- Experts
say many adults who develop type 1 diabetes are being misdiagnosed as
having type 2 diabetes.
- They say this is happening in part because many
medical professionals see type 1 diabetes as something that is diagnosed
in childhood.
- They point out that symptoms for both types of
diabetes are similar, but treatment plans are quite different.
Experts say more adults are being misdiagnosed with type 2
diabetes when they actually have type 1 diabetes.
For decades, type 1 diabetes was known as “juvenile
diabetes” and believed to only develop during childhood.
“Misdiagnosis of type 1 diabetes as type 2 diabetes
occurs far too often,” explained Gary Scheiner, MS, CDCES, the owner and
clinical director of Integrated Diabetes Services.
“I believe it is a simple matter of ignorance on the
part of emergency medical personnel who assume that type 1 only develops in
childhood and that overweight individuals must have type 2,” Scheiner told Medical News
Today.
“The facts tell us otherwise. According to recent
research, more than 50 percent of
type 1 diagnoses occur after age 18, and many in middle or older ages. More
than a third of all people with type 1 are overweight or obese,” he added.
If you’ve been diagnosed with type 2 diabetes and you
either don’t fit the typical profile or your blood sugars continue to rise
despite following your treatment plan, you might have been misdiagnosed.
Why the
right diagnosis of diabetes is critical
Officials estimate that
However, experts note that the misdiagnosis of type 2
diabetes instead of type 1 diabetes can lead to an ineffective treatment plan,
leaving a person with months or years of frustrating high blood sugar levels
and an increased risk of diabetes-related complications.
While the symptoms of both types are nearly identical,
the cause behind those symptoms is entirely different and requires a different
prioritization of treatment options.
Type 2 diabetes is a metabolic disorder in which the
body is struggling with increasing insulin resistance due
to a mix of genetics, lifestyle habits, and other factors.
In type 2 diabetes, the pancreas produces extra insulin but cannot keep up with
the demand to maintain normal blood sugar levels. The body has difficulty
effectively using that insulin. Over time, insulin production can also decline
due to
The usual profile of a person with type 2 diabetes
includes being overweight or living with obesity, along with other metabolic
factors such as high cholesterol and high blood pressure.
The treatment plan usually starts with improving
lifestyle habits (nutrition and exercise), then the drug metformin, and possibly
Type 1 diabetes, on the other hand, is an autoimmune
disease. While genetics can play a role,
In type 1 diabetes, the immune system is triggered to
attack and destroy the cells in the pancreas that produce insulin. In children,
type 1 diabetes progresses quickly and the need for daily insulin therapy is
nearly immediate after symptoms are identified.
In many adults, insulin production can decline more
slowly, which could delay the need for insulin therapy by years. When caught in
the earlier stages, type 1 diabetes can look like type 2 diabetes, but it’s
actually “latent autoimmune diabetes in adults,” commonly known as LADA.
Misdiagnosed patients are sometimes put on type 2
medications that seem to help at first — because LADA progresses so slowly —
but blood sugars eventually start to rise more aggressively.
“It is important to establish a correct diagnosis, as
proper treatment hinges on the nature of the condition,” said Scheiner. “Many
people with type 1 who are assumed to have type 2 because of their age or
physical characteristics are treated with non-insulin pharmacologics. In the
least, this shortens or eliminates the ‘honeymoon’ period of type 1 diabetes in
which the pancreas continues to produce some insulin. At worst, it can lead to
excessive hyperglycemia, ketoacidosis, and death.”
Misdiagnosed
with type 2 diabetes in his late 50s
Peter Bongiorno was
shocked when his doctor informed him that his HbA1c was approaching prediabetic
levels at 5.5% when he was in his late 50s.
HbA1c is
a simple blood test that indicates your average blood sugar levels over the
previous three months. A result of 5.7% qualifies for a prediabetes diagnosis.
Already physically active, lean, and passionate about
nutrition, Bongiorno intensified his daily exercise routine and started a
vegetarian diet.
Bongiorno isn’t new to diabetes — his daughter, Lauren
Bongiorno, has lived with type 1 diabetes for 25 years and is the
founder and chief executive officer of Risely Health, a diabetes coaching
company.
However, the Bongiorno family assumed the rest of the
family was safe from developing type 1 simply based on their ages.
“Within the next two years, [my Hb1Ac] went up to 5.7
percent,” Bongiorno told Medical News Today. “This scared me into getting even
more strict with my diet. I went totally vegan and started checking my blood
sugar regularly.”
When his A1c reached 6%, Bongiorno channeled his
frustration into stricter nutrition and more exercise. With a fasting blood
sugar level of 110 mg/dL, his doctor was also perplexed but encouraged him to
focus on his lifestyle habits.
“I lost 20 pounds,” says Bongiorno, who had been
reluctant to try any diabetes medications. “But the next year, my A1c was up to
6.3 percent. I couldn’t believe it. Over the next two years, I saw it climb to
7.1 percent. That’s when I finally agreed to try metformin.”
It wasn’t until his daughter got off a call with a
client at Risely Health who had been misdiagnosed with type 2 diabetes that it
suddenly struck her.
“I was telling my parents about this issue of people
being misdiagnosed and then I just realized this was my father’s story, too,”
Lauren Bongiorno told Medical News Today. Over the next several months, the
Bongiorno family worked with his healthcare team to get tested for the clear
indicators of type 1 diabetes.
Getting
screened for type 1 diabetes
Thanks to decades of
research, identifying type 1 diabetes is relatively simple with a few specific
blood tests.
These tests include:
- Autoantibodies: Autoantibodies
develop when your immune system is attacking your own body. Research from TrialNet and
other organizations have pinpointed specific autoantibodies and can
identify them with blood testing. The presence of two more autoantibodies
suggests a person is in one of the three stages of
developing type 1 diabetes. The earliest stages can develop years before
noticeable symptoms develop.
- C-peptide levels: C-peptide indicates
how much insulin your pancreas is producing. In people with type 2
diabetes, C-peptide levels are generally quite high. In people with type 1
diabetes, C-peptide levels are usually quite low.
Identifying type 1 diabetes before the need for daily
insulin therapy is also critical.
In 2023, the Food and Drug Administration approved the
Clinical trials continue to examine the full potential
of the drug.
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