38 per cent of adults with type 1 diabetes are misdiagnosed with type 2

[Robinredbreast]

Personally I think this justice a formal complaint to the GMC about the GP.

Tbh, I never thought of that, it was so unbelievably ridiculous at the time, as I had never even seen him, also GP left the surgery.
Thank you for your reply @ringi

 

[JAT1]

As so many doctors and medics are so wrong so often about diabetes, makes you question how well they are doing regarding other physical ailments, yet they will tell you your chances of surviving this and that and so many patients believe them.

 

[ickihun]

I'm noted as type2 due to being obese. An old nurse describe me as being gestational diabetic and I said no. I was diagnosed diabetic before pregnancies. Hence this nurse told me once Iost weight I'd no longer need insulin. Consultant says otherwise.
We'll see.
I've had diabetes too long to determined if I was type1 but due to low carb eating and huge exercise regimes I didn't get tested for diabetes til I stopped low carbing in 2001 due to low income, shift work (only way to shake off money grabbing hubby) and paying single handedly for a London home.
I'm regularly checked for pituitary gland irregularities due to my thyroid malfunction.
I only lose weight on low calorie and low carb eating. To satisfy my thyroid and diabetes.
However I never don't ever have none diabetic hba1c levels, ever.
Maybe I'm either a tired pancreas diabetic (type 2) and huge IR enables my liver to overcompensate with my injections or I'd hv antibodies in my blood test, if specialist decides to test me.
If I'm coeliac after op then I will insist on it.

 

[Mr_Pot]

I get my C-peptides tested fairly regularly

I understand the testing of C-peptides for diagnosis, but having been diagnosed what is the purpose of repeated tests?

 

[bulkbiker]

I understand the testing of C-peptides for diagnosis, but having been diagnosed what is the purpose of repeated tests?

To test that insulin production isn't becoming impaired over time?

 

[Mr_Pot]

Maybe I'm being dim here, but....

Supposedly the ratio of T1 to T2 is 10 to 100.
But if 40% of those T1s are misdiagnosed as T2 initially, it means that approximately 4 in every 100 T2s has actually got T1, so about 4%.

That is a mind blowing article which should probably be shown to every new T2 posting on these boards. I thought I was going over the top in urging a test for T1 every time a T2 seems to need insulin early in the game, but maybe not. I start to wonder just how many insulin dependant T2s have been incorrectly diagnosed....

I agree with your general point, but regarding your calculation, note that the article is about adults misdiagnosed, presumably a lot of the 10% with Type 1 were diagnosed ( hopefully correctly) as children.

 

[Mr_Pot]

To test that insulin production isn't becoming impaired over time?

My question was specifically for @AloeSvea. I was interested to know how the results of the tests would change her "treatment".

 

[Scott-C]

@Mr_Pot , thought you might be interested in this link.

I'm treated at one of the hospitals which forms part of ECED, and they're exploring the use of c-pep for diagnostic purposes.

In the link, there's a link to a pdf setting out their c-pep testing protocol, with a flowchart algorithm. They say it's for T1s at the moment but may be rolled out to T2.

An interesting look at it from the doc's perspective.

http://www.edinburghdiabetes.com/diabetes-protocols

 

[Mr_Pot]

@Mr_Pot , thought you might be interested in this link.

I'm treated at one of the hospitals which forms part of ECED, and they're exploring the use of c-pep for diagnostic purposes.

In the link, there's a link to a pdf setting out their c-pep testing protocol, with a flowchart algorithm. They say it's for T1s at the moment but may be rolled out to T2.

An interesting look at it from the doc's perspective.

http://www.edinburghdiabetes.com/diabetes-protocols

Thanks Scott, it is very interesting, particularly the flowchart you mentioned. I think this would be very good reading for those who think that diagnosis is clear cut and a simple test is all that is required.
In my own case as a diet controlled type 2 diagnosed aged 68 with no symptoms or risk factors, I suspect my insulin production is just waining with age. It would be interesting to know, but as it wouldn't make any difference and the test is likely to be inconclusive, it seems pointless.

 

[AloeSvea]

Hi @Mr_Pot. I get my insulin levels tested via the C-peptide over time to check how my regime, or an experiment with regimes, is affecting my insulin production, as in keeping it in check to make sure it is not getting dangerously high.

As a person with severe insulin resistance, I just need to look at a piece of battered fish or a piece of toast and my insulin levels start getting very high. ie eating glucose high food or food that turns into high glucose in my blood causes a greater insulin response than most presumably, in someone with a diabetic profile like me. And I take keen note of the latest research into insulin production, and to Krafft and so on, who put the cardio vascular risk that we with diabetes have, down to the unhealthy levels of insulin, not necessarily the levels of glucose that ends up in our blood. This is why I am very keen to keep a sharp eye on my insulin levels, and adjust my regimes accordingly. (I treat with diet and exercise, no medication.)

 

[michita]

I agree with your general point, but regarding your calculation, note that the article is about adults misdiagnosed, presumably a lot of the 10% with Type 1 were diagnosed ( hopefully correctly) as children.

The way I read this is:

Current T1/T2 split is 10/90. 90% of T2 includes those misdiagnosed.

If 38% of the 90% T2 are misdiagnosed and actually T1, misdiagnosed type 2 (type1) is 38% x 90% = 34%

So true T1/T2 split is : 44/56

Type 1 correctly diagnosed :10%
Type 1 but misdiagnosed as type 2: 34%
True type 2 : 56%

 

[Member496333]

I believe the T1/T2 ratio is likely far far greater than 10/90 if one takes into account the potentially massive numbers of folk walking around undiagnosed with severe insulin resistance. Not particularly relevant to this discussion, I suppose, but nevertheless.

 

[Mr_Pot]

The way I read this is:

Current T1/T2 split is 10/90. 90% of T2 includes those misdiagnosed.

If 38% of the 90% T2 are misdiagnosed and actually T1, misdiagnosed type 2 (type1) is 38% x 90% = 34%

So true T1/T2 split is : 44/56

Type 1 correctly diagnosed :10%
Type 1 but misdiagnosed as type 2: 34%
True type 2 : 56%

The original article is about T1's being initially diagnosed as T2. So it is the 10% that is misdiagnosed.
Type 1 initially diagnosed as Type 2 38% x 10% = 3.8%

Also as I said this article is about adults. Type 1 children with diabetes are more likely to be correctly diagnosed as statistically it is more likely a child has Type 1 and an adult has type 2.

This is really a maths discussion, I think we are both agreed that too many people are misdiagnosed.

 

[ringi]

To test that insulin production isn't becoming impaired over time?

I see no point unless A1c is over 52.