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Patients ‘at risk’ over failure to recognise diabetes subtype

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The health of some diabetes patients is being put at risk due to the failure of clinicians to recognise that they have a subtype of the condition, according to researchers from the University of Surrey.

In the first ever study of its kind, they examined the UK primary care records of more than two million people, assessing the frequency of different types of diabetes and the accuracy of diagnosis.

“Greater awareness of type 3c diabetes within the medical profession is required immediately”

Simon de Lusignan

Particular focus was given to those who developed type 3c diabetes. It occurs as a result of pancreatic inflammation, abnormal growth of tissue on the organ or surgically removing part or all of the tissue, which affects the body’s ability to produce insulin.

The researchers found that up to 97.3% of people who have previously experienced pancreatic disease were misdiagnosed, typically with type 2 diabetes, rather than the correct condition type 3c.

Such a misdiagnosis could impact on the treatment offered to patients, with those with type 3c diabetes requiring insulin therapy more urgently than those with type 2, noted the researchers.

They warned delays in delivering appropriate treatment could have devastating long term effects for patients with type 3c diabetes with nerve, eye and kidney damage all possible consequences.

The researchers said they were also surprised to find in their study population that adults were more likely to develop type 3c diabetes than type 1 diabetes. In their sample, 205 more people were newly diagnosed with type 3c diabetes than with type 1.

The finding shows this under-recognised form of diabetes is more common than previously thought and could pose a potential threat to public health, they said.

“Diabetes of the exocrine pancreas is frequently labeled type 2 diabetes but has worse glycemic control and a markedly greater requirement for insulin,” they stated in the journal Diabetes Care.

University of Surrey

Patients ‘at risk’ over failure to recognise diabetes subtype

Simon de Lusignan

Senior study author Professor Simon de Lusignan said: “Greater awareness of type 3c diabetes within the medical profession is required immediately to improve management of this disease, which now has a higher incidence than type 1 diabetes in adults.

“Our research shows that the majority of people with type 3c diabetes are being misdiagnosed with type 2 diabetes, putting both their short and long term health at risk,” he said.

“Diabetes and its complications place a tremendous burden on the NHS and it is important that patients are diagnosed quickly and correctly, helping them get the specific care they need,” added.

“This builds on our previous work that suggests that failure to flag the right diagnosis is associated with lower quality care,” warned Professor De Lusignan.

What is type 3c diabetes?

Type 3c diabetes is diabetes that occurs following damage to the pancreas. It is also termed “pancreatogenic diabetes” or “diabetes of the exocrine pancreas”. Pancreatic disease is thought to produce a form of diabetes (Type 3c) which has some features similar to type 1 diabetes (a need for medical insulin relatively soon after diagnosis) and some features similar to type 2 diabetes (diagnosed in a similar age group and easy to miss unless blood sugar testing is performed).

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