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Can Older Adults Get Type 1 Diabetes?

Type 1 Diabetes

Type 1 Diabetes

Type 1 diabetes is much less common than type 2 diabetes and typically affects younger individuals. Type 1 diabetes usually begins before age 40, although there have been people diagnosed at an older age. In the United States, the peak age at diagnosis is around 14. Type 1 diabetes is associated with deficiency (or lack) of insulin. It is not known why, but the pancreatic islet cells quit producing insulin in the quantities needed to maintain a normal blood glucose level. Without sufficient insulin, the blood glucose rises to levels which can cause some of the common symptoms of hyperglycemia. These individuals seek medical help when these symptoms arise, but they often will experience weight loss developing over several days associated with the onset of their diabetes. The onset of these first symptoms may be fairly abrupt or more gradual. To learn more about type 1 diabetes basics, see our type 1 diabetes slideshow. It has been estimated that the yearly incidence of type 1 diabetes developing is 3.7 to 20 per 100,000. More than 700,000 Americans have this type of diabetes. This is about 10% of all Americans diagnosed with diabetes; the other 90% have type 2 diabetes. What You Need to Know about Type 1 Diabetes Type 1 Diabetes Causes Type 1 diabetes usually develops due to an autoimmune disorder. This is when the body's immune system behaves inappropriately and starts seeing one of its own tissues as foreign. In the case of type 1 diabetes, the islet cells of the pancreas that produce insulin are seen as the "enemy" by mistake. The body then creates antibodies to fight the "foreign" tissue and destroys the islet cells' ability to produce insulin. The lack of sufficient insulin thereby results in diabetes. It is unknown why this autoimmune diabetes develops. Most often Continue reading >>

Late Onset Type 1 Diabetes

Late Onset Type 1 Diabetes

BMJ 2012; 344 doi: (Published 30 April 2012) Cite this as: BMJ 2012;344:e2827 Daniel Lasserson, senior clinical researcher 1 , Andrew Farmer, professor of general practice 1 1University of Oxford, Department of Primary Care Health Sciences, Oxford OX1 2ET, UK Correspondence to: D Lasserson daniel.lasserson{at}phc.ox.ac.uk A 41 year old man from an Indian family whose father had type 2 diabetes presented to his general practitioner with a four week history of increasing thirst and polyuria. He had not noticed any weight loss. Blood tests were arranged to confirm the diagnosis of diabetes. One week later, after having to push his car home, he began to feel exhausted and developed intermittent vomiting, which he attributed to exertion. Over the next two days he became more unwell, and the out of hours primary care service was contacted. He was reviewed urgently and admitted with diabetic ketoacidosis. A spectrum of autoimmune diabetes presents in adulthood, with type 1 diabetes characterised by the requirement of insulin at diagnosis to control glycaemia and prevent ketogenesis. Latent autoimmune diabetes of adulthood (LADA) also occurs but with much slower progression to requiring insulin after initial diagnosis. How common is late onset type 1 diabetes? In the 3050 year age group, type 1 diabetes accounts for 13% of all new cases of diabetes 1 Annual incidence is 15/100 000 in the 1534 year age group, increasing by 2.8% annually, 2 and is 7/100 000 in the 3050 age group 1 Similar rates of ketoacidosis are seen in patients with type 1 diabetes at diagnosis in adulthood and childhood, 3 and diagnostic delay is thought to account for many presentations with ketoacidosis in children. 4 Although the classic symptoms produced by hyperglycaemia are unlikely to be missed, there Continue reading >>

