What is Diabetes Type 1.5? Understanding LADA and Its Impact on Eye Health

When most people think about diabetes, they picture either Type 1 or Type 2 diabetes. However, there's a lesser-known form that often goes undiagnosed or misdiagnosed—Latent Autoimmune Diabetes in Adults (LADA), sometimes referred to as Type 1.5 diabetes. LADA is an autoimmune condition that shares features of both Type 1 and Type 2 diabetes, but its slow progression makes it unique. Understanding how LADA develops, why it is frequently misdiagnosed, and how it affects overall health, including vision and eye health, is crucial for those living with this condition.

What is LADA?

LADA is a type of diabetes that occurs in adults over 30 years old and is characterized by the presence of autoantibodies to islet β cells in the pancreas. However, unlike Type 1 diabetes, individuals with LADA do not immediately require insulin therapy. Instead, the disease progresses slowly, often leading to an initial misdiagnosis of Type 2 diabetes. It is only after poor response to typical Type 2 diabetes treatments (such as oral medications) that doctors realize insulin therapy is needed.

According to the Immunology for Diabetes Society, LADA is diagnosed when the following criteria are met:

• The patient is over 30 years old at the time of diagnosis.
• Autoantibodies against islet β cells are present in lab tests.
• The patient does not require insulin therapy for at least six months after diagnosis.

Why is LADA Commonly Misdiagnosed?

Misdiagnosis occurs frequently because the initial symptoms of LADA closely resemble Type 2 diabetes. Patients may be overweight or have some degree of insulin resistance, leading healthcare providers to prescribe oral diabetes medications instead of insulin. However, because LADA is an autoimmune disease, these treatments often fail.

Additionally, the presence of autoantibodies in LADA varies. Some patients have higher antibody levels, which leads to a faster progression toward insulin dependence, while others have lower levels and may retain some natural insulin production for years. Because of this variability, many patients do not receive the correct diagnosis until their blood sugar control becomes unstable.

How Does LADA Impact Eye Health?

Like other forms of diabetes, LADA increases the risk of diabetic eye disease, including:

• Diabetic Retinopathy – High blood sugar levels damage the blood vessels in the retina, leading to vision problems and even blindness if left untreated.
• Diabetic Macular Edema (DME) – Swelling in the central part of the retina can cause blurry vision and difficulty seeing fine details.
• Cataracts and Glaucoma – People with diabetes, including LADA, have a higher risk of developing cataracts at an earlier age and an increased risk of glaucoma, a disease that can cause permanent vision loss.

How Can You Protect Your Eyes?

Because diabetes-related eye conditions often develop without noticeable symptoms, early detection is key. If you have been diagnosed with LADA or suspect you may have it, it’s important to schedule regular eye exams with an optometrist. At Town Eyecare, we specialize in providing comprehensive diabetic eye exams to detect early signs of eye damage before they become serious.

We offer:

• Retinal imaging to detect early changes in the blood vessels of your eyes.
• Diabetic eye screenings that can be coordinated with your primary care physician or endocrinologist.
• Treatment recommendations to protect your vision, including lifestyle adjustments, prescription glasses, and medical referrals if needed.

Schedule an Eye Exam Today

If you have diabetes, don’t wait until vision problems appear. Early intervention is the best way to prevent long-term complications. Schedule an appointment with Town Eyecare today to ensure your vision remains clear and healthy.

By staying proactive with your diabetes management and eye health, you can enjoy clear vision for years to come. If you have any questions, our team at Town Eyecare is always here to help!