When first diagnosed with diabetes, people with LADA may not yet need insulin injections. At this stage, your treatment will concentrate on improving your blood sugar control, which may help preserve your natural ability to secrete insulin. To achieve this, your doctor may use type 2 diabetes drugs such as metformin or GLP-1 receptor agonists, which can help improve insulin sensitivity. Lifestyle adjustments, such as a wholesome diet and enhanced physical activity, could also extend this period before insulin treatment becomes necessary.
Eventually, however, everyone with LADA will need insulin. Some doctors may choose to prescribe insulin relatively soon after diagnosis, while others may prefer to wait until it is no longer possible to control blood sugar levels without it.
Initially you may be prescribed a long-acting “basal” insulin. This is a once or twice-daily injection that provides a constant steady stream of insulin. When you begin taking insulin, you may also need to increase the frequency with which you test your blood sugar, partially to help reduce the risk of low blood sugar (hypoglycemia). Some doctors will encourage you to use a continuous glucose monitor (CGM), a device that measures your blood sugar constantly around the clock and sends data to a smartphone app or a separate receiver.
Finally, you will probably need to start using a rapid-acting insulin before every meal you eat. At this stage in LADA’s progression, treatment is essentially identical to the treatment of type 1 diabetes. Intensive treatment is very complex and occasionally frustrating, and many people with LADA will rely heavily on their healthcare teams to help them navigate this new challenge.
