Mistaken Identity: Missed Diagnosis of Type 1 Diabetes in an Older Adult

Main Article Content

Yicheng K Bao Jessica Ma Vishwanath C Ganesan Janet B McGill

Abstract

Type 1 diabetes can occur at any age from infancy to elderhood. Patients with hyperglycemia onset at older ages are presumed to have type 2 diabetes. We discuss the case of a 58-year-old man who presented with diabetic ketoacidosis (DKA) at age 51 but was given the diagnosis of type 2 diabetes.  During two subsequent admissions for DKA, he suffered severe complications.  After his third episode of DKA, antibodies and C-peptide were checked, prompting a change in diagnosis to T1DM.  Following a correct diagnosis of T1DM, diabetes education and appropriate treatment, the patient remained free of DKA and had improved glucose control.  Under-diagnosis of type 1 diabetes can lead to recurrence of life-threatening episodes of DKA. Anti-GAD antibody and C-peptide testing are under-utilized in the differential diagnosis of type 1 versus type 2 diabetes in adults. The correct diagnosis is necessary to prevent hospital readmissions, morbidity, mortality and medical errors.  

Keywords: late, onset, type 1 diabetes, diabetic ketoacidosis, DKA

Article Details

How to Cite
BAO, Yicheng K et al. Mistaken Identity: Missed Diagnosis of Type 1 Diabetes in an Older Adult. Medical Research Archives, [S.l.], v. 7, n. 8, aug. 2019. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/1962>. Date accessed: 28 mar. 2024. doi: https://doi.org/10.18103/mra.v7i8.1962.
Section
Case Reports

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