How LADA Usually Presents

There is a pattern to how LADA turns up, though no single feature proves it.

The symptoms are the ordinary symptoms of high blood sugar: passing urine often, especially at night; constant thirst; tiredness; blurred vision; and losing weight without trying. What is distinctive is the timing. They build over weeks to months — slower than the sudden onset of childhood Type 1, but more noticeably than the near-silent start of Type 2.

The person is usually an adult, most often diagnosed between 30 and 50, and often lean or normal weight rather than carrying extra weight around the middle. Blood pressure and blood fats are frequently normal. In other words, the usual Type 2 risk picture is missing.

A case series of ten people with LADA at a hospital in western India illustrates it well. Their diabetes was first identified at a median age of 33, their average build was slim at a BMI of around 22.6, and by the time LADA was actually recognised their HbA1c — the three-month average blood sugar measure — had reached a median of 10.7%.

The other half of the pattern only shows up over time. Tablets work at first. Then control slips despite doses going up, and weight keeps falling.

If that sequence sounds like yours, it is worth reading about being misdiagnosed as Type 2.