Type 1 diabetes defined by severe insulin deficiency occurs after 30 years of age and is commonly treated as type 2 diabetes
| Autor: | Anita Hill, Timothy J. McDonald, Beverley M. Shields, Angus G. Jones, Michael N. Weedon, Anita L. Lynam, Richard A. Oram, Andrew T. Hattersley, Nicholas J. Thomas |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Adult medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Short Communication 030209 endocrinology & metabolism Disease Type 2 diabetes 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Diabetes mellitus Internal medicine Internal Medicine medicine Humans Insulin Aged Autoantibodies geography Type 1 diabetes geography.geographical_feature_category C-Peptide C-peptide business.industry Autoantibody Middle Aged Islet medicine.disease Classification Genetic risk score 3. Good health 030104 developmental biology Diabetes Mellitus Type 1 chemistry Diabetes Mellitus Type 2 business |
| Zdroj: | Diabetologia |
| ISSN: | 1432-0428 |
| Popis: | Aims/hypothesis Late-onset type 1 diabetes can be difficult to identify. Measurement of endogenous insulin secretion using C-peptide provides a gold standard classification of diabetes type in longstanding diabetes that closely relates to treatment requirements. We aimed to determine the prevalence and characteristics of type 1 diabetes defined by severe endogenous insulin deficiency after age 30 and assess whether these individuals are identified and managed as having type 1 diabetes in clinical practice. Methods We assessed the characteristics of type 1 diabetes defined by rapid insulin requirement (within 3 years of diagnosis) and severe endogenous insulin deficiency (non-fasting C-peptide 600 pmol/l) and 220 participants with severe insulin deficiency who were diagnosed under age 30. Results Twenty-one per cent of participants with insulin-treated diabetes who were diagnosed after age 30 met the study criteria for type 1 diabetes. Of these participants, 38% did not receive insulin at diagnosis, of whom 47% self-reported type 2 diabetes. Rapid insulin requirement was highly predictive of severe endogenous insulin deficiency: 85% required insulin within 1 year of diagnosis, and 47% of all those initially treated without insulin who progressed to insulin treatment within 3 years of diagnosis had severe endogenous insulin deficiency. Participants with late-onset type 1 diabetes defined by development of severe insulin deficiency had similar clinical characteristics to those with young-onset type 1 diabetes. However, those with later onset type 1 diabetes had a modestly lower type 1 diabetes genetic risk score (0.268 vs 0.279; p |
| Databáze: | OpenAIRE |
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