NHS - Decision Document about T1 24 January 2024

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Proud to be erratic

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A generally good bit of info for Newbies. Pity they still claim T1 is (just) an auto-immune disease. The reason 50% of cases are in the over 18s is that these are more likely to be caused by a virus or something else.
 
DaveB said:
A generally good bit of info for Newbies. Pity they still claim T1 is (just) an auto-immune disease. The reason 50% of cases are in the over 18s is that these are more likely to be caused by a virus or something else.
Click to expand...
@DaveB, I'm not clear what you are suggesting here.

Are you inferring that T1 is anything other than an autoimmune condition damaging insulin production? The fundamental definition of a T1 diagnosis is diabetes caused by this autoimmune condition, so to my understanding if you have diabetes and do NOT have the autoimmune condition you must have some other type of diabetes and canot be T1.

However if you are saying that certain viruses cause the autoimmune conditions for a T1 diagnosis, then surely the diagnosis is still T1! Since we don't really know what has caused T1 in the past then surely we are just one step closer to having some explanation for the origins of T1 diagnoses.

I'm not arguing against your thought that recent viruses have resulted in some increase in T1. Whether that actually is solely the cause of a 50% increase I have no idea and I've not seen any definitive stats from the NHS to support the figure of 50%.

Edit: sorry I should have said it is really good to see NHS confirmation that more than 50% of T1 diagnoses are now in the age group > age 25. That helpfully adds value to what is widely understood by many members of this forum that T1 is not confined to children and young adults.
 
DaveB said:
A generally good bit of info for Newbies. Pity they still claim T1 is (just) an auto-immune disease. The reason 50% of cases are in the over 18s is that these are more likely to be caused by a virus or something else.
Click to expand...
I think people will often be diagnosed with T1following a virus, as we require more insulin when ill and our depleted beta cells finally let us know that they can’t cope. However the destruction of the beta cells will have started a long time before, especially for us late starters Where this process is slower than in youngsters. This is caused by the antibodies which are triggered, and is one of the tests that they do to determine the presence of T1.
It is good to see the acknowledgement that so many are now diagnosed as adults, although it still surprises people, including some HCPs, as they still associate T1 with children.
 
Exactly! when I was diagnosed aged 22 they reckoned mine was 'probably brought on' by a gastric virus I'd had in the late January/early February of that year. Wasn't actually that violent a 'tummy upset' anyway, really. Threw up a couple of times one Thursday night just after going to bed, followed by violent 'needing to go to the toilet pdq stomach ache' in the early hours Friday morning so didn't go to work on Friday; plenty more loo visits the next few days hardly ate anything over the weekend but still in pain and couldn't contemplate a 45minute drive to work on Monday so rang the Doctor as soon as they opened at 9am Monday, Home visit from GP that morning (remember when they used to do them, daily? and she signed me off for a week - no meds, 'most likely viral, just see how you go and make an appt to come and see us if it doesn't improve) It did improve by Tues/Weds so had a dead lazy week after that. Started feeling 'a bit not quite right' sometime around Easter that year which by July had progressed into what were (had I known it) definite symptoms of Type 1, instantly recognised by the GP I eventually saw, who instantly got me admitted to hospital (well - next morning) where I stayed for the next week and a half.
 
Proud to be erratic said:
@DaveB, I'm not clear what you are suggesting here.

Are you inferring that T1 is anything other than an autoimmune condition damaging insulin production? The fundamental definition of a T1 diagnosis is diabetes caused by this autoimmune condition, so to my understanding if you have diabetes and do NOT have the autoimmune condition you must have some other type of diabetes and canot be T1.

However if you are saying that certain viruses cause the autoimmune conditions for a T1 diagnosis, then surely the diagnosis is still T1! Since we don't really know what has caused T1 in the past then surely we are just one step closer to having some explanation for the origins of T1 diagnoses.

I'm not arguing against your thought that recent viruses have resulted in some increase in T1. Whether that actually is solely the cause of a 50% increase I have no idea and I've not seen any definitive stats from the NHS to support the figure of 50%.

Edit: sorry I should have said it is really good to see NHS confirmation that more than 50% of T1 diagnoses are now in the age group > age 25. That helpfully adds value to what is widely understood by many members of this forum that T1 is not confined to children and young adults.
Click to expand...
What I'm highlighting is that the medical profession is in rut with regard to T1 definition and beta cell death and this needs to be updated (but won't be!). There is an awful lot of diagnosis guesswork going on. Many LADAs have negative antibodies yet a C-Peptide test may show low insulin i.e. some beta cell death. In my case I rapidly developed LADA following a viral infection. So what is my diabetes type? I'm still listed a T2 yet my consultant agrees I'm effectively T1. The symptoms are the same as T1 - the same as many of those with LADA. We need a change to the definitions so that T1 includes any condition where there is beta cell death whatever the cause. Yes, we could introduce something T3, T4 etc but what would be the point?
 
DaveB said:
A generally good bit of info for Newbies. Pity they still claim T1 is (just) an auto-immune disease. The reason 50% of cases are in the over 18s is that these are more likely to be caused by a virus or something else.
Click to expand...
a virus may trigger it but i dont think its the cause. for example i was diagnosed at 29. however i found after diagnosis i found out that my great granddad had type 1 diabetties so there was a gernectic link there.
 
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