Latent Autoimmune Diabetes Of Adults

Latent Autoimmune Diabetes Of Adults

Latent autoimmune diabetes of adults (LADA) is a form of diabetes mellitus type 1 that occurs in adulthood, often with a slower course of onset than type 1 diabetes diagnosed in juveniles.[3] Adults with LADA may initially be diagnosed incorrectly as having type 2 diabetes based on their age, particularly if they have risk factors for type 2 diabetes such as a strong family history or obesity. The diagnosis is typically based on the finding of hyperglycemia together with the clinical impression that islet failure rather than insulin resistance is the main cause; detection of a low C-peptide and raised antibodies against the islets of Langerhans support the diagnosis. It can only be treated with the usual oral treatments for type 2 diabetes for a certain period of time,[4][5] after which insulin treatment is usually necessary, as well as long-term monitoring for complications. The concept of LADA was first introduced in 1993,[6] though The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus does not recognize the term, instead including it under the standard definition of diabetes mellitus type 1.[7] Signs and symptoms[edit] The symptoms of latent autoimmune diabetes of adults are similar to those of other forms of diabetes: polydipsia (excessive thirst and drinking), polyuria (excessive urination), and often blurred vision.[8] Compared to juvenile type 1 diabetes, the symptoms develop comparatively slowly, over a period of at least six months.[9] Diagnosis[edit] It is estimated that more than 50% of persons diagnosed as having non-obesity-related type 2 diabetes may actually have LADA. Glutamic acid decarboxylase autoantibody (GADA), islet cell autoantibody (ICA), insulinoma-associated (IA-2) autoantibody, and zinc transporter autoantibody (ZnT8) t Continue reading >>

Understanding Adult-onset Type 1 Diabetes

Understanding Adult-onset Type 1 Diabetes

When then 34-year-old Rebecca Gill was pregnant with her second child in 2004, high blood sugar levels led to a diagnosis of gestational diabetes, an often-temporary form of diabetes that can occur in pregnant women. After Gill’s son was born, her blood sugar levels returned to normal, and her doctors assumed that the diabetes was gone. But another blood test given several weeks after she gave birth showed that her diabetes problems had returned. She was referred to an endocrinologist who ran tests and eventually diagnosed her with latent autoimmune diabetes in adults, or LADA. “Thankfully, I was one of the lucky ones whose endocrinologist had experience with LADA,” says Gill, an internet marketing consultant in Commerce, Mich. LADA, also known as type 1.5 diabetes or double diabetes, is a form of diabetes in which an adult’s immune system destroys beta cells in the pancreas, cells that produce insulin. Insulin is a hormone that converts the body’s blood sugar to energy. Without enough insulin, blood sugar levels can become too high, resulting in nerve damage, blindness, and other problems if untreated. LADA is similar to type 1 diabetes in that both forms are caused by the immune system mistakenly attacking beta cells. However, most diabetics with LADA are diagnosed after age 30, while the most common form of type 1 diabetes usually develops in children or adolescents. LADA: A Different Diabetes Because LADA appears in adulthood, it may be initially mistaken for type 2 diabetes, but it is different. People who have LADA are often initially misdiagnosed with type 2 diabetes, says Priscilla Hollander, MD, PhD, an endocrinologist at Baylor University Medical Center in Dallas. “Many people with LADA present symptoms a little like type 2s,” Dr. Hollander expla Continue reading >>

Age Of Your Type 1 Diagnosis

Age Of Your Type 1 Diagnosis

Back when I was diagnosed in 1970 at the age of 8, it was so simple. If you were a child, you had type 1, if you were an older adult, you had type 2. There wasn't any discussion about right or wrong diagnosis or what treatment you needed. My question is, what happened? I noticed when I was on MyGlu that the average age for type 1 diagnosis was 19 and 38% of type 1's are diagnosed as adults. Is it really due to the fact that we are not as physically active as we use to be? Is it because we don't eat as well as before? Is it because we are just staying older longer and things catch up with us?i read all of our stories and mine feels like it is not the norm. I read these stories and feel.horrible for how many are misdiagnosed and why this is still happening? I read all your stories and think, wow it was pretty darn clear when we got my diagnosis, drinking, peeling, weight loss, sleepiness and of course coma kinda finished it off. But wow, some of you have gone through hell and back trying to get an answer. So why do you think there has been such an increase in adult's getting the type 1 diagnosis? This is not my dark thinking here, but could this be that survival of the fittest? Are we going to survive this epidemic? Or will this be ours doing? I know this sounds like gloom but I really don't understand why and how we have had such a huge shift. And I remember back in 1970, I knew no one in any of my schools with diabetes. There just wasn't a lot of us around. Now, I'm sorry to say, we are everywhere. Am I crazy? Just wondering? And finally there is a retreat forums adult type 1's TCOYD in San Diego in June! I was diagnosed as Type 2 at age 40, and two months later (at age 41) re-diagnosed as Type 1 based on antibody tests. I didn't eat or "sit" my way into either diagnos Continue reading >>

