Also found this comment interesting.
“Adult-onset T1D has become more common than childhood-onset with more than half of all new cases diagnosed in adult patients.”
@MM2 I can’t help but wonder if the increase in adult T1D is actually an increase or if awareness of the potential, testing, and finding adults with T1D has just occurred and the numbers have been there all along. A I’m a gray vs black&white kind of guy, its’ probably a bit of both…
Using myself as an example: I went to the USAF Academy as a young pup, but almost got eliminated based on a physical. I had to take a GTT three times because of the findings (I don’t know the specifics, I just drank the coke bottle of glucose and played the vampire’s victim for blood letting!). I also got warned by one of the admin NCOs that I was borderline underweight (at the time USAF took underweight more seriously than overweight). Looking back on it some 40 years later, I suspect my LADA or other diabetes name had already had sufficient effect to make the GTTs suspect, but not sufficiently defining. The weight loss issue was what drove the final testing resulting in my D diagnosis, though it was for T2 at first, finally T1 when a GAD test was done.
Found this re “mechanistic”: NIH defines mechanistic studies as designed to understand a biological or behavioral process, the pathophysiology of a disease, or the mechanism of action of an intervention . Not all mechanistic studies are clinical trials, but many are.
With “classic” juvenile diabetes, the symptoms come on more quickly. Parent or individual is likely to notice weight loss, tiredness, and do something about it. My mom noticed this when i was 5, went to doc, and sent directly to hospital (55+ years ago).
Hmmm. Thinking out loud here, so this could be wrong: More widespread testing would reveal an underlying increase in prevalence sooner, but if there is no actual underlying increase in T1D, then increased testing would only add to the count by finding adults who otherwise would have died before diagnosis. I thought I vaguely recalled that LADA generally causes dramatic symptoms within a few years. If that’s true, then more widespread testing would’t find enough new cases to explain the rise. I don’t see an immediate flaw in this line of reasoning…