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Type 1 or Type 2? Diabetes Care Depends on the Right Diagnosis

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By    |   Monday, 29 Jan 2018 03:22 PM

British Prime Minister Theresa May was diagnosed with diabetes, but as is often the case with adults, she was told she had Type 2 diabetes, when she actually had Type 1.

The treatment for many adults with Type 2 is medication, like Metformin, and diet and exercise. But this regimen does not work for Type 1 diabetics. In fact, May didn’t see any improvement, which may have clued doctors into the misdiagnosis, and her treatment was changed.

Registered diabetes educator Nancy Salem of the Western Connecticut Health Network says that the recognition of Type 1 diabetes as an auto-immune disorder means that we have to understand that it can happen anytime in a person’s life.

“What we call latent auto-immune disease of adulthood can present gradually,” she tells Newsmax Health. “But we can test for antibodies of type 1 to help with a diagnosis.”

The American Diabetes Association notes there are specific criteria for diagnosing the disease, including a fasting blood sugar over 126, and having a hemoglobin A1c reading over of 6.5 or higher. Individuals with an A1c between 5.7 and 6.4 are considered prediabetic.

“We are trying to diagnose prediabetes,” Salem explains. “We can see people whose immune system is attacking the beta cells of the pancreas. The only way to know for sure whether it’s Type 1 or 2 is to check for antibodies.”

You can’t tell which kind of diabetes it is just through the symptoms, Salem notes. “If it comes on all at once with very high blood sugar, it may indicate Type 1, but not everyone has classic symptoms.”

The classic symptoms of diabetes include excessive thirst, increased urination, fatigue and weight loss. If someone is overweight and inactive, then a doctor may assume it’s Type 2. If a patient is very thin, the assumption might be Type 1.

“A primary care doctor may not think to test for antibodies,” Salem adds, “but if there is any uncertainty, then an endocrinologist will do this.”

Typically, children get Type I diabetes, which means that the pancreas is not making any insulin. In these cases injections of insulin are necessary. But over the past few years there has been a shift with more adults getting Type 1, and more children getting Type 2.

According to the American Diabetes Association, it doesn’t matter whether you are an adult or child. You can get either type of diabetes and knowing which type is critical to successful treatment.

A British study done at the University of Exeter, published in Lancet Diabetes and Endocrinology, showed that 40 percent of Type 1 diabetes cases occurred after age 30. This contradicts the common assumption that Type 1 diabetes is a disease of childhood.

When a person develops Type 1 diabetes, immune cells destroy the body’s insulin, necessitating injections. Insulin allows the body to get glucose from the bloodstream into the cells of the body. In the case of Type 2, the body continues to produce insulin, allowing successful treatment with medication, diet and exercise. One clue to a proper diagnosis is when medications (not insulin injections) fail to control blood sugar.

In Type 2, the body doesn’t use insulin properly, or develops insulin resistance. The pancreas may keep up for a while, but eventually high blood sugar signals a point where treatment is needed. The confusing diagnosis comes, in part, because it has usually been trim, younger people who develop Type 1. Older people have predictably developed Type 2, along with obesity.

Adding to the confusion is the fact that more younger people are developing Type 2, partly because of increasing rates of obesity and poor diet. Type 2 diabetes doesn’t just happen to older adults.

If you are diagnosed with diabetes, several clues can help you and your doctor decide if it is Type 1 or 2:

Medications other than insulin do not have any impact on Type 1 diabetes.

Type 1 is genetic and can’t be prevented; immune cells destroy the body’s insulin producing beta cells.

If diet and exercise reduce symptoms and blood sugar numbers, the odds are better that you have Type 2.

People who have been misdiagnosed with Type 2, rather than Type 1, may go for more than a year without getting the proper treatment.

© 2018 NewsmaxHealth. All rights reserved.

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British Prime Minister Theresa May was diagnosed with diabetes, but as is often the case with adults, she was told she had Type 2 diabetes, when she actually had Type 1. An incorrect diagnosis can lead to poor treatment, experts note.
diabetes, type, 1, 2
Monday, 29 Jan 2018 03:22 PM
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