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Why adults are misdiagnosed with type 2 diabetes

by Ginger Vieira
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Experts say adults with type 1 diabetes are being misdiagnosed as having type 2 diabetes. SDI Productions/Getty Images
  • Experts say many adults who develop type 1 diabetes are misdiagnosed as having type 2 diabetes.
  • Researchers say this is partly because many medical professionals consider type 1 diabetes to be diagnosed in childhood.
  • They point out that although the symptoms of both types of diabetes are similar, the treatment plans are completely 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 was thought to only develop in childhood.

“Too often, type 1 diabetes is misdiagnosed as type 2 diabetes,” he explained. Gary ShinerMS, CDCES, Owner and Clinical Director of Integrated Diabetes Services.

“I think it’s just a matter of simple ignorance on the part of emergency medical workers who assume that Type 1 only occurs in childhood and that people who are overweight must have Type 2,” Shiner said. Today’s medical news.

“The facts tell us otherwise. According to recent research, 50% or more Type 1 is diagnosed after the age of 18, often in middle age or older. “Of all people with type 1, more than one in three are overweight or obese,” he added.

If you’ve been diagnosed with type 2 diabetes and don’t fit the typical profile, or if your blood sugar levels keep rising despite following your treatment plan, you may have been misdiagnosed.

Officials speculate that 90%~95% Type 2 diabetes accounts for the most cases of diabetes in the United States.

But experts say misdiagnosing type 2 diabetes instead of type 1 diabetes can lead to ineffective treatment plans, frustrating months or years of hyperglycemic conditions, and increased risk of diabetes-related complications. It is pointed out that the risks may increase.

Although the symptoms of both types are almost the same, the causes behind them are completely different and require a different prioritization of treatment options.

Type 2 diabetes is a disease in which the body suffers from increased metabolic abnormalities. insulin resistance Due to the contamination of genetics, lifestyle, 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 a harder time using its insulin effectively. Over time, insulin production can also decrease for reasons such as: Beta cell dysfunction.

The typical profile of people with type 2 diabetes includes living with overweight or obesity, along with other metabolic factors such as high cholesterol and high blood pressure.

Treatment plans usually begin with lifestyle changes (nutrition and exercise) and then the drug metformin, sometimes given. GLP-1 or SGLT-2 medicine. insulin Injections may also be used.

Type 1 diabetes, on the other hand, is an autoimmune disease. Although genetics may play a role, 85 percent None of the patients with type 1 diabetes had a family history of the disease.

Type 1 diabetes triggers the immune system to attack and destroy the cells in the pancreas that produce insulin. In children, type 1 diabetes progresses rapidly and requires daily insulin therapy as soon as symptoms are identified.

In many adults, insulin production declines more slowly and the need for insulin treatment may be delayed for years. Type 1 diabetes can look like type 2 diabetes when it is discovered in its early stages, but it is actually ‘latent autoimmune diabetes of adults’, commonly known as LADA.

Misdiagnosed patients may be given type 2 drugs, which appear to be effective at first because LADA progresses so slowly, but eventually blood sugar levels begin to rise more violently.

“It is important to establish the correct diagnosis because the appropriate treatment depends on the nature of the condition,” Shiner said. “Many people with Type 1 who are presumed to have Type 2 because of their age and physical characteristics are taking medications other than insulin. At least this allows the pancreas to continue producing some insulin. The diabetes “honeymoon” period is shortened or eliminated. In the worst cases, it can lead to excessive hyperglycemia, ketoacidosis, and death. ”

When Peter Bongiorno was in his late 50s, he was shocked when his doctor told him his HbA1c was approaching pre-diabetic levels of 5.5%.

HbA1c is a simple blood test that shows your average blood sugar levels over the past three months. A result of 5.7% qualifies for a diagnosis of prediabetes.

Already physically active, slim, and passionate about nutrition, Bongiorno stepped up his daily exercise routine and started a vegetarian diet.

Mr. Bongiorno is no stranger to diabetes – his daughter, Lauren Bongiornohas lived with type 1 diabetes for 25 years and is the founder and CEO of diabetes coaching company Risely Health.

But the Bongiorno family didn’t think the rest of their family would be at risk of developing type 1 simply because of their age.

“Within the next two years, [my Hb1Ac] It went up to 5.7 percent,” Bongiorno said. Today’s medical news. “This scared me and made me even more restrictive. I went completely vegan and started checking my blood sugar levels regularly.”

When his A1c hit 6%, Bongiorno channeled his frustration into stricter nutrition and more exercise. His fasting blood sugar level was 110 mg/dL, so the doctor was confused but advised him to be careful about his lifestyle.

“I lost 20 pounds,” said Bongiorno, who was reluctant to try diabetes medication. “But the next year, my A1c rose to 6.3 percent. I couldn’t believe it. Over the next two years, that rate rose to 7.1 percent. That’s when I finally put him on metformin. I agreed to try it.”

It wasn’t until his daughter got off the phone with a Risely Health customer who had been misdiagnosed with type 2 diabetes that it suddenly dawned on him.

“I was talking to my parents about this issue of people being misdiagnosed, and now I realize this is also my father’s story,” Lauren Bongiorno said. Today’s medical news. Over the next few months, the Bongiorno family worked with their medical team to get tested for clear indicators of type 1 diabetes.

Thanks to decades of research, type 1 diabetes is relatively easy to identify with a few specific blood tests.

These tests include:

  • Autoantibodies: Autoantibodies occur when the immune system attacks its own body.research from trial net Organizations such as have pinpointed certain autoantibodies, and blood tests can identify them. Further he suggests that the presence of two autoantibodies suggests that a person has the following conditions: 1 of 3 stages Onset of type 1 diabetes. Early stages can occur years before noticeable symptoms appear.
  • C-peptide level: C-peptide indicates how much insulin your pancreas is producing. People with type 2 diabetes generally have very high C-peptide levels. In people with type 1 diabetes, C-peptide levels are usually very low.

It is also important to identify type 1 diabetes before daily insulin therapy is required.

In 2023, the Food and Drug Administration approved: First treatment in life To delay the full onset of the disease. This means that if an autoantibody test identifies his type 1 diabetes in its early stages, teplizumab (TZield) could delay the need for insulin by several years.

Clinical trials continue to explore the full potential of this drug.

“Although the incidence of proper diagnosis is improving, there are still too many misdiagnoses,” Shiner said. “It is estimated that one in four adult type 1 patients seen at a comprehensive diabetes center are mistakenly thought to have type 2 at the time of diagnosis and receive ineffective treatment. , insulin therapy is absolutely necessary to restore healthy metabolic function and survival.”

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