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t1d or t2d

More Adults May have Type 1 Diabetes Than Previously Thought

Type 1 diabetes (T1D) used to be known as juvenile diabetes because it is often first diagnosed during childhood. Since the pancreas produces little to no insulin, difficulty regulating blood sugar is typically noticed early on. However, that is not always the case. There are also many individuals who are not diagnosed with T1D until after age 30. In addition, they may be mistakenly identified as having type 2 diabetes rather than type 1.

A recent study compared data from the UK Biobank and also conducted clinical trials to determine how adults are diagnosed and treated when diabetes is suspected. Many people were initially diagnosed with type 2 diabetes and did not receive insulin treatment. They used an oral glucose-lowering medication in order to manage their blood sugar. But even when using rapid acting insulin, some still had difficulty with blood sugar control.

Approximately 5 percent of adults diagnosed with T2D actually have T1D. While this may not seem significant, proper diagnosis is critical to providing accurate treatment and education for patients. In addition, insurance may not cover the cost of supplies for those with T2D, but insulin pumps and continuous glucose monitors may be covered for those with T1D. This can make a major difference in care for many people.

The study involved nearly 600 adults from South West England who were diagnosed with diabetes after age 30 between 2007 and 2017. Results showed that 123 participants (21 percent) had type 1 diabetes with severe insulin deficiency requiring continuous insulin treatment within three years of diagnosis. There were 306 participants diagnosed with type 2 diabetes based on a peptide level of 600 pmol/L or greater for at least three years after initial diagnosis. Another 115 participants were not included in the analysis due to indeterminate results. The study also included 220 participants who had been diagnosed with T1D at age 30 or younger for comparison purposes.

While symptoms are often similar, the study found that “rapid insulin requirement was highly predictive of late-onset type 1 diabetes, with 84 percent requiring insulin within 1 year. And of all the patients treated with insulin within 3 years, 57 percent developed sever endogenous insulin deficiency consistent with type 1 diabetes.” Compared to participants with T2D, those with T1D typically had a lower BMI, were more likely to have a positive islet autoantibody test, and had higher genetic risk scores for T1D.

It can be difficult to differentiate between the two types of diabetes, but medical providers should carefully monitor those they believe may have T1D and conduct related tests to determine whether they should be treated initially using insulin as opposed to an oral medication.

The study was presented at the European Association for the Study of Diabetes (EASD) 2018 Annual Meeting by Nicholas J. Thomas, MD, from the University of Exeter, United Kingdom. Dr. Thomas’ team is working on developing algorithms to improve the accuracy of diabetes diagnoses in order to provide the best care for patients.

Accurate diagnosis of type 1 or type 2 diabetes is essential for effective care and patient education. The Diabetes Research Connection supports research related to T1D and advancing understanding related to the diagnosis, treatment, and prevention of this disease. Early career scientists are provided with up to $70,000 in funding to conduct peer-reviewed, novel research studies. Learn more and find a project to support by visiting http://diabetesresearchconnection.org.

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Role of the integrated stress response in type 1 diabetes pathogenesis
In individuals with type 1 diabetes (T1D), the insulin-producing beta cells are spontaneously destroyed by their own immune system. The trigger that provokes the immune system to destroy the beta cells is unknown. However, accumulating evidence suggest that signals are perhaps first sent out by the stressed beta cells that eventually attracts the immune cells. Stressed cells adapt different stress mitigation systems as an adaptive response. However, when these adaptive responses go awry, it results in cell death. One of the stress response mechanisms, namely the integrated stress response (ISR) is activated under a variety of stressful stimuli to promote cell survival. However, when ISR is chronically activated, it can be damaging to the cells and can lead to cell death. The role of the ISR in the context of T1D is unknown. Therefore, in this DRC funded study, we propose to study the ISR in the beta cells to determine its role in propagating T1D.
Wearable Skin Fluorescence Imaging Patch for the Detection of Blood Glucose Level on an Engineered Skin Platform
A Potential Second Cure for T1D by Re-Educating the Patient’s Immune System
L Ferreira
Validating the Hypothesis to Cure T1D by Eliminating the Rejection of Cells From Another Person by Farming Beta Cells From a Patient’s Own Stem Cells
Han Zhu
Taming a Particularly Lethal Category of Cells May Reduce/Eliminate the Onset of T1D
JRDwyer 2022 Lab 1
Can the Inhibition of One Specific Body Gene Prevent Type 1 Diabetes?
Is Cholesterol Exacerbating T1D by Reducing the Functionality and Regeneration Ability of Residual Beta Cells?
Regeneration Ability of Residual Beta Cells
A Call to Question… Is T1D Caused by Dysfunctionality of Two Pancreatic Cells (β and α)?
Xin Tong
Novel therapy initiative with potential path to preventing T1D by targeting TWO components of T1D development (autoimmune response and beta-cell survival)
flavia pecanha