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Type 1 diabetes misunderstood as “disease of childhood”

Published on 01/12/17 at 09:11am

New research published in The Lancet has revealed that type 1 diabetes cannot be understood as a “disease of the childhood” as 42% of those diagnosed with the condition were found to individuals over 30 years old.

The finding is particularly important because there are many cases of individuals being misdiagnosed as having type 2 diabetes, which can lead to the wrong medication being prescribed. This can cause hospitalisation in those living with type 1 diabetes, as improperly managed insulin levels can result in diabetic ketoacidosis – a potentially life threatening condition.

The reason misdiagnosis is a challenge for doctors is because type 1 diabetes is widely understood to be a disease likely to occur in childhood; the reality is that type 2 diabetes generally only presents itself later in life, whereupon the proportion of diagnosis of diabetes is 96% in favour of type 2.

This often leads to the natural conclusion that adult diagnosis of insulin issues are related to type 2 diabetes; the study found that 4% of all diagnosis of diabetes cases were actually type 1 and displayed clinical characteristics that differed from those with type 2.

During the course of the study, those with type 1 diabetes were more likely to have a lower BMI and were more likely to have experienced diabetic ketoacidosis.

Type 1 diabetes occurs in individuals due to the pancreas not producing sufficient levels of insulin, which is assumed to be caused by genetic and environmental risk factors.

By comparison, type 2 diabetes is more often diagnosed due to lifestyle factors, in combination with genetics factors and results in a resistance to insulin produced by the body, alongside lower levels produced.

The study concluded: “use of a novel genetic approach to define type 1 diabetes has shown that it presents across the first six decades of life and should not be considered a disease of children and young adults. Whatever age it presents, type 1 diabetes is associated with rapid requirement for insulin and risk of ketoacidosis, suggesting that it is not a milder phenotype if diagnosed later in life. A key area for both clinical practice and research in the future is to improve recognition of late-onset type 1 diabetes.”

Ben Hargreaves

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