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Question:
I was diagnosed at age 20, overweight, and I'm a black female. I tend to believe that I'm a misdiagnosed Type 2, or a Type 1.5. My doctors diagnosed me as Type 1. Do you find that many Type 2's or Type 1.5's are misdiagnosed because of their age when they're diagnosed?

Answer:
As your question indicates, the "Types" of diabetes are difficult to understand. There's a reason why.

Many years ago, the terms that were available to subdivide the different kinds of diabetes were terribly confusing to researchers, patients, and physicians. At that time, diabetes was subdivided into "juvenile" (also called childhood-onset) diabetes, and "adult-onset" diabetes (sometimes called maturity-onset diabetes), plus other terms that were misleading and not well-thought-out, like "chemical" diabetes, and "borderline" diabetes. There even was a term for people who don't have diabetes yet: "prediabetes"!

However, a better system of terminology was definitely needed so that research could be done on the different varities of diabetes. Therefore, a committee dreamed up new names, including "Insulin-dependent diabetes" ("Type 1") and "Non-Insulin-dependent diabetes" ("Type 2") and then added additional terms such as "Secondary diabetes" (meaning some other condition, like overactive thyroid, was the cause of the abnormally high blood sugar level). The new system was based more upon whether the patient needed insulin because their own pancreas was kaput ("Insulin-dependent diabetes," "Type 1"), or whether the patient's own insulin was insufficient to control the blood sugar because of other problems ("Non-Insulin-dependent diabetes," "Type 2"). In the new system, the age of the patient at the time of diagnosis is not the major factor in making the diagnosis.

Although the revised system has indeed been a great help to the research work done in the past 15 years, unfortunately it has not helped much for you and me. The problem for you and me is that many doctors (and patients) remember the old terms, and still use or misuse them, and some situations (like your own) aren't really covered by the newer terminology. (By the way, there's another new committee that's again working on trying to develop better names: then we'll be probably be triply confused by three different sets of terms!!!)

If you want to, you can make up your own terms to describe your case. The term "Type 1.5" (pronounced "Type One-and-a-half") has been a popular but unofficial term for people such as yourself. If your doctors had seen you at the time of diagnosis, many of the features of your situation would look like what is officially called "Type 1;" however, later, the diabetes in this situation behaves more like Type 2; hence the cute but unofficial term "Type 1.5" has been popular.

If your physician had been used to the old terms about "juvenile" and "adult-onset" diabetes, and tried to use "Type 1" interchangeably with "juvenile" (or "Type 2" interchangeably with "adult-onset"), then indeed you could be mislabeled because of the confusion about what's what.

Original posting 27 Nov 95

  
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Last Updated: Tuesday April 06, 2010 15:08:52
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