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It is not always easy, even for doctors, to tell if a person has type 1 or type 2 diabetes when diagnosed in adulthood.
And a new study finds that mistakes are common.
& # 39; Oh no, I will have to inject & # 39;
That's what happened to British Prime Minister Theresa May when she was diagnosed with type 2 diabetes in 2012. She was then in her fifties. Despite all the common symptoms of type 1 diabetes, including rapid weight loss, her doctor first announced that she was suffering from type 2 diabetes.
After the prescribed medications did not help, May's doctor pbaded more tests and realized that she was suffering from type 1 diabetes. Her daily treatment quickly went away. of oral medications to insulin hormone injections.
"My very first reaction was that it was impossible because at my age, you do not get it," May told Diabetes UK. "But then my reaction was," Oh no, I'll have to give injections "and think about what it would mean in practical terms."
So, how do the doctors mix the two conditions?
It's very hard to tell the difference in adults, said Dr. Nick Thomas, author of the study.
"In childhood, almost all diabetes is due to type 1 diabetes. After 30 years [there’s] a dramatic increase in type 2 diabetes, and type 1 accounts for less than 5% of all diabetes cases, so trying to identify cases amounts to finding a needle in a haystack, "Thomas said. In England.
There is also a common misconception that type 1 diabetes can only occur in children. But this is not the case.
Insulin plays a key role in metabolism
"Type 1 diabetes can occur at any age.Ministers should be alert to the possibility of type 1 diabetes in situations where patients quickly fail oral treatments," added Thomas.
Type 1 diabetes is an autoimmune disease that causes the immune system to attack insulin-producing cells in the pancreas, according to the US National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Insulin plays a key role in metabolism by introducing sugars into the body's cells for them to be used as fuel.
But the autoimmune attack leaves people unable to produce enough insulin. Without insulin injections – using injections or an insulin pump – type 1 diabetics could not survive.
The exact cause of type 2 diabetes is still unknown, but overweight and genetics play a role, explains NIDDK.
People with type 2 diabetes do not use insulin properly. This forces the body to produce more and more insulin. Eventually, the pancreas is unable to follow and people with type 2 may need insulin injections. However, type 2 can often be managed with lifestyle changes and oral medications.
The present study is about 600 people diagnosed with diabetes after 30 years and having to take insulin. They were diagnosed between 2007 and 2017. The researchers also examined a group of 220 people diagnosed before age 30.
Twenty-one percent of people diagnosed after the age of 30 had severe insulin deficiency, which according to the researchers confirmed the diagnosis of type 1. In this group, almost 40% did not receive insulin at first diagnosis. Nearly half of the Type 1 group reported type 2 diabetes.
Clbadification of very generic diabetes
"Managing type 1 diabetes as type 2 diabetes can result in a rapid deterioration of the patient's health and the development of a life-threatening illness called diabetic ketoacidosis," Thomas said.
Dr. Joel Zonszein, director of the diabetes treatment center at the Montefiore Medical Center in New York, was not surprised that some people were misdiagnosed.
"Years ago, we only saw type 1 in young people and now we are starting to see younger people with type 2. And types 1 are heavier than they were. ", did he declare.
In addition, "the clbadification of diabetes is very generic and not very good, even a good endocrinologist can miss a diagnosis," said Zonszein.
The number of incorrect diagnoses in the British study, however, surprised him.
"They found 20%, and I thought it would be around 10%," said Zonszein, adding that this could be related to 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 generally considered preliminary until they are published in a peer-reviewed journal.
Image credit: iStock
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