The researchers, led by Cynthia E. Muñoz, PhD, of the University of Southern California, conducted a survey of 2,526 people recruited from a type 1 diabetes clinic and from online diabetes communities. About three-quarters of the participants had type 1 diabetes; the others were parents or guardians of children with the condition. The researchers determined that 25% of the respondents or their children had been incorrectly misdiagnosed when they first sought medical attention. Not only that, the researchers also found that the misdiagnosis increased the likelihood that the patients, especially the children, would develop diabetic ketoacidosis (DKA), a dangerous complication of diabetes in which the body produces high levels of blood acids called ketones, turning the blood acidic. DKA is the leading cause of death in children with type 1 diabetes.
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The symptoms that caused the patients to seek medical attention varied. Most common was excessive thirst, followed by fatigue, frequent urination and weight loss. Other symptoms related to age. Adults complained of blurred vision, vaginal yeast infections, tingling in the hands and feet and slow healing of sores, while children suffered more from stomach pain, nausea and vomiting and flu-like symptoms. If the health-care providers were failing to diagnose type 1 diabetes, what conditions were they diagnosing? In children, the most common misdiagnosis was the flu, followed by other viral infections. In adults, it was most often type 2 diabetes.
The authors hope that electronic record-keeping might someday lessen the risk of misdiagnosis by promoting the sharing of health information among emergency and primary-care physicians. They advise physicians to look for signs in younger patients that might indicate diabetes. “Weight loss in a growing child could trigger alerts suggesting inexpensive glucose testing,” they say. When it comes to adults, “A diagnosis of type 2 diabetes in a nonobese adult could similarly offer the option to check diabetes antibodies.”
A freelance writer and editor based in the Chicago area, Gustaitis has a degree in journalism from Columbia University.