Type 1 diabetes often misdiagnosed in adults

October 10, 2018 by Serena Gordon, Healthday Reporter

British Prime Minister Theresa May
(HealthDay)—It's not always easy—even for doctors—to tell if someone has type 1 or type 2 diabetes when they're diagnosed as an adult.

And a new study finds mistakes are common.

That's what happened to British Prime Minister Theresa May when she was diagnosed with type 2 in 2012. She was in her 50s at the time. Despite having all of the symptoms common to type 1 diabetes, including rapid weight loss, her doctor initially said she had type 2 diabetes.

After the prescribed medications didn't help, May's doctor ran more tests and realized she had type 1 diabetes. Her daily regimen was quickly changed from oral medications to injections of the .

"My very first reaction was that it's impossible because at my age you don't get it," May told Diabetes U.K. "But then my reaction was: 'Oh no, I'm going to have to inject' and thinking about what that would mean in practical terms."

So, how do doctors mix up the two conditions?

It's really hard to tell the difference in adults, study author Dr. Nick Thomas said.

"In childhood, almost all diabetes is as a result of type 1 diabetes. After 30 years of age [there's] a dramatic increase in type 2 diabetes, and type 1 represents less than 5 percent of all cases of diabetes, so trying to identify cases is like finding a needle in a haystack," Thomas said. He's a clinical academic fellow at the University of Exeter in England.

There's also a common misconception that type 1 diabetes can only occur in children. But that's not the case.

"Type 1 diabetes can occur at any age. Doctors need to be alert to the possibility of type 1 diabetes in situations where patients rapidly fail oral therapies," Thomas added.

Type 1 diabetes is an autoimmune disease that leads the immune system to attack the insulin-producing cells in the pancreas, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Insulin plays a key role in metabolism by ushering sugars into the body's cells to be used as fuel.

But the autoimmune attack leaves people unable to produce enough insulin. Without —using shots or an —type 1 diabetics couldn't survive.

The exact cause of type 2 diabetes is still unknown, but excess weight and genetics are known to play a role, NIDDK says.

People with type 2 diabetes don't use insulin properly. This makes the body produce more and more insulin. Eventually, the pancreas is unable to keep up, and people with type 2 may need insulin injections. However, type 2 can often be managed with lifestyle changes and oral medications.

The current study looked at almost 600 people diagnosed with diabetes after age 30 who needed to take insulin. They were diagnosed between 2007 and 2017. The researchers also looked at a group of 220 people diagnosed before 30.

Twenty-one percent of those diagnosed after age 30 were found to have severe insulin deficiency, which researchers said confirmed a diagnosis of type 1. In this group, nearly 40 percent weren't given when they were first diagnosed. Almost half of the type 1 group said they had type 2 diabetes.

"Managing type 1 diabetes as type 2 diabetes can result in rapid deterioration of a patient's health and development of a potentially life-threatening condition called diabetic ketoacidosis," Thomas said.

Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center in New York City, wasn't surprised that some people were being diagnosed incorrectly.

"Years ago, we used to see type 1 only in the young, and now we're starting to see younger people with type 2. And type 1s are heavier than they used to be," he said.

Plus, "diabetes classification is very generic, and not very good. Even a good endocrinologist can miss a diagnosis," Zonszein said.

The number of incorrect diagnoses in the British study surprised him, however.

"They found 20 percent, and I thought it would be around 10 percent," Zonszein said, adding that it could have something to do with the population differences between the United Kingdom and the United States.

The study was presented last week at a meeting of the European Association for the Study of Diabetes, in Berlin, Germany. Studies presented at meetings are usually considered preliminary until published in a peer-reviewed journal.

Explore further: Study reveals the current rates of diagnosed type 1 and type 2 diabetes in American adults

More information: Nick Thomas, Bachelor of Medicine, clinical academic fellow, University of Exeter, England; Joel Zonszein, M.D., director, clinical diabetes center, Montefiore Medical Center, New York City; European Association for the Study of Diabetes meeting, Berlin, Germany, Oct. 5, 2018


Learn more about the different types of diabetes from the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

Related Stories

Study reveals the current rates of diagnosed type 1 and type 2 diabetes in American adults

September 18, 2018
A new study from the University of Iowa finds that type 2 diabetes remains overwhelmingly the most common type of diabetes diagnosed in American adults who have the disease.

Exercise could delay progression of type 1 diabetes when first diagnosed

September 5, 2018
The findings of a study led by the University of Birmingham suggests that exercise during the first few months of diagnosis of type 1 diabetes could delay the progression of the condition.

WHO issues recommendations for Tx intensification in T2DM

September 5, 2018
(HealthDay)—Recommendations have been developed by the World Health Organization for treatment intensification in type 2 diabetes. The recommendations were published online Sept. 4 in the Annals of Internal Medicine.

Insulin pumps associated with lower risk of serious complications among young patients with type 1 diabetes

October 10, 2017
Compared with insulin injections, insulin pump therapy among young patients with type 1 diabetes was associated with a lower risk of diabetic ketoacidosis and severe hypoglycemia, according to a study published by JAMA.

Artificial pancreas helps hospitalized type 2 diabetics

June 26, 2018
(HealthDay)—Using an artificial pancreas can help hospitalized patients with type 2 diabetes maintain good blood sugar control, a new study suggests.

New hope from the 'seven year switch' in type 1 diabetes

June 8, 2018
New research has shown that the rapid decline in insulin production that causes Type 1 diabetes continues to fall over seven years and then stabilises.

Recommended for you

Does diabetes damage brain health?

December 14, 2018
(HealthDay)—Diabetes has been tied to a number of complications such as kidney disease, but new research has found that older people with type 2 diabetes can also have more difficulties with thinking and memory.

Researchers study abnormal blood glucose levels of discharged patients

December 14, 2018
University of Minnesota Medical School researchers decided to delve into an area where little data currently exists. They wanted to know what happens after these patients with abnormal blood glucose measurements are discharged? ...

Researchers zero in on potential therapeutic target for diabetes, associated diseases

December 14, 2018
A recent study led by researchers in Texas A&M University's department of nutrition and food science shows how a novel regulatory mechanism serves as an important biomarker for the development of diabetes, as well as a potential ...

Researchers have found that incidence of heart failure was around two-fold higher in people with diabetes

December 11, 2018
Researchers have found that incidence of heart failure was around two-fold higher in people with diabetes.

Millions of low-risk people with diabetes may be testing their blood sugar too often

December 10, 2018
For people with Type 2 diabetes, the task of testing their blood sugar with a fingertip prick and a drop of blood on a special strip of paper becomes part of everyday life.

Very low calorie diets trialled by NHS to tackle diabetes

December 7, 2018
Hundreds of thousands of people will receive NHS help to battle obesity and type 2 diabetes under radical action set out by Simon Stevens, Chief Executive of NHS England.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.