The Problem

It is time that the full scope of Type 1 diabetes is acknowledged, which includes millions of adults who are too frequently misdiagnosed as having Type 2 diabetes, an altogether different disease.

Tuesday, October 20, 2015

LADA Awareness Week 2015

LADA Awareness Week was started by Diabetes Hands Foundation and dLife in 2010(?), to bring awareness to adult-onset Type 1 diabetes.  In 2015, LADA Awareness Week is October 19-26.  Although the vast majority of new-onset Type 1 diabetes occurs in adults, most are misdiagnosed, often with tragic consequences (typically early onset of diabetic complications).  Almost always, a person will be misdiagnosed as having Type 2 diabetes, an altogether different disease. The September 2015 issue of Diabetes Forecast had two articles about adult-onset Type 1 diabetes (“Diagnosing Type 1 in Adults:  Why Type 2 Misdiagnoses Abound and What to Do About It” and “6 Tests to Determine Diabetes Type”).  Although we have come very far in terms of awareness and having resources available (for example, JDRF has an Adult Type 1 Toolkit and has teams of volunteers who meet with newly diagnosed T1D adults), we still have so far to go.

Here are some basic facts:  each year, about 15,000 children are diagnosed with Type 1 diabetes, and slightly more adults are diagnosed with rapid-onset Type 1 diabetes.  Study after study has shown that about 10% of people diagnosed with Type 2 diabetes are autoantibody positive, meaning that they have Type 1 autoimmune diabetes but have been misdiagnosed.  According to the ADA, in 2012 about 1.7 million people over the age of 20 were diagnosed with diabetes, thus a percentage of that large number have slowly progressive Type 1 diabetes/LADA that has been misdiagnosed as Type 2 diabetes.  LADA eclipses childhood onset Type 1 diabetes by large numbers.

Despite the vast numbers of LADAs, misconceptions and misinformation specifically about LADA and in general about Type 1 diabetes abound.  Here are examples of misinformation:
  • dLife labels LADA “a rare form of diabetes”  [Childhood onset Type 1 diabetes is “rare,” not LADA].
  • ADA, on their website, says, “Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. Only 5% of people with diabetes have this form of the disease.”  Yet “The Type 1 Diabetes Sourcebook,” published by ADA and JDRF, says that LADA is more common than childhood onset Type 1 diabetes, and says that 10% of people with “Type 2” diabetes are misdiagnosed and have Type 1 diabetes.  So Type 1 diabetes is most commonly diagnosed in adults and potentially represents about 15% of all cases of diabetes.
Another very dangerous situation is when the stress of pregnancy is “the straw that broke the camel’s back” and pushes a woman over the edge into overt Type 1 diabetes.  Most medical literature only associates gestational diabetes with Type 2 diabetes, yet fully 10% of women with GDM have the autoimmune markers for Type 1 diabetes.  Misdiagnosis can lead to fetal death.

LADA awareness initiated in the patient population and is driven by patients.  It is time that the medical community wake up and acknowledge adult-onset Type 1 diabetes, and let’s dispel the myth that Type 1 diabetes is a childhood disease!

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