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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.
'Oh no, I'm going to have to inject'
That's what happened to British Prime Minister Theresa May when she was diagnosed with type 2 diabetes in 2012. She was in her 50s at the time. Despite having all of the symptoms of diabetes, including rapid weight loss, her doctor was diagnosed with diabetes.
After the prescriptive medications did not help, Her daily regimen was quickly changed from oral medications to insulin 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'm going to have to inject' and thinking about what would mean in practical terms."
So, how do doctors mix up the two conditions?
It's really hard to tell the difference, Dr. Nick Thomas said.
"In childhood, almost all diabetes is 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% of all cases of diabetes, so he said he was a clinical academic fellow at the University of Exeter in England.
There is also a misconception that this type of diabetes can only occur in children. But that's not the case.
Insulin plays a key role in metabolism
"Type 1 diabetes can occur at any age." Doctors need to be alert to the possibility of diabetes in situations where patients rapidly fail oral therapies, "added Thomas.
Type 1 diabetes is an autoimmune disease that leads to the immune system producing insulin-producing cells in the pancreas, according to the US National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Insulin plays a 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 insulin injections – using shots or an insulin pump – type 1 diabetics could not survive.
The exact cause of type 2 diabetes is still unknown, but NIDDK says.
People with type 2 diabetes do not use insulin properly. This makes the body 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 were found to have severe insulin deficiency, which in this group were nearly identical. Almost half of the type 1 group said they had type 2 diabetes.
Diabetes classification very generic
"Managing type 1 diabetes as diabetes can result in the 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, was not surprised that some people were incorrectly diagnosed.
"Years ago, we used to see you guys, and we're starting to see younger people with type 2. And they're heavier than they used to be," he said.
More, "Even a good endocrinologist can be diagnosed," Zonszein said.
The number of incorrect diagnoses in the British study.
"They found 20%, and I thought it would be around 10%," Zonszein said, adding that it could have something to do with the 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 first published in a peer-reviewed journal.
Image credit: iStock
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