Aging & Health A To Z

Aging & Health A To Z

Diabetes Basic Facts & Information What is Diabetes? Diabetes develops when the amount of sugar in your blood becomes too high, either because your body doesn’t make enough insulin (type 1 diabetes), or because your body doesn’t respond to insulin (type 2 diabetes). When your body digests food, it converts much of it into glucose, a sugar that your body’s cells need for energy. The hormone insulin helps your body use glucose, and also helps maintain healthy blood levels of glucose. When your body produces too little insulin, or can’t respond to it, glucose tends to remain in your bloodstream, instead of going into your cells. The Most Common Types of Diabetes Type 1 Diabetes In type 1 diabetes, your body destroys the cells in the pancreas that produce insulin. That’s why people with Type 1 diabetes must take insulin injections or use an insulin pump to control their blood sugar. Though Type 1 diabetes usually occurs in children and young adults, it can occur at any age. Only 5 to 10 percent of people with diabetes have type 1. You can’t prevent this form of diabetes. Type 2 Diabetes In type 2 diabetes, your pancreas can’t produce enough insulin for your needs, or your cells can’t use insulin properly (insulin resistance). Older adults are especially prone to type 2 diabetes, because aging makes the body less accepting of sugars. What’s more, being overweight makes your chances of developing type 2 diabetes extremely high. Most people can prevent or control type 2 diabetes by eating a healthy diet and by being physically active. What are Pre-diabetes and Metabolic Syndrome? In pre-diabetes, your glucose levels are higher than normal, but not high enough to be called diabetes. Pre-diabetes increases your risk for developing type 2 diabetes and other prob Continue reading >>

Clarifying Lada (type 1 Diabetes In Adults)

Clarifying Lada (type 1 Diabetes In Adults)

When I met fellow D-writer Catherine Price for coffee recently, I immediately gushed about everything we had in common: two brunette journalist-types living in the SF Bay Area, both diagnosed a few years ago with LADA (or so I thought). Catherine gave me a sideways look, and then began grilling me about the formal definition of LADA. I had to admit, it's pretty fuzzy. Today, I gratefully present you with the results of her investigation into this mysterious acronym: A Guest Post by Catherine Price, of ASweetLife Having had Type 1 diabetes for nearly ten years now, I can handle most diabetic terms and acronyms thrown my way. Hemoglobin A1c? Got it. Carb ratios? Insulin sensitivity? No problem. But one term has continued to confuse me: LADA. Short for Latent Autoimmune Diabetes in Adults, it's also known as Slow-Onset Type 1 Diabetes, Type 1.5 Diabetes or, occasionally, Late-Onset Autoimmune Diabetes of Adulthood. Four names for the same thing? That's never a good sign. Until recently, the most common definition I'd heard for LADA was that it was a Type 1-like form of diabetes diagnosed in adulthood. But I didn't understand the details. Does being diagnosed with Type 1 diabetes as an adult automatically mean you have LADA? Is there a difference between LADA and the classical definition of Type 1? To answer these questions, I spoke with Marie Nierras, the program officer of the genetics programs at Juvenile Diabetes Research Foundation. She cut right to the chase. "There is a lot of confusion about LADA," she told me, "but Type 1 diabetes and LADA are not the same thing." Here, to get us started, is how JDRF's Adults With Type 1 toolkit defines LADA: "Type 1 diabetes diagnosed in adults over 30 may be Latent Autoimmune Diabetes in Adults (LADA), sometimes known as Type 1.5 Continue reading >>

