Scientists reveal some people with type 2 diabetes may actually have late on set type 1

by Barbara Hewitt on May 9, 2017

Adults diagnosed with type 2 diabetes may actually be suffering from type 1.5 diabetes, which is closer to type 1 diabetes, according to scientists.

In type 1 diabetes, often referred to as juvenile diabetes as it most commonly diagnosed at a young age, the body cannot produce insulin while type 2 diabetes is caused by the body stopping insulin production and is associated with being overweight and not taking enough exercise.

But now a study by researchers from around the world suggests that type 1.5 diabetes, known medically as Latent Autoimmune Diabetes (LADA), shares features with both other types although it is closer to type 1 diabetes. It may also hold clues for the treatment of both.

Like type 1 diabetes, LADA is marked by circulating autoantibodies, an indicator that an overactive immune system is damaging the body’s insulin producing beta cells. But LADA also shares clinical features with type 2 diabetes, which tends to appear in adulthood, as LADA patients do not require insulin treatments when first diagnosed.

The researchers have found that LADA is closer to type 1 diabetes and they believe that genetic influences that may offer clues to more accurate diagnosis and treatment and this is important because if people are diagnosed with the wrong type they may not get the most effective medication.

‘Correctly diagnosing subtypes of diabetes is important, because it affects how physicians manage a patient’s disease,’ said co-study leader Struan Grant, a genomics researcher at the Children’s Hospital of Philadelphia (CHOP) in the United States.

Grant collaborated with European scientists, led by Richard David Leslie of the University of London, and Bernhard Boehm of Ulm University Medical Centre in Germany, along with the Lee Kong Chian School of Medicine, a joint medical school of Imperial College London and Nanyang Technological University in Singapore.

The study team compared DNA from 978 LADA patients, all adults from the UK and Germany, to a control group of 1,057 children without diabetes. Another set of control samples came from 2,820 healthy adults in the UK and all samples were from individuals of European ancestry.

They found several type 1 diabetes genetic regions associated with LADA but relatively few type 2 diabetes gene regions added to the risk of LADA. The genetic risk in LADA from type 1 diabetes risk was lower than in childhood-onset type 1 diabetes, possibly accounting for the fact that LADA appears later in life.

They also found that one variant, which Grant and colleagues showed in 2006 to be among the strongest genetic risk factors for type 2 diabetes reported to date, had no role in LADA.

‘Our finding that LADA is genetically closer to type 1 diabetes than to type 2 diabetes suggests that some proportion of patients diagnosed as adults with type 2 diabetes may actually have late onset type 1 diabetes,’ said Grant.

He added that larger studies are needed to further uncover genetic influences in the complex biology of diabetes. ‘As we continue to integrate genetic findings with clinical characteristics, we may be able to more accurately classify diabetes subtypes to match patients with more effective treatments,’ he concluded.


The opinions expressed in this article do not necessarily reflect the views of the DiabetesForum.com Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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