diabetestalk.net

Diabetes Adults

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 >>

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 >>

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 >>

Prevalence Of Diagnosed Diabetes In Adults By Diabetes Type United States, 2016

Prevalence Of Diagnosed Diabetes In Adults By Diabetes Type United States, 2016

Prevalence of Diagnosed Diabetes in Adults by Diabetes Type United States, 2016 The two most common forms of diabetes are type 1 and type 2. Previous national diabetes prevalence estimates did not distinguish between types among U.S. adults. New data allowed estimation of diagnosed diabetes by type. In 2016, the prevalence of diagnosed type 1 diabetes was 0.55%, representing 1.3 million U.S. adults; the prevalence of diagnosed type 2 diabetes was 8.6%, representing 21.0 million U.S. adults. Non-Hispanic white adults had a higher prevalence of diagnosed type 1 diabetes than did Hispanic adults. Non-Hispanic blacks had the highest prevalence of diagnosed type 2 diabetes. Diagnosed type 2 diabetes prevalence estimates increased with age and decreased with increasing levels of educational attainment. What are the implications for public health practice? Knowledge about national prevalence of diagnosed diabetes by type might be helpful in monitoring trends, assessing the burden of disease for education and management programs, and guiding and prioritizing national plans for future type-specific health services. Currently 23 million U.S. adults have been diagnosed with diabetes (1). The two most common forms of diabetes are type 1 and type 2. Type 1 diabetes results from the autoimmune destruction of the pancreass beta cells, which produce insulin. Persons with type 1 diabetes require insulin for survival; insulin may be given as a daily shot or continuously with an insulin pump (2). Type 2 diabetes is mainly caused by a combination of insulin resistance and relative insulin deficiency (3). A small proportion of diabetes cases might be types other than type 1 or type 2, such as maturity-onset diabetes of the young or latent autoimmune diabetes in adults (3). Although the maj Continue reading >>

Caring For Older Adults With Type 1 Diabetes

Caring For Older Adults With Type 1 Diabetes

Caring for Older Adults With Type 1 Diabetes Failing eyesight and memory, urinary incontinence, and depression are some of the issues faced by elderly people with type 1 diabetes. Sign Up for Our Living with Diabetes Newsletter Thanks for signing up! You might also like these other newsletters: Sign up for more FREE Everyday Health newsletters . Caring for an elderly person with type 1 diabetes is not the same as caring for a younger person with the disease. "Mobility, energy levels, and other age-related conditions can impact the elderly with diabetes," says Meg Bayless, BSN, RN, a diabetes educator for the diabetes clinical research programs at the University of Iowa Health Center in Iowa City. "Individuals living on fixed incomes may have difficulties making healthy choices in the grocery store, getting to the store, or filling all their prescriptions." Diabetes: Medical Complications in the Elderly Common complications of type 1 diabetes include heart disease, stroke, kidney disease, and visual impairment. You can lower the risk of your loved one getting these complications by being aware of: Glucose control. Good control of glucose levels lowers the risk of small blood vessel damage that can cause blindness and kidney disease. "Fatigue, blurry vision, frequent urination, itchy skin, and sores that don't heal can be warning signs of high blood sugar. Confusion, sweating, heart racing, passing out, or falling may indicate low blood sugar," notes Bayless. Cholesterol and blood pressure. Elevated cholesterol and high blood pressure increase the risk of heart disease and stroke in the diabetic patient. It is important to make sure medications for these conditions are taken as prescribed. Cholesterol-lowering medication, proper nutrition, exercise, and weight control ar 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 >>

Latent Autoimmune Diabetes In Adults

Latent Autoimmune Diabetes In Adults

Reviewed by endocrinologist Stanley S. Schwartz, MD, emeritus Associate Professor of Medicine at the University of Pennsylvania and George Grunberger, MD, FACP, FACE, Chairman of the Grunberger Diabetes Institute, Clinical Professor of Internal Medicine and Molecular Medicine & Genetics at Wayne State University School of Medicine and President of the American Association of Clinical Endocrinologists Call it diabetes type 1.5. Double diabetes. Or “slim type 2.” By any name, LADA—latent autoimmune diabetes in adults—plays by its own rules. Similar to type 1 diabetes, in LADA the immune system attacks and destroys insulin-making beta cells in the pancreas. But it progresses more slowly than type 1. Like type 2, it tends to happen after age 30. That’s just one reason LADA is usually misdiagnosed as type 2. Like typical type 2s, people with LADA may be insulin resistant; their bodies don’t respond readily to insulin’s signals to absorb blood sugar. And LADA can usually be controlled for months or years with pills and other non-insulin blood-sugar medications used by type 2s. But eventually, people with LADA need daily insulin shots or a pump to control their blood sugar.1 Researchers are still delving into LADA’s true nature. Some experts think it’s simply slow-motion type 1. Others have a hunch LADA’s got its own unique genetic signature.2 Up to 10% of people with type 2 may have LADA. “Knowing you have LADA could help your doctor choose early medications that can preserve beta cells longer. And it could help you and your doctor move you to insulin therapy sooner when blood sugar levels rise,” explains endocrinologist Stanley S. Schwartz, MD, an emeritus Associate Professor of Medicine at the University of Pennsylvania. Is it LADA? Blood glucose tes Continue reading >>

