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Type 1 Diabetes Adult Onset

Adult-onset Type 1 Diabetes Not Uncommon In China

Adult-onset Type 1 Diabetes Not Uncommon In China

Adult-Onset Type 1 Diabetes Not Uncommon in China by Kristen Monaco, Staff Writer, MedPage Today This article is a collaboration between MedPage Today and: The majority of newly diagnosed type 1 diabetes (T1D) cases in China are diagnosed in adulthood, according to a population-based study of Chinese patients followed between 2010-2013. Note that most epidemiological studies of T1D have focused on childhood onset T1D, and although it most often develops in children T1D can occur at any age, and adult onset is not rare in China. The majority of newly diagnosed type 1 diabetes cases in China are diagnosed in adulthood, researchers said. The population-based study identified 5,018 new cases of type 1 diabetes among a Chinese cohort followed from 2010 to 2013 -- 65.3% of whom were diagnosed at age 20 or older, reported Jianping Weng, PhD, of The Third Affiliated Hospital of Sun Yat-Sen University in Guangzhou, China, and colleagues. Still, estimated incidence of type 1 diabetes was highest among those 14 and younger (incidence 1.93 per 100,000, 95% CI 0.83-3.03), appearing online in The BMJ . Point estimates for the incidence of newly diagnosed type 1 diabetes tapered off among older age groups: 1.23 per 100,000 person years at 15-29 (95% CI 0.45-2.11) and 0.69 among those 30 and older (95% CI 0.00-1.51). "[M]ost epidemiological studies of type 1 diabetes focused on childhood onset type 1 diabetes. Although type 1 diabetes most often develops in children, it can occur at any age," the group wrote. "Our previous study also indicated that the onset of type 1 diabetes in adulthood is not rare in China. Yet little is known about its incidence in adults aged more than 20 years," Weng's group added. These findings echo the results of another recent study from the U.K., which fou Continue reading >>

Adults Can Get Type 1 Diabetes, Too

Adults Can Get Type 1 Diabetes, Too

Type 1 diabetes used to be called "juvenile diabetes," because it's usually diagnosed in children and teens. But don't let that old-school name fool you. It can start when you're a grownup, too. Many of the symptoms are similar to type 2 diabetes, so it's sometimes tricky to know which kind you've got. But it's important to learn the differences and figure out what's going on so you can get the treatment that's right for you. Causes Doctors aren't sure exactly what causes type 1 diabetes. They believe your genes may play a role. Researchers are also checking to see if there are things that trigger the disease, like your diet or a virus that you caught. What experts do know is that when you have type 1 diabetes, something goes wrong with your immune system -- the body's defense against germs. It destroys beta cells in your pancreas that are responsible for making a hormone called insulin. Insulin allows glucose -- or sugar -- to get into your cells, where it's turned into energy. But if you have type 1 diabetes, your body doesn't make insulin. Glucose builds up in your bloodstream and, over time, can cause serious health problems. Symptoms If you have type 1 diabetes, you may get similar symptoms as your friends who have type 2. You may notice that you: Get extremely thirsty or hungry Need to pee often Feel unusually tired or weak Lose weight suddenly Get blurred vision or other changes in the way you see Get vaginal yeast infections Have breath that smells fruity Can't breathe well Sometimes, type 1 diabetes could even make you lose consciousness. Who's Most Likely to Get It as an Adult? People of all races and ethnic groups can get type 1 diabetes, but it's most common among those of northern European descent. *CGM-based treatment requires fingersticks for calibration, 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 >>

