Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

In a patient with recent diabetes diagnosis and medication adherence, which diagnosis is most likely with increased thirst and urine output alongside an elevated A1C?

1. Type 1 diabetes (T1DM)

2. Type 2 diabetes (T2DM)

3. Latent autoimmune diabetes of adults (LADA)

4. Gestational diabetes (GDM)

The correct answer is: Latent autoimmune diabetes of adults (LADA)

The diagnosis most likely indicated by increased thirst, elevated urine output, and an elevated A1C in a patient recently diagnosed with diabetes is indeed the option related to Latent Autoimmune Diabetes in Adults (LADA). LADA presents similarly to Type 2 diabetes but has an autoimmune component that can make it distinct from traditional Type 2 diabetes. Patients with LADA often experience a gradual onset of symptoms, which can lead to increased thirst and urination due to high blood sugar levels—indicating potential hyperglycemia. The elevated A1C further supports the diagnosis by confirming chronically elevated blood glucose levels. Additionally, LADA tends to occur in adults, which differentiates it from the commonly recognized Type 1 diabetes, which usually manifests at a younger age. LADA can sometimes be misclassified as Type 2 diabetes at the outset because it shares many features, including the likelihood of being diagnosed with insulin resistance. In this context, while Type 1 diabetes is characterized by rapid onset and significant insulin deficiency, it is less likely in a case focusing on adult patients with a newer diagnosis. Gestational diabetes typically occurs during pregnancy and resolves after childbirth, and is not applicable here. Finally, while Type 2 diabetes can also present with similar