Mistaken for type 2 diabetes, but it's not: The diabetes type that's often misdiagnosed and is difficult to reverse

India has a diabetes problem that's well documented.

According to the International Diabetes Federation's Diabetes Atlas 11th Edition, as of 2024, an estimated 89.8 million adults in India are living with diabetes, making the country second only to China in absolute numbers.

And projections make for uncomfortable reading, that figure is expected to rise to 156.7 million by 2050.

But buried inside these numbers is a quieter, more stubborn problem that most people and many doctors aren't even aware of.

It's called Type 1.5 diabetes, also known as Latent Autoimmune Diabetes in Adults, or LADA.

The reason it gets missed is almost built into the condition itself.

Type 1.5 diabetes doesn't have a dramatic onset of classic Type 1.

It doesn't fit the familiar profile of Type 2 either.

Instead, it sits between the two, borrowing characteristics from both, and in doing so manages to look exactly like Type 2 on the surface.What's actually happening inside the bodyAt its core, Type 1.5 diabetes is an autoimmune disease.

The body turns on itself. "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 it takes so long to catchLADA is an autoimmune disease that begins in adulthood and does not require insulin for glycemic control at least in the first six months after diagnosis, which is precisely why it's so often mistaken for Type 2.

The condition typically appears after the age of 30 and worsens slowly over years.

A review published in the Cleveland Clinic Journal of Medicine in December 2025 described LADA as a slowly progressive form of autoimmune diabetes that often leads to misdiagnosis and a delay in starting needed insulin therapy, emphasising the importance of testing for antibodies early in patients who have atypical features of Type 2 diabetes.

The symptoms themselves don't help distinguish it early on.

Dr.

Ramesh Goyal says they tend to develop gradually and include slow, unexplained weight loss, excessive thirst and increased hunger, frequent urination, increased susceptibility to infections, delayed wound healing, blurring of vision, and tingling or numbness in the limbs.

None of these are exclusive to Type 1.5.

All of them can look like poorly controlled Type 2.

And so the misdiagnosis continues. “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- preventive health at Apollo Hospitals.The scale of the problem in India“According to experts, it is estimated that nearly 5–12 per cent of all people living with diabetes in India may have Type 1.5 diabetes,” says Dr.

Goyal.

Given that the country has millions of diagnosed diabetics, that's a potentially enormous number of people being treated for the wrong condition.

Adding to this, Dr Shree Vidya says, “among Indians the data is sparse and differs, but it affects roughly 4-8% of people who are diagnosed as type 2 diabetes are seen to be LADA.” And the true burden, as Dr.

Goyal and other specialists point out, could be higher still, because widespread misclassification and lack of awareness at all levels of the healthcare system mean the condition simply isn't being looked for."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 issue might matter more than anyone realises.