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Adult-Onset Type 1 ...
Adult-Onset Type 1 Diabetes : Current Understanding and Challenges
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- Leslie, R. David (author)
- Centre for Immunobiology, Blizard Institute, Queen Mary University of London, London, United Kingdom
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- Evans-Molina, Carmella (author)
- Departments of Pediatrics and Medicine and Center for Diabetes and Metabolic Diseases, Indiana University School of Medicine, IN, Indianapolis, United States; Richard L. Roudebush VA Medical Center, IN, Indianapolis, United States
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- Freund-Brown, Jacquelyn (author)
- JDRF, NY, NY
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- Buzzetti, Raffaella (author)
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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- Dabelea, Dana (author)
- Lifecourse Epidemiology of Adiposity & Diabetes Center, Colorado School of Public Health, Departments of Epidemiology and Pediatrics, University of Colorado Anschutz Medical Campus, CO, Aurora, United States
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- Gillespie, Kathleen M. (author)
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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- Goland, Robin (author)
- Naomi Berrie Diabetes Center, Columbia University, NY, NY
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- Jones, Angus G. (author)
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, United Kingdom
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- Kacher, Mark (author)
- JDRF, NY, NY
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- Phillips, Lawrence S. (author)
- Atlanta VA Medical Center and Division of Endocrinology, Metabolism, Department of Medicine, Emory University School of Medicine, Atlanta, United States
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- Rolandsson, Olov (author)
- Umeå universitet,Allmänmedicin
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- Wardian, Jana L. (author)
- College of Medicine, University of Nebraska Medical Center, Omaha, NE
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- Dunne, Jessica L. (author)
- JDRF, NY, NY
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Centre for Immunobiology, Blizard Institute, Queen Mary University of London, London, United Kingdom Departments of Pediatrics and Medicine and Center for Diabetes and Metabolic Diseases, Indiana University School of Medicine, IN, Indianapolis, United States; Richard L Roudebush VA Medical Center, IN, Indianapolis, United States (creator_code:org_t)
- 2021-10-18
- 2021
- English.
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In: Diabetes Care. - : American Diabetes Association (ADA). - 0149-5992 .- 1935-5548. ; 44:11, s. 2449-2456
- Related links:
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https://diabetesjour...
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https://urn.kb.se/re...
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https://doi.org/10.2...
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Abstract
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- Recent epidemiological data have shown that more than half of all new cases of type 1 diabetes occur in adults. Key genetic, immune, and metabolic differences exist between adult- and childhood-onset type 1 diabetes, many of which are not well understood. A substantial risk of misclassification of diabetes type can result. Notably, some adults with type 1 diabetes may not require insulin at diagnosis, their clinical disease can masquerade as type 2 diabetes, and the consequent misclassification may result in inappropriate treatment. In response to this important issue, JDRF convened a workshop of international experts in November 2019. Here, we summarize the current understanding and unanswered questions in the field based on those discussions, highlighting epidemiology and immunogenetic and metabolic characteristics of adult-onset type 1 diabetes as well as disease-associated comorbidities and psychosocial challenges. In adult-onset, as compared with childhood-onset, type 1 diabetes, HLA-associated risk is lower, with more protective genotypes and lower genetic risk scores; multiple diabetes-associated autoantibodies are decreased, though GADA remains dominant. Before diagnosis, those with autoantibodies progress more slowly, and at diagnosis, serum C-peptide is higher in adults than children, with ketoacidosis being less frequent. Tools to distinguish types of diabetes are discussed, including body phenotype, clinical course, family history, autoantibodies, comorbidities, and C-peptide. By providing this perspective, we aim to improve the management of adults presenting with type 1 diabetes.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
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- ref (subject category)
- art (subject category)
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- By the author/editor
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Leslie, R. David
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Evans-Molina, Ca ...
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Freund-Brown, Ja ...
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Buzzetti, Raffae ...
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Dabelea, Dana
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Gillespie, Kathl ...
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show more...
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Goland, Robin
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Jones, Angus G.
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Kacher, Mark
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Phillips, Lawren ...
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Rolandsson, Olov
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Wardian, Jana L.
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Dunne, Jessica L ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Endocrinology an ...
- Articles in the publication
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Diabetes Care
- By the university
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Umeå University