India's diabetes epidemic is well documented, with 89.8 million adults living with the condition in 2024, second only to China, according to the International Diabetes Federation's Diabetes Atlas 11th Edition. Projections indicate this number will rise to 156.7 million by 2050. However, a quieter and more stubborn problem lurks within these statistics: Type 1.5 diabetes, also known as Latent Autoimmune Diabetes in Adults (LADA). This condition is frequently missed by both patients and doctors because it mimics Type 2 diabetes on the surface.
What Is Type 1.5 Diabetes?
Type 1.5 diabetes is an autoimmune disease where the body's immune system attacks insulin-producing cells. Unlike classic Type 1 diabetes, which often has a sudden onset in childhood, LADA develops gradually in adulthood. It also does not require insulin immediately after diagnosis, which leads to confusion with Type 2 diabetes. "With Type 1.5 diabetes, there is a continuous destruction of insulin-producing cells by antibodies generated within the body," explains Dr. Ramesh Goyal, Senior Consultant Endocrinologist at Apollo Hospitals International Ltd., Ahmedabad. "Since the disease is autoimmune in nature, lifestyle measures alone cannot reverse it. It is a lifelong condition, and most patients eventually require insulin therapy."
Why LADA Is So Often Misdiagnosed
The Cleveland Clinic Journal of Medicine published a review in December 2025 describing LADA as a slowly progressive form of autoimmune diabetes that often leads to misdiagnosis and delayed insulin therapy. The condition typically appears after age 30 and worsens over years. Symptoms include slow, unexplained weight loss, excessive thirst, increased hunger, frequent urination, susceptibility to infections, delayed wound healing, blurred vision, and tingling or numbness in the limbs. None of these are exclusive to LADA, and all can resemble poorly controlled Type 2 diabetes. "Symptoms appear in adulthood and build gradually: excessive thirst, frequent urination, unexplained weight loss, blurred vision, and fatigue, which is why it is so often misdiagnosed as Type 2," adds Dr. Shree Vidya, Medical Director of Preventive Health at Apollo Hospitals.
The Scale of the Problem in India
Dr. Goyal estimates that 5–12% of all people with diabetes in India may have Type 1.5 diabetes. With millions of diagnosed diabetics, this translates to a potentially enormous number of individuals being treated for the wrong condition. Dr. Shree Vidya notes that among Indians, data is sparse but suggests 4–8% of those diagnosed with Type 2 diabetes actually have LADA. The true burden could be higher due to widespread misclassification and lack of awareness at all levels of the healthcare system. "Recognising the condition early can help ensure better blood sugar control and prevent long-term complications," Dr. Goyal says. In a country carrying the world's second-largest diabetes burden, addressing this hidden crisis is crucial.
