Is it possible for someone to have both type 1 and type 2 diabetes at the same time? I don’t mean an adult with type 2 who eventually needs to inject insulin. I mean autoimmune type 1 and also type 2.

Dividing diabetes into just type 1 and type 2 is a very considerable oversimplification of all the possible underlying causes for this disorder. At the same time, specific differentiation has languished because what is important is to maintain blood sugar levels as near as possible to normal and as simply as possible not to establish the specific type.

For many years, there have been descriptions of individuals who seemed to show characteristics of type 1and type 2. The term ‘hybrid’ diabetes was sometimes used, and, in another group, Maturity Onset Diabetes of the Young (MODY), it was eventually shown that these were young people with a specific genetic abnormality that led to a picture that mostly resembled type 2 diabetes. More recently, there has been a reminder the problem usually arises when the diagnosis is initially made entirely on clinical grounds and without any supporting laboratory investigation. A not uncommon situation for example, is for an adolescent who may be a little overweight to be diagnosed initially with type 2, a class of diabetes that has become increasingly prevalent in the young, whereas later studies show that he/she had positive antibody tests and in reality had type 1A (autoimmune) diabetes. See H. Borg, H. J. Arnqvist, E. Bj�rk, J. Bolinder, J. W. Eriksson, L. Nystr�m, J-O. Jeppsson, and G. Sundkvist Evaluation of the new ADA and WHO criteria for classification of diabetes mellitus in young adult people (15 34 years) in the Diabetes Incidence Study in Sweden (DISS) Diabetologia (2003) 46: 173-181.

DOB