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July 15, 2003

Daily Care

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Question from Atlanta, Georgia, USA:

My 49 year old brother, who lives in a small town in Colorado, was just diagnosed with LADA, after spending a few weeks in the hospital with diabetes symptoms. We have suspected he has had some kind of diabetes for a few years now because of problems with his feet and serious weight loss, as well as energy loss sometimes before and after meals.

My brother feels that he cannot communicate at all with his doctor who is not a diabetes specialist and has almost no exposure to nor information about LADA diabetes. My brother is very wary of the level of care he is receiving at the hospital and would like to be able to be treated by someone who has considerable knowledge about LADA after he is released from the hospital, which should happen in the next several days.

We would like to find a doctor in the US, preferably in or near Colorado (but this is not of ultimate necessity} who is extremely knowledgeable about LADA. If this doctor is not covered by my brother’s medical insurance (Blue Cross), the rest of our family would pitch in to cover the cost of initial consultation, and if necessary, treatment. If you could please provide me with a list of LADA specialists, ordered first according to expertise and second according to geographical territory, I/we would be extremely grateful.

Answer:

From: DTeam Staff

I don’t think you need a specialist in Late-onset Autoimmune Diabetes of Adulthood (LADA). Once it is determined that he truly needs insulin and cannot be managed with diet and exercise alone, he just needs an endocrinologist experienced in taking care of adults with type 1 diabetes.”LADA” is just a term coined to describe patients who develop pancreatic failure due to autoimmune destruction very slowly so they often are misdiagnosed as people with type 2 diabetes and insulin treatment is delayed.

TGL
Additional comments from Dr. Larry Deeb:

I would think it is easy to find in Denver. Ask folks at the Barbara Davis Center who they would recommend.

LD
Additional comments from Dr. David Schwartz:

My general advice would be to contact the staff of the University of Colorado and the Medical School there to speak with the Department of Endocrinology. They will likely be the most knowledgeable and/or have access to other specialists that might be close to your brother. They may have out-reach clinics closer to his home.

DS
Additional comments from Dr. Donough O’Brien:

LADA is not a very unusual form of diabetes and once the diagnosis is confirmed by one or more positive antibody tests there is nothing very special about its management. At the same time getting used to controlling blood sugar requires, especially in the first weeks, the help not only of a doctor’; but also of a nurse educator, a dietitian, and if possible a Medical Social Worker. I think that what your brother needs to do is to contact the regional American Diabetes Association office and either visit them or see if they will fax a list of ADA members in Colorado. He could then contact those nearest to him and enquire whether they had the support services he might need. The possibilities would be likely to be limited to the bigger towns in the front range.

DOB

[Editor’s comment: I would suggest that your brother also contact the local American Diabetes Association affiliate for recommendations.

SS]