Adults Can Get Type 1 Diabetes, Too

Adults Can Get Type 1 Diabetes, Too

David Lazarus had just moved to Los Angeles to start a new job as a business and consumer columnist for the Los Angeles Times when he suddenly developed some of the classic signs of diabetes: extreme thirst, fatigue and weight loss. He dropped close to 15 pounds in two weeks. Lazarus was in his early 40s. "The weight loss was the first big red flag. It happened really fast," he says. He consulted a physician, who diagnosed him with Type 2 diabetes and recommended a "monastic" low-carb, macrobiotic diet. When he continued to feel lousy a few days later, Lazarus spoke with another physician. That doctor suggested that Lazarus might have Type 1 diabetes, an autoimmune condition in which the insulin-making cells in the pancreas are attacked and destroyed. But that physician didn't take insurance. Finally Lazarus made his way to the diabetes center at the University of California, Los Angeles. There, an endocrinologist diagnosed him with Type 1 diabetes and immediately put him on the correct treatment, insulin. Without insulin injections or infusion via a pump, people with Type 1 diabetes typically fall into a coma and die within days to weeks, although sometimes adults may have a small amount of reserve insulin that keeps them going longer. Still, eventually all people with Type 1 diabetes must receive insulin. Lazarus' story is not uncommon. It has long been thought that Type 1 diabetes arises primarily in childhood or adolescence and only rarely in adulthood. In fact, Type 1 diabetes was formerly called "juvenile" diabetes, and that term is still widely used, even though the terminology was officially changed in 1997. Across the ages Now, it looks as if not only can Type 1 diabetes occur in adults, it's just as likely to appear in adulthood as in childhood or adolescence. Continue reading >>

Classifications For Diabetes In Older Adults

Classifications For Diabetes In Older Adults

The risk for diabetes increases with age, making diabetes common in older adults. In fact, approximately 25% of adults over the age of 60 years have diabetes. Diabetes means that your blood glucose (sugar) level is too high. Your body’s cells need glucose for energy. When you eat, your pancreas releases the hormone insulin, which helps the glucose from food get into your cells. People with diabetes do not make enough insulin or do not use insulin well, causing glucose to build up in their blood and not reach their cells. This can lead to complications including damage to the heart, eyes, kidneys, and feet. While type 1 diabetes is usually thought of as beginning in childhood and type 2 diabetes as a beginning in adulthood, it is becoming more clear that adults—including older adults—can develop new-onset type 1 diabetes and that children can develop type 2 diabetes. The different classifications of diabetes that may occur in older people are described below. Type 2 Diabetes People with type 2 diabetes do not make or use insulin well. This is the most common type of diabetes and typically occurs in people who are overweight and inactive. Other risk factors include a family history of the disease, older age, certain ethnicities (blacks, Hispanics, American Indians and Asian-Americans), polycystic ovary syndrome, and a history of gestational diabetes (diabetes in pregnancy). Type 1 Diabetes People with type 1 diabetes make little or no insulin and need to take insulin therapy as soon as they are diagnosed. Type 1 diabetes typically begins in childhood, but also may first begin in adulthood. This form is typically caused by an autoimmune disorder, meaning that the body’s immune system mistakenly attacks cells that make insulin. In some people, type 1 diabetes may oc Continue reading >>

Type 1 Diabetes In Adults

Type 1 Diabetes In Adults

For years, distinguishing between the various types of diabetes was pretty straightforward: “Juvenile diabetes,” an autoimmune disease, was diagnosed primarily in children and teenagers when their own body’s immune system destroyed the insulin-producing (beta) cells in their pancreas. “Adult-onset diabetes” occurred in adults and was generally associated with insulin resistance and often with overweight. And “gestational diabetes” occurred in pregnant women and disappeared once the pregnancy was over. In the past 25 years, however, determining what type of diabetes a person has has become more of a challenge. In large part, that’s because more and more children and teenagers are now being diagnosed with Type 2 diabetes — the type that occurred predominantly in adults in generations past. Most of these children and teens are overweight. At the same time, it’s becoming clearer that Type 1 diabetes can occur at any age and sometimes occurs in people who are overweight. In addition, another type of diabetes, called latent autoimmune diabetes in adults, or LADA, that shares some characteristics with both Type 1 and Type 2 diabetes, has been recognized. Muddying the water further is the realization that diabetic ketoacidosis, an acute, life-threatening complication of diabetes that is caused by a lack of insulin, can occur in people with Type 2 diabetes — not just in people with Type 1, as was previously thought. And while gestational diabetes is still diagnosed only in pregnant women, it is sometimes discovered that what is thought to be gestational diabetes is really Type 1 or Type 2 diabetes that happens to start during pregnancy. The incidence of diabetes has increased so greatly around the world in the past 25 years that health organizations and med Continue reading >>

