From the Guidelines
Type 1 diabetes typically starts in childhood or adolescence, with most cases diagnosed before age 18, though it can develop at any age, while type 2 diabetes is generally considered an adult-onset condition, typically developing after age 10 in children with overweight or obesity and additional risk factors, as stated in the most recent guidelines 1. The distinction between type 1 and type 2 diabetes is crucial for appropriate treatment planning, and the increasing overlap in age of onset means that proper diagnostic testing is essential. Some key points to consider include:
- The prevalence of type 2 diabetes in youth has continued to increase over the past 20 years, with a significant impact on historically marginalized communities 1.
- Risk-based screening for prediabetes and/or type 2 diabetes should be considered after the onset of puberty or at age 10, whichever occurs earlier, in youth with overweight or obesity and additional risk factors 1.
- The presence of islet autoantibodies has been associated with faster progression to insulin deficiency, and obesity contributes to the development of type 1 diabetes in some individuals, further complicating the diagnostic challenges 1.
- Accurate diagnosis is critical, as treatment regimens, educational approaches, dietary advice, and outcomes differ markedly between patients with type 1 and type 2 diabetes 1. Given the complexity of diagnosing and managing diabetes in children and adolescents, a multidisciplinary team of specialists trained in pediatric diabetes management should provide care for this population, with a focus on diabetes self-management education, medical nutrition therapy, and psychosocial support 1.
From the Research
Type 1 Diabetes Onset Age
- Type 1 diabetes can occur at any age, but it is typically considered a disease of children and young adults 2
- The frequency of type 1 diabetes is higher in individuals diagnosed at a younger age, but it can also occur in adults, with 42% of genetically defined type 1 diabetes cases occurring in individuals diagnosed between 31-60 years old 2
- Diabetic ketoacidosis at diagnosis is more common among those with onset in childhood, while participants diagnosed as adults are more likely to be overweight/obese at diagnosis and to have used oral agents preceding type 1 diabetes diagnosis 3
Type 2 Diabetes Onset Age
- Type 2 diabetes is often considered a disease of adults, but it can also occur in children and adolescents 4
- The prevalence of complications and comorbidities is higher among teenagers and young adults with type 2 diabetes compared to those with type 1 diabetes 4
- Type 2 diabetes can occur at any age, but the risk of developing the disease increases with age, with most cases occurring in individuals over 40 years old 5
Comparison of Type 1 and Type 2 Diabetes
- Type 1 diabetes is characterized by insulin dependence, while type 2 diabetes is often characterized by insulin resistance and impaired insulin secretion 2
- The clinical characteristics of type 1 diabetes differ from those of type 2 diabetes, with type 1 diabetes often presenting with diabetic ketoacidosis, lower BMI, and higher rates of insulin use 2
- The distinction between type 1 and type 2 diabetes can be difficult to make, especially in adults, and requires careful consideration of clinical characteristics, genetic susceptibility, and other factors 3, 2