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December 2017

Type 1 diabetes as common in adults as children,but many adults are misdiagnosed



Type 1 diabetes is not predominantly a ‘disease of childhood’ as previously believed, but can also develop in adults, new research published in the Lancet Diabetes & Endocrinology shows.

Research by the University of Exeter Medical School found that adults are as likely to develop type 1 diabetes as children, with more than 40 per cent of type 1 diabetes cases occurring after the age of 30.

Type 1 diabetes accounts for more than 85 per cent of diabetes in under 20s, but only 4% of diabetes that develops between the ages of 31 and 60.

But many of those with type 1 diabetes after the age of 30 are thought to have type 2 diabetes at first, and not initially treated with insulin to control blood glucose levels.

A crucial clue to the possibility of adult–onset type 1 diabetes is the failure of drug therapy to control blood glucose. Adult-onset type 1 patients are also likely to be slim compared to type 2 patients who are usually overweight or obese.

Exeter University’s diabetes research team found that one in nine of adult onset type 1 diabetes patients had been admitted to hospital with diabetic ketoacidosis, a potentially fatal condition that develops when type 1 patients are not adequately treated.

Study author Dr Richard Oram, a senior lecturer at the University of Exeter and consultant physician, said: ‘Our study shows that it is prevalent throughout life. The assumption among many clinicians is that adults presenting with the symptoms of diabetes will have type 2 but this misconception can lead to misdiagnosis with potentially serious consequences. This study should raise awareness that type 1 diabetes occurs throughout adulthood and should be considered as a diagnosis.’

To improve knowledge about correctly diagnosing diabetes the Exeter team is carrying out further research. The StartRIGHT study, funded by NIHR and Diabetes UK, is open to anyone over 18 who has been diagnosed with diabetes in the last year and is now on insulin. Contact the Exeter Clinical Research Facility by emailing crf@exeter.ac.uk or calling 01392 408182.