Latent Autoimmune Diabetes In Adults

Latent Autoimmune Diabetes In Adults

Context: Autoantibodies that are reactive to islet antigens are present at the time of diagnosis in most patients with type 1 diabetes. Additionally, approximately 10% of phenotypic type 2 diabetic patients are positive for at least one of the islet autoantibodies, and this group is often referred to as “latent autoimmune diabetes in adults (LADA).” These patients share many genetic and immunological similarities with type 1 diabetes, suggesting that LADA, like type 1 diabetes, is an autoimmune disease. However, there are differences in autoantibody clustering, T cell reactivity, and genetic susceptibility and protection between type 1 diabetes and LADA, implying important differences in the underlying disease processes. Evidence Acquisition and Synthesis: In this clinical review, we will summarize the current understanding of LADA based on the MEDLINE search of all peer-reviewed publications (original articles and reviews) on this topic between 1974 and 2009. Conclusions: In LADA, diabetes occurs earlier in the β-cell-destructive process because of the greater insulin resistance. Complexities arise also because of variable definitions of LADA and type 1 diabetes in adults. As immunomodulatory therapies that slow or halt the type 1 diabetes disease process are discovered, testing these therapies in LADA will be essential. Context: 11β-Hydroxysteroid dehydrogenase (11β-HSD) enzymes are now appreciated to be important regulators of hormone action at a tissue level. 11β-HSD1 is widely expressed and increases glucocorticoid action through its unique ability to convert inactive glucocorticoids (cortisone in man, 11-dehydrocorticosterone in rodents) to their active forms (cortisol and corticosterone, respectively). The enzyme has roles in the normal hypothalamus-pitui Continue reading >>

Type 2 Diabetes

Type 2 Diabetes

Print Overview Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose), your body's important source of fuel. With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to maintain a normal glucose level. More common in adults, type 2 diabetes increasingly affects children as childhood obesity increases. There's no cure for type 2 diabetes, but you may be able to manage the condition by eating well, exercising and maintaining a healthy weight. If diet and exercise aren't enough to manage your blood sugar well, you also may need diabetes medications or insulin therapy. Symptoms Signs and symptoms of type 2 diabetes often develop slowly. In fact, you can have type 2 diabetes for years and not know it. Look for: Increased thirst and frequent urination. Excess sugar building up in your bloodstream causes fluid to be pulled from the tissues. This may leave you thirsty. As a result, you may drink — and urinate — more than usual. Increased hunger. Without enough insulin to move sugar into your cells, your muscles and organs become depleted of energy. This triggers intense hunger. Weight loss. Despite eating more than usual to relieve hunger, you may lose weight. Without the ability to metabolize glucose, the body uses alternative fuels stored in muscle and fat. Calories are lost as excess glucose is released in the urine. Fatigue. If your cells are deprived of sugar, you may become tired and irritable. Blurred vision. If your blood sugar is too high, fluid may be pulled from the lenses of your eyes. This may affect your ability to focus. Slow-healing sores o Continue reading >>

Diabetes Type 2

Diabetes Type 2

Diabetes means your blood glucose, or blood sugar, levels are too high. With type 2 diabetes, the more common type, your body does not make or use insulin well. Insulin is a hormone that helps glucose get into your cells to give them energy. Without insulin, too much glucose stays in your blood. Over time, high blood glucose can lead to serious problems with your heart, eyes, kidneys, nerves, and gums and teeth. You have a higher risk of type 2 diabetes if you are older, have obesity, have a family history of diabetes, or do not exercise. Having prediabetes also increases your risk. Prediabetes means that your blood sugar is higher than normal but not high enough to be called diabetes. If you are at risk for type 2 diabetes, you may be able to delay or prevent developing it by making some lifestyle changes. The symptoms of type 2 diabetes appear slowly. Some people do not notice symptoms at all. The symptoms can include Being very thirsty Urinating often Feeling very hungry or tired Losing weight without trying Having sores that heal slowly Having blurry eyesight Blood tests can show if you have diabetes. One type of test, the A1C, can also check on how you are managing your diabetes. Many people can manage their diabetes through healthy eating, physical activity, and blood glucose testing. Some people also need to take diabetes medicines. NIH: National Institute of Diabetes and Digestive and Kidney Diseases 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 >>

