Diabaté Aider

The Three Types Side by Side

Reviewed by CDE Mehandi Sharma · Updated

Seeing the three together makes the position of LADA clearer than any description does.

Typical patterns — individuals vary widely
Type 1LADAType 2
CauseAutoimmuneAutoimmuneInsulin resistance
Usual age at onsetChildhood, teensOver 30Over 40
How fast it startsWeeksMonths to yearsYears, often silent
BuildUsually leanOften leanOften overweight
Islet antibodiesPositivePositiveNegative
C-peptideVery lowLow, fallingNormal or high
Insulin at diagnosisAlwaysNot in first 6 monthsUsually not
Ketoacidosis at onsetCommonUncommonUncommon

Read the middle column carefully. Every entry in it either matches Type 1 or matches Type 2 — which is exactly why LADA gets sorted into the wrong box so easily.

The one row that never bends is the antibody row. Cause is what separates the three, and antibodies are how cause is measured. Build, age and speed of onset are tendencies, and tendencies have exceptions.

The bottom two rows explain the diagnostic confusion in practice. Someone with LADA arrives without a crisis and without an immediate need for insulin — so they look like Type 2 on the day, and only reveal themselves over time.

Sources