Management Of Type 1 Diabetes In Older Adults

Management Of Type 1 Diabetes In Older Adults

Go to: Challenges in the Management of Type 1 Diabetes in Older Adults There is a paucity of data related to glycemic management and control of type 1 diabetes later in life. The Type 1 Diabetes (T1D) Exchange clinic registry reported characteristics of older adults with type 1 diabetes who are followed in diabetes centers across the United States.17 Of those ages 50 to < 65 years (n = 2,066), mean A1C was 7.7% (27% had an A1C < 7.0%, 46% had an A1C < 7.5%, and 11% had an A1C ≥ 9.0%), and mean self-reported blood glucose testing was 5.5 times daily. Of those ≥ 65 years of age (n = 683), mean A1C was 7.4% (34% had an A1C < 7.0%, 52% had an A1C < 7.5%, and 8% had an A1C ≥ 9.0%) and mean self-reported blood glucose testing was 5.6 times daily. Greater frequency of self-monitoring of blood glucose (SMBG) was associated with lower A1C levels in both those who used an insulin pump and those who administered insulin via injections.18 Diabetic ketoacidosis (DKA) was lower with increasing age and was not associated with duration of diabetes.19 DKA was more likely in those with higher A1C levels and lower socioeconomic status. No relationship was found between DKA and pump versus injection use. Longstanding diabetes in older adults has been associated with increased risks of severe hypoglycemia, micro- and macrovascular complications, cognitive decline, and physical disabilities. Older adults may also have other medical comorbidities, functional disabilities, erratic food intake, and insufficient social support. Individuals with geriatric syndromes (i.e., chronic pain, urinary incontinence, polypharmacy, cognitive impairment, frequent falls, and depression)20–23 face additional difficulties in performing self-management tasks and lower quality of life. Clinical, functiona Continue reading >>

Type 1 Diabetes Diagnoses Can Happen Well Into Adulthood.

Type 1 Diabetes Diagnoses Can Happen Well Into Adulthood.

A patient receives a test for diabetes during a Care Harbor L.A. free medical clinic in Los Angeles on Sept. 11, 2014. Jocelyns bathroom breaks were becoming a cause for concern. The first-year teacher found she was increasingly asking colleagues to cover for her as she nipped out to the restroom. Suspecting that something was up, the 22-year-old asked her mother, a nurse, to check her blood sugar. She thought I was crazy, said Jocelyn, until the blood-glucose meter bleeped its reply: Her blood sugar levels were too high for the machine to even read them. (Editors note: We are withholding Jocelyns last name due to the sensitive medical information given in this article.) There must have been a mistake. There was no history of diabetes in the family, and 22-year-old Jocelyn was lean, a former competitive gymnast. Maybe the meter was broken, or perhaps she still had traces of sugar on her fingers from something shes eaten earlier. Jocelyns mom sent her home with the glucometer and told her to check again in the morning. Each year, somewhere between tens and hundreds of thousands of patients are likely misdiagnosed with Type 2 diabetes when they in fact have Type1. Before breakfast the next day, Jocelyns blood sugar levels were four times what they should have been for a healthy adult. I wouldnt let myself eat because I was so paranoid, she said. Later that day in the hospital, she was diagnosed with Type 2 diabetes, a condition associated with adults who are older and overweight. While the nurses at the hospital seemed unsurprised by the diagnosis, Jocelyn was upset, wondering how this could have happened, as she put it. After a week of rumination, Jocelyn went to see an endocrinologist who ran additional blood tests, and eventually diagnosed her with latent autoimmune d Continue reading >>

Can You Get Type 1 At Any Age?

Can You Get Type 1 At Any Age?

