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COMMENTARY

Diagnosing Diabetes: Many Variations in Type 2 Profile

Anne L. Peters, MD

Disclosures

October 13, 2023

1

This transcript has been edited for clarity.

Most adults with diabetes have type 2 diabetes, which is a polygenic disorder, meaning that we haven't found just one gene that defines it. We all know what we consider to be classic type 2 diabetes: someone who is perhaps older, heavier, has metabolic syndrome, and has family members with diabetes. However, looks can be deceiving.

In my type 1 clinic in East Los Angeles, I see many Latino individuals with type 1 diabetes who also have metabolic syndrome and are often misdiagnosed as having type 2 diabetes. When I see these patients, I tend to diagnose them based on a positive islet autoantibody level and/or their clinical requirement for insulin.

I also do a large amount of continuous glucose monitoring (CGM) in people with type 2 diabetes, even those on noninsulin therapies, and I see so many different variations in daily glucose profiles. It's often hard to believe that all of these people have the same disorder. I'm sure we're going to find many subtypes of type 2 diabetes even though we haven't defined them yet.

A number of people have tried to categorize type 2 diabetes into these subtypes. In 2018,

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