June 19, 2002
Diagnosis and Symptoms
Question from Austin, Texas, USA:
In light of seeing more and more people diagnosed with type 1 diabetes later in life, I was wondering if perhaps I am seeing more people diagnosed with type 1 simply because antibody testing becoming more common when diagnosing adults to distinguish what type they have. I myself was diagnosed with type 1 at 20, and my doctor had herself convinced I had type 2 because I was an “adult”. My doctor looked at me like I was insane when I asked about antibody testing, so of course I found another doctor who would test me.
I wonder if maybe even 10 years ago all of these people would have been labeled type 2 simply because they were adults, not because of what type they actually had, similar to how I was. In contrast, I wonder if the rise of type 2 in children is also similar, (i.e. since it is now possible to tell the difference), maybe there were just as many 5 or 10 years ago, but the doctors just couldn’t tell the difference as easily. What are your thoughts on this?
Answer:
Using antibody testing, we can certainly classify type 1 and type 2 diabetes more often. The tests are sometimes not so helpful and clinical characteristics are also very useful.
There is a real increase in both type 1 and type 2 diabetes by any definition used. This occurs all over the world, in rich countries and in poor countries when consistent criteria are utilized and good epidemiological techniques used.
We have always known about “older” people with type 1 diabetes, so the names juvenile onset and adult onset were discarded about two decades ago. First in favor of “insulin dependent” and “noninsulin dependent” and now type 1 (usually presumed autoimmune) and type 2 diabetes. There are some other types that have separate categories as well — post trauma, related to cystic fibrosis or other pancreatic damage, such as malnutrition/calcific pancreatitis, etc.
SB
