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“‘What you just explained to me, I believe, is a classic case of LADA,’” Clarke recalled being told.

During that visit, she recounted her struggles to manage her blood sugar despite taking oral medications and making significant changes to her diet and exercise regimens. Mila Clarke, who lives in Houston, finally saw an endocrinologist in November 2020, more than four years after being diagnosed with Type 2 diabetes. “But that’s the thing with LADA: It unmasks itself over time.” “If you have someone who comes into your office who is obese and/or overweight and may have a family history of Type 2 diabetes - if you’re a betting person, you bet on them having Type 2 diabetes,” Gaglia said. That delay can lead physicians to believe their patients have Type 2 diabetes even as treatment becomes less effective. But, like Type 1 patients, most will eventually depend on injections of pharmaceutical insulin for the rest of their lives. Typical LADA patients are over 30 and don’t require injectable insulin for at least six months after diagnosis. LADA is difficult to diagnose because it progresses slowly, Gaglia said. Type 1 occurs when the body attacks its cells that produce insulin - the naturally occurring hormone that regulates blood sugar by helping turn food into energy. LADA is more akin to, or even thought to be another form of, Type 1 diabetes, an autoimmune condition once dubbed “juvenile diabetes” because it was most often diagnosed in children. It can often be managed with lifestyle changes and oral medications. and has a high prevalence among African Americans, Native Americans, and Hispanic populations. Type 2 accounts for at least 90% of diabetes cases in the U.S. Type 2 diabetes develops in people, often over age 45, whose bodies cannot properly regulate their blood sugar levels. LADA ostensibly has nothing to do with race, but misconceptions about race, weight, and age can all lead doctors to misdiagnose LADA patients with Type 2 diabetes, said Kathleen Wyne, an endocrinologist who leads the adult Type 1 diabetes program at Ohio State University. Even a common test used to manage diabetes can underestimate blood sugar levels for patients who have sickle cell trait, which is present in nearly 1 in 10 African Americans.

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Hospital software used to treat patients has been investigated for discrimination. In a recent KFF survey, for example, 55% of Black adults said they believed they needed to be careful at least some of the time about their appearances to be treated fairly during medical visits. “Doctors, like any other person walking this planet, we all have implicit biases that impact our patient experiences and our patient care delivery.”īlack patients have long struggled with bias across the U.S. “That does seem to happen more frequently for African American patients and for other minoritized groups,” said Rochelle Naylor, a pediatric endocrinologist at the University of Chicago who researches atypical forms of diabetes. Three of them wonder if their race played a role.

Without the correct diagnosis - which can be confirmed through blood tests - they described being denied the medicines, technology, and tests to properly treat their diabetes. As many as 10% of patients diagnosed with Type 2 diabetes might actually have LADA, said Jason Gaglia, an endocrinologist at the Joslin Diabetes Center in Boston.ĭeroze and three other LADA patients who spoke with KFF Health News, all Black women, are among those who were initially misdiagnosed.

Patients with it can be misdiagnosed with Type 2 diabetes and spend months or years trying to manage the wrong condition. The condition is often called latent autoimmune diabetes of adults, or LADA for short.