Each year, more than 15,000 children and 15,000 adults are diagnosed with type 1 diabetes. Yet a new study shows that such numbers may only begin to describe the actual prevalence of the disease. The study, appearing in the American Journal of Forensic Medicine and Pathology, found that over a six-year period, nearly a third of people in Maryland who died from a complication of severe insulin deficiency had no known history of diabetes. That is, they died from type 1 diabetes that had not been diagnosed or treated.
Diabetic ketoacidosis, a consequence of uncontrolled diabetes, occurs when the body s cells don t have enough glucose to use for energy, so they switch to burning ketones which are acidic products of fat breakdown. If blood ketone levels climb too high, the resulting chemical imbalance can lead to coma or death. In the most recent study, a team led by Dr. Zabiullah Ali, assistant medical examiner for Maryland s Office of Chief Medical Examiner, examined over 20,000 autopsy reports and identified 92 people who died of diabetic ketoacidosis. Of these, about a third had not been previously diagnosed with diabetes, and nearly half of those who died with no history of the disease were in their 40s.
While type 1 diabetes has long been referred to as juvenile diabetes, physicians are now growing aware of the possibility that the disease may develop in adult patients as well. Warning signs include frequent urination, constant thirst, nausea, and vomiting. The study authors suggest that healthy people have their blood sugar checked at least once a year.
As for why such a significant portion of the Maryland cases were undiagnosed, the likely explanation is a general lack of awareness of the possibility of type 1 diabetes in adults, combined with a population that has no regular access to medical care.
This study should be a wake-up call to physicians and the public alike that type 1 diabetes is not necessarily restricted to children, notes ACSH's Dr. Ruth Kava. While it s true that the number of adults dying of this disease is relatively small, there s no reason that this should be happening at all. Type 1 diabetes is not that difficult to diagnose.