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Hi I have been type 1 since I was 5 and I always assumed you only got it as a child and up to early adulthood but I heard recently that you can get it in your 30's and 40's is this true? Yes you can get T1 at any age just more common in younger years than in the older age group Older people though do tend to have a slower onset unlike children who have a very short on set period Yes you can get it in adulthood too. I was 20 when i was diagnosed, and there's more amongst the forum that were diagnosed older than i was. I think that's why it's more often called Type 1 diabetes and not Juvenile onset diabetes now as it can be misleading to say it only happens to children. It's similar to Type 2 diabetes, not just adults get that type either. Diabetes doesn't really mind what age, sex, shape, race you are As others have said, indeed you can. I was diagnosed T1 (or 1.5) at the age of 36. Yes you most definitely can develop T1 as an adult. As has been mentioned it is less common though. Typically you will find that adults that develop T1 will have a hostory of some other Autoimmune conditions and this is the key. It is genetic it just happens that your immune system took its time taking an interest in your Beta Cells. I developed T1, confirmed with test for antibodies, 2 years ago at age 31. In a way I think that I am lucky, in that I had 49 years without diabetes, a diabetes free childhood and adolescence. My heart goes out to the children (and their parents) that have to cope with diabetes at such an early age. Yes I got it in my early 50s, I've read of people developing it at much older ages. One study in Italy found that among males there were twin peaks Continue reading >>

Management Of Type 1 Diabetes In Older Adults

Management Of Type 1 Diabetes In Older Adults

Abstract In Brief Older adults with type 1 diabetes are at high risk for severe hypoglycemia and may have serious comorbid conditions. Problems with cognition, mobility, dexterity, vision, hearing, depression, and chronic pain interfere with the ability to follow complex insulin regimens. With the development of geriatric syndromes, unpredictable eating, and frailty, treatment regimens must be modified with the goal of minimizing hypoglycemia and severe hyperglycemia and maximizing quality of life. Challenges in the Management of Type 1 Diabetes in Older Adults There is a paucity of data related to glycemic management and control of type 1 diabetes later in life. The Type 1 Diabetes (T1D) Exchange clinic registry reported characteristics of older adults with type 1 diabetes who are followed in diabetes centers across the United States.17 Of those ages 50 to < 65 years (n = 2,066), mean A1C was 7.7% (27% had an A1C < 7.0%, 46% had an A1C < 7.5%, and 11% had an A1C ≥ 9.0%), and mean self-reported blood glucose testing was 5.5 times daily. Of those ≥ 65 years of age (n = 683), mean A1C was 7.4% (34% had an A1C < 7.0%, 52% had an A1C < 7.5%, and 8% had an A1C ≥ 9.0%) and mean self-reported blood glucose testing was 5.6 times daily. Greater frequency of self-monitoring of blood glucose (SMBG) was associated with lower A1C levels in both those who used an insulin pump and those who administered insulin via injections.18 Diabetic ketoacidosis (DKA) was lower with increasing age and was not associated with duration of diabetes.19 DKA was more likely in those with higher A1C levels and lower socioeconomic status. No relationship was found between DKA and pump versus injection use. Longstanding diabetes in older adults has been associated with increased risks of severe hypo Continue reading >>

Type 1 Diabetes

Type 1 Diabetes

Print Overview Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin. Insulin is a hormone needed to allow sugar (glucose) to enter cells to produce energy. Different factors, including genetics and some viruses, may contribute to type 1 diabetes. Although type 1 diabetes usually appears during childhood or adolescence, it can develop in adults. Despite active research, type 1 diabetes has no cure. Treatment focuses on managing blood sugar levels with insulin, diet and lifestyle to prevent complications. Symptoms Type 1 diabetes signs and symptoms can appear relatively suddenly and may include: Increased thirst Frequent urination Bed-wetting in children who previously didn't wet the bed during the night Extreme hunger Unintended weight loss Irritability and other mood changes Fatigue and weakness Blurred vision When to see a doctor Consult your doctor if you notice any of the above signs and symptoms in you or your child. Causes The exact cause of type 1 diabetes is unknown. Usually, the body's own immune system — which normally fights harmful bacteria and viruses — mistakenly destroys the insulin-producing (islet, or islets of Langerhans) cells in the pancreas. Other possible causes include: Genetics Exposure to viruses and other environmental factors The role of insulin Once a significant number of islet cells are destroyed, you'll produce little or no insulin. Insulin is a hormone that comes from a gland situated behind and below the stomach (pancreas). The pancreas secretes insulin into the bloodstream. Insulin circulates, allowing sugar to enter your cells. Insulin lowers the amount of sugar in your bloodstream. As your blood sugar level drops, so does the secre Continue reading >>

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