Adults Being Diagnosed With The Wrong Diabetes, Study Finds

Adults Being Diagnosed With The Wrong Diabetes, Study Finds

Adults being diagnosed with the wrong diabetes, study finds By Katie Silver Health reporter, BBC News These are external links and will open in a new window Image caption Helen Philibin was misdiagnosed with Type 2 diabetes Many might think type 1 diabetes is a "disease of childhood", but research, published in the Lancet Diabetes & Endocrinology, has found it has similar prevalence in adults. More than 40% of Britons diagnosed with the condition are over 30. Many of these are initially diagnosed with type 2, and receiving the wrong treatment can be life-threatening. Charity Diabetes UK is calling for doctors not to rule out the possibility a patient over 30 might have type 1. Helen Philibin, a mother of two from Torquay, who was 40, slim and active when she was diagnosed. She said: "Having the wrong diagnosis was extremely frustrating. I just knew it wasn't right. "I'm always running around with my two young kids and I walk the dog every day." She visited her GP complaining of extreme thirst. A blood test strongly indicated she had diabetes. Her doctor diagnosed her with type 2 and prescribed metformin, the most commonly-used drug for the condition. She was also sent on a course to learn about lifestyle factors including a low-sugar diet. "All the other people on the course were in their mid-60s and overweight. I was 5ft 10in and nine-and-a-half stone. I stood out like a sore thumb," said Helen. "When I raised it with nurses or my GP, I was told that type 1 diabetes is always diagnosed in childhood, so I had to be type 2. I felt like I was banging my head against a wall." Helen changed her diet to get better blood sugar control - but she began vomiting up to four times a week. "It was horrible," she said. "Even a single piece of toast would send my blood sugar levels Continue reading >>

Diabetes In Older Adults

Diabetes In Older Adults

What is the epidemiology and pathogenesis of diabetes in older adults? According to the most recent surveillance data, the prevalence of diabetes among U.S. adults aged ≥65 years varies from 22 to 33%, Continue reading >>

Latent Autoimmune Diabetes Of The Adult: Current Knowledge And Uncertainty

Latent Autoimmune Diabetes Of The Adult: Current Knowledge And Uncertainty

Go to: Patients with adult-onset autoimmune diabetes have less Human Leucocyte Antigen (HLA)-associated genetic risk and fewer diabetes-associated autoantibodies compared with patients with childhood-onset Type 1 diabetes. Metabolic changes at diagnosis reflect a broad clinical phenotype ranging from diabetic ketoacidosis to mild non-insulin-requiring diabetes, also known as latent autoimmune diabetes of the adult (LADA). This latter phenotype is the most prevalent form of adult-onset autoimmune diabetes and probably the most prevalent form of autoimmune diabetes in general. Although LADA is associated with the same genetic and immunological features as childhood-onset Type 1 diabetes, it also shares some genetic features with Type 2 diabetes, which raises the question of genetic heterogeneity predisposing to this form of the disease. The potential value of screening patients with adult-onset diabetes for diabetes-associated autoantibodies to identify those with LADA is emphasized by their lack of clinically distinct features, their different natural history compared with Type 2 diabetes and their potential need for a dedicated management strategy. The fact that, in some studies, patients with LADA show worse glucose control than patients with Type 2 diabetes, highlights the need for further therapeutic studies. Challenges regarding classification, epidemiology, genetics, metabolism, immunology, clinical presentation and treatment of LADA were discussed at a 2014 workshop arranged by the Danish Diabetes Academy. The presentations and discussions are summarized in this review, which sets out the current ideas and controversies surrounding this form of diabetes. What’s new? Latent autoimmune diabetes of the adult (LADA) is an autoimmune diabetes defined by adult-onset, Continue reading >>

Symptoms Of Diabetes Type 1 In Adults

Symptoms Of Diabetes Type 1 In Adults

Symptoms of type 1 diabetes in adults may occur suddenly It’s important to realize that early signs of type 1 diabetes in adults often develop quickly and may sometimes be brushed off—or mistaken for illness. Here’s what you should look out for: Frequent Urination: If you’re constantly running to the bathroom, your kidneys may be trying to rid your blood of excess sugar, resulting in an increased need to urinate. Extreme thirst: Increased urination can then result in dehydration, which will leave you feeling more thirsty than normal. Increased appetite: If you’re suddenly hungry all the time it may be because your body isn’t able to get proper energy from the food you eat. Unexpected weight loss: Along the same lines, if your body is losing sugar in your urine instead of absorbing it, you may lose weight without trying. Other symptoms of type 1 diabetes in adults Other diabetic symptoms in adults include feeling drowsy or lethargic; sudden vision changes; fruity or sweet-smelling breath; heavy or labored breathing; and stupor or unconsciousness. If you do have high blood sugar and it goes untreated, it could develop into diabetic ketoacidosis—a life-threatening condition. So please see your doctor immediately if you are exhibiting these warning signs. So what are the low blood sugar symptoms you should look out for? It’s important to realize that the signs of… The reality is that signs of type 1 diabetes usually develop suddenly. And, that’s why it can be… Continue reading >>

More in diabetes