Black and Asian patients at risk of wrong diabetes diagnosis by GPs, study shows

Thousands of people may be on the wrong treatment because of the difficulty in determining whether they have type 1 or type 2 diabetes
PA

Thousands of patients are at risk of having their type of diabetes misdiagnosed because of a lack of understanding of the role of ethnicity, a hospital doctor warned today.

Dr Shivani Misra, of Imperial College Healthcare NHS trust, said many people “may be on the wrong treatment” because of the difficulty in determining whether they have type 1, type 2 or a rare genetic form of the disease.

Some patients could be injecting themselves with insulin unnecessarily because they think they have type 1 diabetes, she said.

More worryingly, others with type 1 could be in a “life-threatening” situation taking tablets for type 2 diabetes that cannot generate the insulin they need.

Interim results from Dr Misra’s My Diabetes study at Imperial College London, which recruits patients diagnosed under the age of 30 from more than 35 NHS trusts, found that 58 per cent were not making their own insulin, meaning they were type 1 diabetics.

About 20 per cent could have “shorter duration” type 1 diabetes, and the remaining 23 per cent either had type 2 diabetes or a rare genetic form known as MODY (maturity-onset diabetes of the young).

Dr Misra, a consultant in metabolic medicine, said: “GPs often assume they have type 2 diabetes, but my data shows that type 1 diabetes is still the most common form in people presenting at a young age.

“In ethnic minority groups who pre­sent at a young age, don’t assume it’s type 2. It could still be type 1. If you are uncertain, refer to a specialist.”

Problems in differentiating between type 1 and type 2 diabetes were already known, as there is no test that is 100 per cent accurate.

About four million people in the UK have diabetes. Of these, research charity Diabetes UK estimates 20,000 to 40,000 have MODY, which might not require insulin injections.

Five years ago Prime Minister Theresa May revealed her “real shock” at being told she had type 1 diabetes, having previously been diagnosed with the more common type 2.

When diagnosing diabetes, GPs typically consider a patient’s body mass index and age. Dr Misra said her research indicated these factors were “increasingly poor” at ensuring correct diagnosis in young patients, especially those of south Asian or African-Caribbean heritage.

Research at Imperial into 3,264 people diagnosed with type 1 diabetes found 54, or 1.7 per cent, did not have the disease.

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