Background: In order to prevent diabetes it is important to identify common, modifiable
risk factors in the population. Such knowledge is extensive for type 2 diabetes but limited to autoimmune
forms of diabetes.
Objective: This review aims at summarizing the limited literature on potential environmental (lifestyle)
risk factors for LADA.
Method: A PubMed search identified 15 papers estimating the risk of LADA in relation to lifestyle.
These were based on data from two population-based studies; one Swedish case-control study and one
Norwegian cohort study.
Results: Studies published to date indicate that the risk of LADA is associated with factors promoting
insulin resistance and type 2 diabetes such as overweight, physical inactivity, smoking, low birth
weight, sweetened beverage intake and moderate alcohol consumption (protective). Findings also indicate
potential effects on autoimmunity exerted by intake of coffee (harmful) and fatty fish (protective).
This supports the concept of LADA as being a hybrid form of diabetes with an etiology including factors
associated with both insulin resistance and autoimmunity.
Conclusion: LADA may in part be preventable through the same lifestyle modifications as type 2 diabetes
including weight loss, physical activity and smoking cessation. However, current knowledge is
hampered by the small number of studies and the fact that they exclusively are based on Scandinavian
populations. There is a great need for additional studies exploring the role of lifestyle factors in the development
Keywords: LADA, lifestyle, cohort, case-control, latent autoimmune diabetes in adults, risk factors, etiology
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