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Double diabetes: A distinct high-risk group?

Noppadol Kietsiriroje1,2, Sam Pearson1, Matthew Campbell3

  • 1Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK.

Diabetes, Obesity & Metabolism
|August 3, 2019
PubMed
Summary

Double diabetes (DD) in type 1 diabetes (T1D) increases complication risk. Identifying DD using estimated glucose disposal rate (eGDR) aids personalized interventions for better outcomes.

Keywords:
double diabetesestimated glucose disposal ratemetabolic syndromeobesitytype 1 diabetes

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Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Diabetes Research

Background:

  • Double diabetes (DD) describes type 1 diabetes (T1D) patients with obesity, type 2 diabetes family history, or insulin resistance.
  • Individuals with DD exhibit elevated risk for diabetes complications, irrespective of glycemic control (HbA1c).
  • The rising prevalence of DD necessitates pragmatic identification criteria for targeted interventions.

Purpose of the Study:

  • To review criteria for identifying individuals with DD.
  • To explore potential mechanisms underlying DD and its link to complications.
  • To emphasize the utility of estimated glucose disposal rate (eGDR) in DD diagnosis and management.

Main Methods:

  • Review of existing literature on DD definitions and diagnostic criteria.
  • Analysis of potential pathophysiological mechanisms contributing to DD.
  • Evaluation of the role of eGDR in identifying and managing DD.

Main Results:

  • Several criteria exist for DD identification, each with limitations.
  • DD is associated with increased risk of diabetes complications.
  • Estimated glucose disposal rate (eGDR) shows promise as a practical diagnostic and monitoring tool for DD.

Conclusions:

  • Type 1 diabetes is more complex than previously thought, with DD representing a high-risk subgroup.
  • Pragmatic diagnostic criteria, such as eGDR, are crucial for risk stratification in DD.
  • Personalized management strategies based on accurate DD identification can improve patient outcomes and quality of life.