What is LADA Diabetes and How to Manage It

The Rarer Form of Diabetes

IzzyMany people haven’t heard of Latent Autoimmune Diabetes of Adults (LADA), also known as type 1.5 or slow onset type 1 diabetes. Usually diagnosed in people over the age of 25, it doesn’t require medication of insulin immediately, but this can become required further down the line.

Izzy Mustafa, 32 from Hull, was recently diagnosed with this less commonly known condition early this year.

“My immune system is attacking my Beta Cells – Insulin producing cells in the pancreas. It will eventually reduce my insulin production to a level that requires me to have insulin injections.”

A Confused Doctor

LADA or type 1.5 diabetes is often misdiagnosed as type 2 initially, with Diabetes UK estimating about 10-15% of people have been wrongly diagnosed. It can take a while for the correct diagnosis to be made, as people with LADA often appear quite healthy – they often don’t share the standard type 2 diabetes characteristics of being overweight, unfit or having metabolic syndrome indicators (a group of risk factors including high blood pressure, high blood sugar, unhealthy cholesterol levels and abdominal fat).

For Izzy, a diagnosis didn’t come quickly. “The whole process took about 2 months,” he says.

“I’m an electrical engineer and work offshore for one of the world’s biggest oil companies. I travel the world to different installations, both land and sea based, to provide support for drilling equipment.

“I first noticed symptoms of my illness when I was working in Angola, West Africa in May this year. I returned to the UK feeling unwell and went straight to my GP. I was sweating profusely, light headed, shaking and unable to steady myself on my feet. However, I confused these symptoms with heat stress due to the climate in Angola, which was 32°C with 75% humidity.

“My GP carried out several blood tests, including for malaria and diabetes, but the only abnormal results were my Blood Glucose (BG) Levels. They then carried out a blood and glucose fasting test. You fast for 12 hours, have a blood test, drink a 500ml bottle of Lucozade in less than 2 minutes, and then have another blood test 2 hours later for comparison. The results of this test confirmed diabetes.

“My GP was quite concerned as I didn’t match the criteria for a typical type 1 or 2 diabetic, therefore he struggled to determine a type. I had even more blood tests to check for antibodies which would help to figure out my diabetes type. The results showed the presence of Glutamic Acid Decarboxylase (GAD), which confirmed it as the rare type 1.5 or LADA.

Daily Life on Medication

As for many people with diabetes, Izzy takes a variety of medications to help control his LADA.

“I’ve tried to ensure my condition has very little effect on my lifestyle. The most difficult challenge for me was admitting I was ‘ill’ – I’ve always tried to stay healthy and haven’t had any health problems before. This is now something I use to motivate me. Two years ago I ran 5 marathons in 5 days from Manchester to York, so I’m determined to achieve the same level of fitness again.

“I take 100mg Sitagliptin and 20mg Cetrizine on a daily basis, and monitor my BG levels as necessary. If I’m feeling unwell, I monitor my Ketone levels too and any abnormalities are reported to my GP.

“I’ve changed my medication around a bit to find something that works for me. Initially I was prescribed Metformin and Metformin Slow release, both type 2 medications which reduce the liver glucose output to reduce my BG levels. However, I suffered sensitivity to the medication and have since moved on to Sitagliptin, which stimulates insulin production. This is also under review though as this doesn’t appear to be having the correct effect and my BG levels are increasing. My GP believes I’ll be on Insulin sooner rather than later.”

Managing in a Work Environment

Diabetes can be tricky to manage wherever you work, but travelling around the world to oil rigs and installations has some unique challenges – especially as Izzy often works at height or in hazardous environments.

“I haven’t noticed any major changes to my work routine other than taking medication and monitoring my BG levels regularly. I no longer miss meals though, as this can have a detrimental effect on my health in a short space of time.

“Thankfully, I haven’t had any emergencies whilst at work. Although isolated on a rig, you are very well taken care of whilst on-board and during transit. For a diabetic, hypoglaecemic episodes are the biggest threat, but there is plenty of food and drink available on-board, so you should never find yourself in this position.

“Safety procedures vary depending on the installation and what country I’m in. Each individual site has their own requirements for my condition – some installations require my BG levels to be above 5.0 before I can leave the accommodation complex, whilst others require me to make radio contact every 30 minutes. This can be a bit of a pain but I believe they only have my best interests at heart.

“My employers and all my colleagues have been more than supportive of my condition. I often work alone but when I have been part of a team I’ve had no issues. I think the only likely issue would be someone misunderstanding my illness. Most people assume diabetics are overweight, fast food eaters, which I did too until recently! Education and communication is definitely the key.”

Medical ID Jewellery

Izzy has recently discovered medical ID jewellery and was full of praise for the idea.

“I think medical ID jewellery is a great idea for people with health conditions. It can tell any paramedics how to treat me if I have an accident, so could save the hassle of trying to figure out my condition on their own. I’d definitely recommend it to other people – anything that can help in an emergency situation is a great idea.”

Support for Others Recently Diagnosed

After his diagnosis, Izzy’s search for more information about his condition led him to talking to other people experiencing the same thing.

“I’ve found the DCUK forum to be a great help. There are thousands of members who have lots of experience of diabetes, and there’s always someone with experience of what you may be going through at the time.

“Advice I’d give to anyone else newly diagnosed is don’t panic and don’t let it get you down. The illness doesn’t stop you carrying out anything you want to do. Join the forum and you will realise how many people there are to help and support you. You’re not alone, which is the most important thing to remember.”