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Onset of Type 1 Diabetes In Adults: The Need For Correct Diagnosis And Treatment

Type 1 or autoimmune diabetes has for some time been thought of as a disease of childhood and was previously called juvenile diabetes. But the myth that Type 1 diabetes is a childhood disease is a relatively new-on-the-scene myth. In 1934 Dr. Elliot Joslin noted that the incidence of diabetes in lean individuals was relatively constant in each decade of life, but that diabetes in the obese was related to older age. A book published in 1958 (“How to Live with Diabetes” by Henry Dolger, M.D. and Bernard Seeman) that states that “[Type 1] diabetes is almost three times more frequent among young adults than among youngsters.” Since the 1980s the autoimmune nature of Type 1a diabetes has been known, and antibody testing (glutamic acid decarboxylase antibodies (GADA), islet cell antibodies (ICA), and insulinoma-associated (IA-2) autoantibodies) has been the gold standard for the diagnosis of Type 1a diabetes. In numerous scientific studies, approximately 10% of people diagnosed with Type 2 diabetes were found to be antibody positive and in fact had Type 1a diabetes, sometimes called latent autoimmune diabetes in adults (LADA) or Type 1.5. A recent article in the July 2007 issue of “Diabetes Care” indicated that autoimmune gestational diabetes (new onset Type 1 diabetes) accounts for about 10% of all Caucasian women diagnosed with gestational diabetes. However, the medical community has been slow to abandon the myth of Type 1 diabetes as a childhood disease, and Type 1 diabetics diagnosed as adults are still treated as abnormalities and frequently given inappropriate treatment for the disease they have. All too often, they are diagnosed with Type 2 diabetes, which is a fundamentally different disease not only clinically but genetically, and the methods of treatment for the two diseases are also different. The misdiagnosis typically results in undertreatment, and causes needless suffering, the hastening of complications, and sometimes even death. In a recent survey conducted by Australia’s Type 1 Diabetes Network, one third of all Australians with Type 1 diabetes reported being initially misdiagnosed as having the more common Type 2 diabetes. In a recent dLife poll (dlife.com), 13% of respondents said that they initially had been misdiagnosed as having Type 2 diabetes when in fact they have Type 1 diabetes.

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