Reclassification of type 2 diabetes to type 1 diabetes in Asturias (Spain) between 2011 and 2020

Diabetology & Metabolic Syndrome

Research

Paula Morales Sánchez¹  Edelmiro Menéndez Torre²  Elías Delgado Álvarez²  Carmen Lambert³  Raúl Rodríguez Escobedo⁴ 

[1] Grupo de investigación en Endocrinología, Diabetes y Obesidad (ENDO), Instituto de Investigación del Principado de Asturias (ISPA), Oviedo, Asturias, España;Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Madrid, España;Grupo de investigación en Endocrinología, Diabetes y Obesidad (ENDO), Instituto de Investigación del Principado de Asturias (ISPA), Oviedo, Asturias, España;Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Madrid, España;Servicio de Endocrinología y Nutrición. Hospital Universitario Central de Asturias. Oviedo, Asturias, España;Departamento de Medicina, Universidad de Oviedo. Oviedo, Asturias, España;Grupo de investigación en Endocrinología, Diabetes y Obesidad (ENDO), Instituto de Investigación del Principado de Asturias (ISPA), Oviedo, Asturias, España;Universidad de Barcelona, Barcelona, España;Servicio de Endocrinología y Nutrición. Hospitales Universitarios San Roque, Las Palmas de Gran Canaria, España;Grupo de investigación en Endocrinología, Diabetes y Obesidad (ENDO), Instituto de Investigación del Principado de Asturias (ISPA), Oviedo, Asturias, España;

关键词: Type 1 diabetes;    Type 2 diabetes;    Diagnosis;    Insulin;    Epidemiolgy;    Reclassification;    LADA;   

DOI  :  10.1186/s13098-023-01069-y

 received in 2023-01-18, accepted in 2023-04-24,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundDifferentiating between type 1 diabetes (T1D) and type 2 diabetes (T2D) can be difficult in adults. The aim of this study was to determine the frequency of diagnostic reclassification from T2D to T1D, the characteristics of the patients and the impact on the management of the disease.MethodsObservational and descriptive study including patients diagnosed with T1D in Asturias (Spain) between 2011 and 2020 who had been considered as T2D for at least 12 months.ResultsA total of 205 patients were included, representing 45.3% of those diagnosed with T1D over 30 years of age. Median time of evolution as T2D was 7,8 years. The age was 59.1 ± 12.9 years. BMI was > 25 kg/m2 in 46.8% of patients. HbA1c was 9.1 ± 2.1%, 77 ± 22 mmol/mol, and 56.5% were using insulin. Pancreatic antibodies were present in 95.5%, the most frequent being GAD, 82.6%. At 6 months, basal insulin use increased from 46.9 to 86.3%, and HbA1c decreased, 9.2 ± 2.0%vs7.7 ± 1.2%, 77 ± 22vs60 ± 13 mmol/mol; p < 0.0001.ConclusionsDiagnosis as T2D in patients with T1D in adults is common. Age, BMI, insulin use and other clinical features are not definitely discriminatory. GAD is the antibody of choice in case of diagnostic suspect. Reclassification has important implications for metabolic control.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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Fig. 7

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