Reviews
Description
At a time of dramatic increases in the prevalence of obesity, it is appropriate that Type 2 diabetes has received a great deal of attention by the endocrinology community. Clearly, the management of insulin resistance and cardiovascular risk is a critical issue. However, it is important to also acknowledge and address Type 1 diabetes, whose prevalence is also increasing, and whose management remains complex. Currently it is estimated that 10-15% of those with diabetes carry the diagnosis of Type 1 diabetes, and frequently the diagnosis is not straightforward, as many clinicians recognize that more adults previously thought to have Type 2 diabetes actually have late-onset Type 1 diabetes (also termed latent autoimmune diabetes of the adult or LADA). Over the last decade tools for the management of Type 1 diabetes have also evolved; therefore, clinicians now have the opportunity to more closely replicate normal physiologic insulin secretion with either basal-bolus insulin therapy
or continuous subcutaneous insulin infusions. While these advancements allow clinicians to manage patients with Type 1 diabetes better, they also add complexity to patient treatment. An updated text to address the concepts behind the recognition of new onset Type 1 diabetes in adults, the ongoing care of adults with established Type 1 diabetes, and future potential therapies and devices is warranted to review these issues for both endocrinologists and primary care providers with an interest in diabetes.
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At a time of dramatic increases in the prevalence of obesity, it is appropriate that Type 2 diabetes has received a great deal of attention by the endocrinology community. Clearly, the management of insulin resistance and cardiovascular risk is a critical issue. However, it is important to also acknowledge and address Type 1 diabetes, whose prevalence is also increasing, and whose management remains complex. Currently it is estimated that 10-15% of those with diabetes carry the diagnosis of Type 1 diabetes, and frequently the diagnosis is not straightforward, as many clinicians recognize that more adults previously thought to have Type 2 diabetes actually have late-onset Type 1 diabetes (also termed latent autoimmune diabetes of the adult or LADA). Over the last decade tools for the management of Type 1 diabetes have also evolved; therefore, clinicians now have the opportunity to more closely replicate normal physiologic insulin secretion with either basal-bolus insulin therapy
or continuous subcutaneous insulin infusions. While these advancements allow clinicians to manage patients with Type 1 diabetes better, they also add complexity to patient treatment. An updated text to address the concepts behind the recognition of new onset Type 1 diabetes in adults, the ongoing care of adults with established Type 1 diabetes, and future potential therapies and devices is warranted to review these issues for both endocrinologists and primary care providers with an interest in diabetes.
Reviews