Here is a link to a study that found that of people who died of DKA over a 6 year period in Maryland, about one-third of them died from type 1 diabetes that had not been diagnosed or treated. And of those that had not been diagnosed/treated, about half were in their 40s (adults).
Some significant statements and findings that came from the study:
(1) While type 1 diabetes has long been referred to as “juvenile diabetes,” physicians are now growing aware of the possibility that the disease may develop in adult patients as well.
(2) As for why such a significant portion of the Maryland cases were undiagnosed, the likely explanation is a general lack of awareness of the possibility of type 1 diabetes in adults, combined with a population that has no regular access to medical care.
(3) “This study should be a wake-up call to physicians and the public alike that type 1 diabetes is not necessarily restricted to children,” notes ACSH's Dr. Ruth Kava. “While it’s true that the number of adults dying of this disease is relatively small, there’s no reason that this should be happening at all. Type 1 diabetes is not that difficult to diagnose."
I would say that, although Type 1 diabetes is not difficult to diagnose, the myth that Type 1 diabetes is a childhood disease keeps adults from getting appropriately diagnosed and treated.
Yes, Acid; QUITE unpleasant. "Growing Aware" is NOT good enough. BTW and off topic, I like your new "running man" profile pic.:+)
Very scary indeed. I think that the bigger issue is, from what I've read on this listserv, docs seem very willing to push oral meds for both T2s and people who may be T1 but don't fit neatly into either category. What I don't understand is why treatment isn't considered simply based on what helps the patient achieve normal blood sugar levels, regardless of the "type." And why isn't BG testing standard, like taking your blood pressure each time you visit the doc or an ER? Such a simple, cheap test that could easily save lives.
I agree with you. I still have doubts about my own diagnosis as a T2, but I long ago stopped caring. All I really care about is getting treatment that works to help me achieve normal blood sugars.
Treatment simply based on what helps the patient achieve normal blood sugar levels will work for sudden onset Type 1, but will leave LADA/Type 1's taking oral meds instead of the insulin they should have for months, sometimes years because they do initially control the blood sugar. I know I was on oral meds for 15 months (I wince everytime I hear the commercials saying "if you took Actos for more than a year and got bladder cancer"...that would be one hell of a lawsuit.
I guess I have a different view. I think the reason for moving to insulin when oral medications fail is to avoid glucotoxicity (both for LADA and T2). If oral medications work and you don't have high blood sugars, then a LADA should be fine on oral medications. But I agree, when those blood sugars rise, it is time to move to insulin (for both LADA and T2).
My understanding, Brian, and Melitta can explain this further is that if LADA/Type 1's are started on insulin right away it slows down the beta cell destruction and preserves insulin production for awhile which is the motivation for starting people on insulin right away. Though frankly I wonder about that conventional wisdom as it sounds like some LADA's who are diagnosed and started on insulin right away have trouble with control due to their low insulin needs and periodic "spurts" from their pancreas.
These are really public health questions that should be aimed at the regulating bodies. There is article after article about "Diabetes Growth" but very little aimed at curing it, other than the suggestion to eat less and exercise more which goes for just about everyone facing various challenges, not all of whom have diabetes. It's almost like the burden to test for this is moving to patients, since you can go get (buy) a BG tet or an A1C at Walgreens on your own. Although whether your doctor will do anything or choose the correct test to differentiate between the two varieties of diabetes seems questionable.
Please explain to me ...with thanks :Second paragraph , copied and pasted from Melitta's provided link " Diabetic ketoacidosis, a consequence of uncontrolled diabetes, occurs when the body’s cells don’t have enough glucose to use for energy, so they switch to burning ketones " ???
Should this read instead ???( copied and pasted as well ): DKA results from a shortage of insulin; in response the body switches to burning fatty acids and producing acidic ketone bodies that cause most of the symptom
Seems like it should be a combination of the two: DKA results from a shortage of insulin, which means the body's cells cannot get sufficient glucose for energy, so the body burns fatty accids, which in turn, produces ketones.
Thanks Shawnmarie !...and I am still confused about the article's statement because I have this notion , that one has too much glucose in the cells ??? :( I may need to put the thought to bed ??
I think of it as too much glucose in the blood resulting from the fact that the cells themselves can't use it for energy or store it as fat for later use because insulin is a necessary part of that metabolic process. This means all the glucose just stays in the blood.
aha to your comment and I found this : This is where insulin becomes important, because it is insulin that opens up cells to glucose. ...thanks again Shawnmarie !