- 1 in 4 patients with new-onset type 1 diabetes (T1D) is initially misdiagnosed.
- Misdiagnosis is associated with an 18% increased risk for diabetic ketoacidosis (DKA) in children.
- Providers should consider T1D in adults with new-onset diabetes, and T1D should be ruled out in children with nonspecific viral symptoms.
Why this matters
- DKA is a life-threatening condition.
- T1D requires immediate insulin treatment.
- Retrospective online survey of 2526 adults with T1D or parents of children with T1D, from the T1D Exchange.
- Funding: T1D Exchange.
- Initial misdiagnosis was reported by 24% overall, and by 16% of those
- In adults, the wrong diagnosis most often was type 2 diabetes (76.8%), while in children it was influenza/other viral infection (53.7%).
- At diagnosis, 66.1% were hospitalized, and 40.9% experienced DKA.
- Patients with misdiagnosed T1D were at 17.6% increased risk for DKA compared with those correctly diagnosed at onset (45.2% vs 38.4%; P<.05>
- In children, DKA occurred in 68% initially misdiagnosed vs 42.8% correctly diagnosed (P<.001 but no difference among adults.>
- Retrospective self-reported data, possible ascertainment and recall biases.
- Online respondents may not generally represent the overall T1D population.