Adults Can Get Type 1 Diabetes, Too

Medically Reviewed by Shruthi N, MD on August 29, 2024
Written by Tammy Worth
8 min read

Type 1 diabetes used to be called juvenile diabetes, as it was usually diagnosed in children and teens. But more than half of all new cases of type 1 diabetes are now diagnosed in adults. 

Adult-onset type 1 diabetes happens when your pancreas stops producing insulin, usually because of an autoimmune condition that attacks the organ's cells. Because it is often related to an autoimmune condition, it is sometimes also called latent autoimmune diabetes in adults (LADA).

Symptoms of adult-onset type 1 diabetes usually begin after age 30. Many of the symptoms are similar to those of type 2 diabetes, so many adults are misdiagnosed at first. But it's important to learn the differences and figure out what's going on so you can get the treatment that's right for you.

Type 1 diabetes and LADA are both typically caused by an autoimmune condition that attacks the pancreas, causing the organ to make less insulin. Insulin is a hormone that helps your body regulate the amount of sugar in your blood. If you aren't making enough insulin, glucose (sugar) from the food you eat stays in your bloodstream instead of moving to your muscles, fat, and liver, where it can be used for energy.

Traditionally, type 1 diabetes was thought to be found mostly in children. It's frequently diagnosed during the ages of 4-6 or 10-14. When children are diagnosed, they typically have to begin tracking their blood sugar to make sure it stays at healthy levels. Children with type 1 diabetes also usually take insulin several times a day.

If you are diagnosed with adult-onset type 1 diabetes, you may not need to begin taking insulin right away. Your pancreas may still make some insulin, as damage to it tends to happen more slowly. Because of this, adults are often misdiagnosed at first as having type 2 diabetes.

Some health care professionals think this condition should be diagnosed as something different than traditional type 1 diabetes because it progresses so slowly. You may hear it called adult-onset type 1 diabetes, LADA, or even type 1.5 diabetes.

No one knows exactly why your body begins to attack the pancreas when you have adult-onset type 1 diabetes. It could be a virus or toxins in the environment that cause your immune system to attack your cells. And if you have a parent with type 1 diabetes, it's more likely that you will then get type 1 diabetes. If one of your parents has type 1 diabetes, your risk of getting it is 1%-8%. If two parents have it, the risk climbs to 30%.

But unlike type 1 diabetes in children, lifestyle factors also may play a role in getting adult-onset diabetes. As with type 2 diabetes, if you are overweight, not physically active, drink alcohol, or smoke, you may be more likely to be diagnosed with LADA.

 

You may have late-onset type 1 diabetes and have no symptoms. But more likely, you will have symptoms that are similar to those of type 2 diabetes. Over several months, you may notice that you:

  • Are extremely thirsty or hungry even when you've had enough to eat or drink
  • Need to pee often, or frequently during the night
  • Feel unusually tired or weak
  • Lose weight suddenly, without any changes in diet or exercise
  • Get blurred vision or other changes in the way you see
  • Get vaginal yeast infections
  • Have breath that smells fruity
  • Can't breathe well
  • Have tingling in your feet or hands
  • Have skin that is dry and itchy
  • Frequent infections

Adult-onset type 1 diabetes is usually diagnosed in people over the age of 30. People of all races and ethnic groups can get late-onset type 1 diabetes, but it's most common among those of Northern European descent. Having a low birth weight is also a risk factor.

Because genetics also plays a role in LADA, you may be at higher risk if one of your parents or a brother or sister has it. Because it is an autoimmune condition, you are also at greater risk if you, or a family member, has another autoimmune condition. Other risk factors that are related to your lifestyle that can place you at a higher risk include:

  • Heavy smoking
  • Drinking alcohol
  • Drinking two or more sweetened beverages, such as soda, each day
  • Having excess body weight (usually considered a body mass index of 25 or higher)
  • Having a high waist-to-hip ratio (This can be found by measuring your waist and hips, and then dividing the first number by the second. A high number for men is 0.90, and for women, it's 0.85.)

 

 

It's not always easy to tell if you have type 1 diabetes when you're an adult. There are several reasons for this.

Symptoms take longer to show up in adults than they do in children. This can make it harder for doctors to know what's going on, especially if they don't specialize in the condition.

Also, many people with type 1 diabetes are lean or have a normal weight. Your doctor might rule out diabetes since most people with type 2 diabetes are overweight.

Your doctor may suggest several tests that can tell you if you have diabetes, although these won't show if it's type 1 or type 2.

Glycated hemoglobin (A1c) test. It measures your average blood glucose level for 2-3 months. If you have an A1c level of 6.5 or higher on two separate exams, you have diabetes.

Random blood sugar test. It checks your blood glucose at a random time of day. A level of 200 milligrams/deciliter (mg/dL) or higher is a sign that you have diabetes.

