Many people diagnosed with type two diabetes after the age of 30 have undiagnosed type 1 disease, delaying appropriate treatment, a European conference has heard.
Researchers at the University of Exeter, UK, analysed 583 people who had insulin-treated diabetes that had been diagnosed after the age of 30.
They compared the characteristics of the disease with other participants who still produced some insulin, as well as with 220 individuals with severe insulin deficiency that was diagnosed before the age of 30.
Dr Nick Thomas and colleagues found that 21% of those with insulin-treated diabetes who were diagnosed after the age of 30 had type 1 diabetes (T1D). Out of this group, 39% did not receive insulin when they were initially diagnosed, with 46% of those individuals self-reporting that they had type 2 (T2D).
The team also found that a rapid progression to insulin dependence was highly predictive of late-onset T1D with 84% of those with the disease requiring insulin within just one year.
Of those who became insulin dependent within three years, 44% developed a severe deficiency of their body’s own insulin and their clinical, biochemical, and genetic characteristics were comparable to those who had been diagnosed before the age of 30.
Dr Thomas said: “Type 1 diabetes leading to severe insulin deficiency has similar clinical and biological characteristics to that occurring at younger ages but is frequently not identified.
"Clinicians should be aware that the majority of patients needing insulin within three years of diagnosis will have Type 1 diabetes, even if they were initially thought to have type 2 diabetes and did not need insulin at diagnosis. Getting the right diagnosis is important for these patients to receive the right education and treatment."
The research was presented at this year’s annual meeting of the European Association for the Study of Diabetes (EASD) in Berlin.
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