This review evaluates interventions for latent autoimmune diabetes in adults (LADA). LADA is a slowly progressing type 1 diabetes that initially resembles type 2 diabetes. The review compared various interventions, including sulphonylurea (SU), insulin, and other oral agents, to determine their effectiveness in managing LADA. The review included 15 studies involving 1019 participants, with follow-up periods ranging from three months to 10 years. All studies had a high risk of bias. SU did not significantly improve metabolic control compared to insulin, and SU use was associated with earlier insulin dependence. Insulin was found to maintain stimulated C-peptide levels better than SU. In a five-year follow-up of GAD65, improvements in fasting and stimulated C-peptide levels were maintained. Chinese remedies and vitamin D with insulin showed some benefit in maintaining natural insulin production. However, there was no conclusive evidence that any other treatment was better than insulin. The review found that insulin treatment may be preferable compared to SU treatment for LADA. However, there is little evidence regarding other forms of treatment. Future studies are needed, should have a clear definition of LADA, investigate patient-important outcomes, and use a common method of measuring stimulated C-peptide. The review highlights the need for further research to determine the best treatment for LADA, given the limited evidence and heterogeneity in the studies. The findings suggest that insulin is more effective than SU in managing LADA, but more research is needed to confirm this and to explore other potential treatments.This review evaluates interventions for latent autoimmune diabetes in adults (LADA). LADA is a slowly progressing type 1 diabetes that initially resembles type 2 diabetes. The review compared various interventions, including sulphonylurea (SU), insulin, and other oral agents, to determine their effectiveness in managing LADA. The review included 15 studies involving 1019 participants, with follow-up periods ranging from three months to 10 years. All studies had a high risk of bias. SU did not significantly improve metabolic control compared to insulin, and SU use was associated with earlier insulin dependence. Insulin was found to maintain stimulated C-peptide levels better than SU. In a five-year follow-up of GAD65, improvements in fasting and stimulated C-peptide levels were maintained. Chinese remedies and vitamin D with insulin showed some benefit in maintaining natural insulin production. However, there was no conclusive evidence that any other treatment was better than insulin. The review found that insulin treatment may be preferable compared to SU treatment for LADA. However, there is little evidence regarding other forms of treatment. Future studies are needed, should have a clear definition of LADA, investigate patient-important outcomes, and use a common method of measuring stimulated C-peptide. The review highlights the need for further research to determine the best treatment for LADA, given the limited evidence and heterogeneity in the studies. The findings suggest that insulin is more effective than SU in managing LADA, but more research is needed to confirm this and to explore other potential treatments.