Unmasking Latent Autoimmune Diabetes: A Case That Challenges Type 2 Diabetes

Latent autoimmune diabetes in adults (LADA) is an underrecognized form of autoimmune diabetes that is commonly misdiagnosed as type 2 diabetes mellitus (T2DM) because of its indolent progression and overlapping features with metabolic syndrome. We present a case of a 60-year-old woman with an initial diagnosis of T2DM who persistently had elevated hemoglobin A1c (HbA1c) despite optimal treatment and lifestyle modifications. After subsequent hospitalization and an episode of euglycemic diabetic ketoacidosis (DKA), further evaluation unmasked the diagnosis of LADA. This case emphasizes the need for a high index of suspicion for adults with poor glycemic control or unexplained DKA, as a timely diagnosis can significantly alter management and improve outcomes.