Diagnosed With Type 1 Diabetes As An Adult: The Day That Changed My Life Forever

Diagnosed With Type 1 Diabetes As An Adult: The Day That Changed My Life Forever

Diagnosed with Type 1 Diabetes as an Adult: The Day That Changed My Life Forever By: Valerie Abner I’m approaching my 2nd Type 1 Diabetes birthday and just turned 41. Yes, I’m one that was fortunate enough to be diagnosed at 39. I’m the mom who was saved by my mom and my son’s broken leg. July 6, 2015 . . . it’s the day that my life changed forever. It’s the day that I now like to call my birthday. It all began with what I thought was a stomach virus on July 4th. I was on the couch all day. The next day was a Sunday and just as anyone recovering from a virus, I was weak, but feeling better. We went to a nearby park for the afternoon. My son was playing on the playground and fell from the fireman’s pole, fracturing his leg in two places. After leaving the hospital we had to get pain medication and when we arrived back at home, I was sick all over again. I vaguely remember falling asleep on the bathroom floor. Monday morning came and again I was weak, but feeling some better. My husband had to go for a meeting and my mother came to stay with us, mostly to care for my son. The symptoms were just the same. I thought maybe I was dehydrated and began drinking Gatorade, and lots of it. It was just after lunch when I lost control of myself. I was dizzy, confused, lethargic and completely out of my mind. I could not catch my breath. I somehow got back in the bed when my mom found me and called for an ambulance. I knew nothing. Not even enough to know that I was in serious danger. At the age of 39… Who would have ever thought that I would be diagnosed with Type 1 Diabetes as an adult? I spent the next week in ICU being treated for diabetic ketoacidosis or DKA. If it wasn’t for my son’s broken leg, my mother probably would not have been at our house. Today, I 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 >>

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 >>

Diabetes Lada

Diabetes Lada

Tweet LADA stands for Latent Autoimmune Diabetes of Adulthood. LADA is a form of type 1 diabetes that develops later into adulthood. LADA tends to develop more slowly than type 1 diabetes in childhood and, because LADA can sometimes appear similar to type 2 diabetes, doctors may mistakenly diagnose LADA as type 2 diabetes. The definition provided by Prof. David Leslie, Principle Investigator of Action LADA, is that in Europe: LADA is defined as initially non-insulin requiring diabetes diagnosed in people aged 30-50 years with antibodies to GAD - glutamic acid decarboxylase. How does LADA compare with other diabetes types? LADA is sometimes referred to as type 1.5 diabetes. This is not an official term but it does illustrate the fact that LADA is a form of type 1 diabetes that shares some characteristics with type 2 diabetes. As a form of type 1 diabetes, LADA is an autoimmune disease in which the body’s immune system attacks and kills off insulin producing cells. The reasons why LADA can often be mistaken for type 2 diabetes is it develops over a longer period of time than type 1 diabetes in children or younger adults. Whereas type 1 diabetes in children tends to develop quickly, sometimes within the space of days, LADA develops more slowly, sometimes over a period of years. The slower onset of diabetes symptoms being presented in people over 35 years may lead a GP to initially diagnose a case of LADA as type 2 diabetes. Symptoms of LADA The first symptoms of LADA include: Feeling tired all the time or regularly tired after meals Foggy headedness Experiencing hunger soon after meals As LADA develops, a person’s ability to produce insulin will gradually decrease and this may lead to symptoms such as: It is important to catch the symptoms at the earliest stage because 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 >>

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 >>

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 >>

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 >>

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 >>

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 >>

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 >>

Adult-onset Type 1 Diabetes, Other Autoimmune Diseases Linked

Adult-onset Type 1 Diabetes, Other Autoimmune Diseases Linked

Adult-Onset Type 1 Diabetes, Other Autoimmune Diseases Linked CHICAGO, Illinois The risk of developing 1 or more additional autoimmune conditions rises with age at onset of type 1 diabetes, particularly among women who develop diabetes in adulthood, new research suggests. Findings from more than 1100 adults with type 1 diabetes were presented March 19 here at ENDO 2018: The Endocrine Society Annual Meeting by Yicheng Bao, a medical student at the University of MissouriKansas City (UMKC) School of Medicine. "Physicians should be aware that a lot of autoimmune diseases can occur in people with type 1 diabetes. People who develop type 1 diabetes in adulthood are at special risk," Bao told Medscape Medical News. The finding is particularly important in light of the recent UK Biobank study that showed type 1 diabetes onset is equally likely to occur after age 30 years as prior, but is often misdiagnosed as type 2 diabetes in adults. Bao noted that previous studies have focused on comorbid endocrine autoimmune conditions, and in children with type 1 diabetes. In the new study, people with type 1 diabetes onset after age 40 years had twice the risk for 1 or more autoimmune conditions, such as thyroid disease, pernicious anemia, vitiligo, and gastrointestinal autoimmune conditions, as those diagnosed with type 1 diabetes in childhood. Betty Drees, MD, professor of medicine at UMKC, who was not involved in the study, told Medscape Medical News that she was struck by "the number and variety of [autoimmune] conditions that are outside the endocrine system...I think it has an important clinical message in terms of continuing to monitor adults with type 1 diabetes for late complications that may be associated with autoimmune conditions." Drees said that although routine screening i Continue reading >>

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