A third of type 1 diabetes is misdiagnosed in the over 30s

More than a third of people over the age of 30 who are initially diagnosed with type 2 diabetes actually have type 1, meaning they are not receiving the right treatment, new research has revealed | Diabetologia | via ScienceDaily

A new study, led by the University of Exeter, shows that 38% of patients with type 1 diabetes occurring after age 30 were initially treated as type 2 diabetes (without insulin). The researchers found that half of those misdiagnosed were still diagnosed as type 2 diabetes 13 years later.

Full story at ScienceDaily

The research is published in the journal Diabetologia:

Nicholas J. Thomas et al. | Type 1 diabetes defined by severe insulin deficiency occurs after 30 years of age and is commonly treated as type 2 diabetes | Diabetologia, 2019; DOI: 10.1007/s00125-019-4863-8

 

Early age of type 1 diabetes diagnosis linked to greater heart risks and shorter life expectancy, compared to later diagnosis

University of Glasgow | August 2018 | Early age of type 1 diabetes diagnosis linked to greater heart risks and shorter life expectancy, compared to later diagnosis

Researchers at the University of Glasgow have found that early onset for type 1 diabetes is linked to a shorter life expectancy, by an average of 16 years shorter than a patient without diabetes. For those diagnosed with type 1 later in life,  their lifespan is 10 years shorter than people without a diagnosis of diabetes (via University of Glasgow). life-stage-icon-2889015_1280.png

 

The research, which is published in The Lancet, is a longitudinal observational study in Sweden that tracked over 27, 000 people with type 1 for an average of 10 years.

Although it is well established that  patients with type 1 diabetes are at increased risk of health problems and have shorter life expectancies, partly due to premature cardiovascular disease. Until this point the impact of age of diagnosis on this excess mortality and cardiovascular risk was unclear. In order to contribute to the limited evidence base, the researchers calculated the excess risk of all-cause mortality, cardiovascular mortality, acute heart attack, stroke, cardiovascular disease, coronary heart disease, heart failure, and atrial fibrillation in 27,195 individuals from the Swedish National Diabetes Register compared to 135,178 controls matched for age, sex, and county from the general population (average age 29 years).

After adjustment for a range of variables that could have influenced the results  among them but not limited to  age, sex, , diabetes duration, and previous history of cardiovascular complications. The researchers found cardiovascular risks and survival were strongly related to the participant’s age at disease onset, with people diagnosed under the age of 10 having five-fold increased risk of heart attack and coronary heart disease than those diagnosed at age 26-30 years. The younger group also had much higher risk of heart failure and stroke than peers without diabetes and those diagnosed at an older age.

These new estimates suggest that individuals diagnosed before the age of 10 have a 30-times greater risk of serious cardiovascular outcomes like heart attack (0.31 cases per 100,000 person years for participants with diabetes vs 0.02 cases in every 100,000 person-years for controls) and heart disease than those in the general population, whilst risk levels are around six times higher for people diagnosed between ages 26 and 30 (Source: University of Glasgow).

Read the full, unedited news release from the University of Glasgow

 

New resource for patients newly diagnosed with type 1 diabetes

NHS Digital | August 2018 | Type 1 diabetes 

NHS Digital have developed a new interactive resource for patients with type 1 diabetes. The resource is intended to equip people with Type 1 with the knowledge and confidence to manage their diabetes. 

The section on ‘newly diagnosed- things to help’ which includes resources on how to inject insulin, checking blood glucose levels and appointments and check ups as well as useful advice around living with the condition. They are encouraging healthcare  professionals to refer newly diagnosed patients, their parents and carers to the site as a ‘one stop shop’ for Type 1 Diabetes support. 
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NHS Digital Type 1 
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Diabetes diagnosis has doubled since 1998

The incidence of diabetes has doubled in the last twenty years according to figures released by Diabetes UK, the leading UK diabetes charity.   This analysis shows 1.9 million more people living with a diagnosis of the condition in the UK, since 1998.  The number of individuals diagnosed with Type 1 or Type 2 diabetes has increased by almost 100,000 since last year to 3,689,509.   (Diabetes UK)

diabetes uk
Image source: diabetes.org.uk

Nationally, 6.6 per cent of the population live with the condition.  In Bradford, West Yorkshire over 1 in 10 people have diabetes, this is  the highest incidence according to the figures. Richmond, London had the lowest at 3.6 per cent.

Diabetes UK calls on the Government to introduce stricter restrictions on junk food advertising to children and on supermarket promotions of unhealthy foods. Chief Executive Chris Askew said: “We want the Government to recognise the seriousness of the growing diabetes crisis, take action to help those at increased risk, and help us turn the tables on this devastating condition.”

To support this Diabetes UK partners the NHS Diabetes Prevention Programme in England. This programme supports adults who are at high risk of Type 2 diabetes to make lifestyle changes that could reduce their risk.

The full news story can be read at Diabetes UK 

Related:

The Royal College of General Practitioners  Doubling of diabetes cases could reflect better early diagnosis, but is still ‘dramatic and disappointing’, says RCGP

In the media:

The Guardian: Diabetes diagnoses have more than doubled in 20 years, UK analysis suggests

The Pharmaceutical Journal:  Diabetes diagnoses have almost doubled in the last 20 years, says leading UK charity