabetes.
• They don’t have other signs of type 2 diabetes, such as being overweight or having obesity or having signs of insulin resistance.

The diagnosis of LADA is then confirmed by the presence of at least one pancreatic auto-antibody, Adi said, which provides evidence of beta cells being destroyed.

Another lab test which suggests that someone may have LADA instead of type 2 diabetes is a low level of C-peptide, he said. This is a surrogate for insulin levels in the blood.

There is currently no way to prevent LADA.

As a result, “the most critical factor in improving the outcomes of patients with LADA is a correct diagnosis and prompt treatment with insulin,” said Adi.

Early treatment can prevent diabetes-related complications such as kidney disease, cardiovascular problems, eye disease, and nerve problems.

In the beginning, LADA may be managed with lifestyle changes such as maintaining a healthy weight, staying physically active, eating a healthy diet, and quitting smoking. These are also recommended for people with type 2 diabetes.

However, as the body slowly loses its ability to produce insulin, most people with LADA will eventually need to use insulin to control their blood sugar. Monitoring their blood glucose with frequent blood sugar testing will also be needed.

“Patients with LADA who finally start taking insulin describe a marked regain in their energy, physical and mental strength, and healthy weight gain,” said Adi.

Earlier treatment can help in other ways.

“Current evidence is that early initiation of insulin therapy can slow down beta cell loss,” said Adi, “making it easier to manage diabetes without a high risk of hypoglycemia.”

Singer Lance Bass announced that he was diagnosed with type 1.5 diabetes, or latent autoimmune diabetes in adults (LADA). This is a form of diabetes that usually develops after the age of 30 and slowly worsens over time.

Unlike type 2 diabetes, LADA is an autoimmune disease in which the immune system mistakenly attacks and destroys the cells in the pancreas that produce insulin. Type 1 diabetes is also an autoimmune form of diabetes, but it begins in childhood or adolescence.

There is currently no way to prevent LADA, but early diagnosis can ensure that people start appropriate treatment. This can prevent diabetes-related complications such as kidney disease and eye problems.

The most common treatment is insulin, which helps control blood sugar levels.