Fasting blood sugar test. Your doctor does this first thing in the morning before you've eaten. You have diabetes if your level is 126 mg/dL or higher on two separate tests.

There are few reliable tests that let your doctor know that you have LADA. But if you are lean, are age 40 or younger, and your symptoms get worse even if you are on diabetes medication, it may be adult-onset type 1 diabetes. If this is the case, your doctor may also test your blood for certain autoimmune antibodies, which you have with type 1 diabetes, but not in type 2. They might also check your pee for ketones, or fat by-products. If these are in your sample, you probably have LADA.

Your doctor can also test your C-peptide levels. C-peptide is a substance your body produces when it makes insulin. If your levels are low, your body isn't producing enough insulin. This measure is important to diagnose LADA because, with type 2 diabetes, levels are high. If you have LADA, your levels will drop more slowly than with traditional type 1 diabetes. 

If you have latent autoimmune diabetes, you will probably need insulin but may not need it for months or years after your diagnosis. You may initially be able to manage the condition with exercise, a healthy diet, and/or medications. The goal of treatment, at the beginning, is to keep your blood glucose at healthy levels and to delay the disease from progressing.

There are also some lifestyle treatments that your doctor will recommend to keep your blood sugar levels healthy and avoid complications down the road. These include:

  • Quitting smoking, if you are a smoker
  • Losing weight, if you are overweight
  • Getting regular exercise of about 150 minutes per week (but talk to your doctor first, to make sure you can manage your blood glucose levels during physical activity.)
  • Talking with your doctor about a nutritional plan for people with diabetes

A couple of medications your doctor may prescribe are metformin, which helps lower blood sugar levels, and dipeptidyl peptidase (DPP), which can help preserve the function of your cells. You will need to talk with your doctor to understand the best kind of medicine, depending on how far your LADA has progressed and your blood glucose levels.

 

 

When you are diagnosed with adult-onset type 1 diabetes, the way you manage it will depend upon the progression of the condition. Your doctor will help you decide the best way to care for yourself after diagnosis.

Because your insulin is directly impacted by what you eat, one of the most important things you can do is have a healthy diet. If you have LADA, this includes:

  • Lean proteins, such as chicken, beans, or eggs
  • Non-starchy vegetables including broccoli, cucumbers, peppers, and mushrooms
  • Small amounts (think one-quarter of a small plate at your meal) of starchy vegetables and carbohydrates such as potatoes, rice, and bread
  • Unsweetened drinks such as iced tea or sparkling water

Exercising can help keep your blood glucose levels normal, improve cholesterol, and lower your weight. It's an important component of living with LADA. Experts recommend 150 minutes of moderate physical activity a week. But with adult-onset diabetes, you should talk with your doctor to make sure you can manage your glucose levels during physical activity. You may start with a short walk every day, just to get your body moving.

Here are other tips for living well with adult-onset diabetes: 

  • Test your blood sugar regularly (talk to your doctor about how often is right for you -- it could be anywhere from 4 to 10 times a day).
  • Take any medication prescribed by your doctor regularly.
  • Find good ways to manage your stress.
  • Go to all of your scheduled doctor's appointments.
  • Get plenty of sleep.

Adult-onset diabetes can be similar to both traditional type 1 diabetes and type 2. But LADA, unlike type 2, is an autoimmune disease. People are usually diagnosed after the age of 30, have symptoms that progress slower than type 1, and often become dependent on insulin at some point. There is a genetic component to adult-onset diabetes, so you are at higher risk if you have an immediate family member with the condition.

What are the complications of type 1 diabetes?

If you manage your blood sugar well, you are less likely to have complications. If your blood sugar isn't managed very well, you can end up having:

  • Eye problems, such as glaucoma
  • Ulcers and infections on your feet
  • Heart disease, high blood pressure, and stroke
  • Nerve damage
  • Kidney disease

Do symptoms of type 1 diabetes differ in adults & children?

Symptoms of type 1 diabetes are the same in children and adults. They may show up slightly differently in children — they may wet the bed, where an adult wakes up and gets to the bathroom. Also, if you have LADA, your symptoms may progress more slowly than those of a child diagnosed with type 1 diabetes.

What types of insulin are used for adults with type 1 diabetes? 

Insulin may be injectable or given through a pump worn on your body. Types of insulin include:

  • Short-acting, which starts working in about 30 minutes, reaches its peak in about 90 minutes, and lasts in the body from 4 to 6 hours
  • Rapid-acting, often taken before a meal, starts working in 15 minutes, peaks at about 60 minutes, and lasts about 4 hours
  • Intermediate-acting, which works in around an hour, peaks at 6-8 hours, and lasts 12-24 hours
  • Long-lasting, which stays in the body for 14-40 hours
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