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Double Diabetes: Supporting Patients Through the Diagnostic Overlap
If you’ve never heard the term “double diabetes” before, don’t be alarmed. It’s not an official diagnosis, and you likely won’t find it in a medical textbook. However, it’s a term that’s gaining traction to describe a growing population of adults whose diabetes doesn’t fit neatly into the diagnostic criteria for either type 1 or type 2. Sometimes referred to as “hybrid diabetes,” “type 1.5,” or “LADA” (Latent Autoimmune Diabetes in Adults), recent research suggests that the distinction between type 1 and type 2 diabetes is less clear-cut than previously thought. In some cases, features of both types can coexist.…
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Remission vs Reversal
I’d like to think we are at the cusp of finding a cure for diabetes. Given the immense day-to-day burden, it can’t come fast enough. Until then, it’s important to proactively manage blood sugars, macro- and microvascular changes, and long term complications. With early and aggressive intervention, it’s not impossible to achieve euglycemia in those with endogenous insulin production—usually Type 2 Diabetes (T2D). Substantial lifestyle change may even yield near “normal” glucose with little to no pharmacological intervention. While it is tempting to think of this process as a “reversal” of diabetes, a 2021 consensus report recommends the term “remission”…
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Diagnosing Type 1 Diabetes in Adults
The UK T1D Immunotherapy Consortium recently updated their guidance on diagnosing type 1 diabetes (T1D) in adults. This is particularly important as a large portion of new onset T1D in adults are misdiagnosed as Type 2 diabetes (T2D). An accurate diagnosis matters. It can shape selection and advancement of treatment, understanding of natural disease progression, and expectations around the efficacy of diet and lifestyle. Most importantly, a misdiagnosis can be incredibly frustrating and discouraging for patients. Clinical Features While there is no single feature that distinguishes T1D from T2D in adults, presence of the following parameters suggest the need…
