CUHK Scientist leads global effort to map adult-onset diabetes
The epidemiology of adult-onset type 1 diabetes is not well-characterised due to a historic focus on this type of diabetes as a childhood-onset disease. However, in a global study led by Professor Ronald Ching Wan Ma (Croucher Fellowship 2001, Croucher Senior Medical Research Fellowship 2020), head of the Division of Endocrinology and Diabetes at the Faculty of Medicine of the Chinese University of Hong Kong, researchers found that there is a significant incidence of type 1 diabetes among adults aged 20 and above, much higher than previously believed.
Type 1 diabetes is an autoimmune condition where the immune system attacks the cells responsible for producing insulin in the body, resulting in severe insulin deficiency and elevated blood glucose. Once developed, those with type 1 diabetes require lifelong treatment with insulin.
In this collaborative study, published in Diabetes Care, researchers examined 46 studies from 32 countries between 1990 and 2021. Their review revealed a global pattern of adult-onset type 1 diabetes and indicated that the incidence varied considerably by geographical region, ranging from less than 1 per 100,000 in China to more than 30 per 100,000 in Sweden.
Incidence of adult-onset type 1 diabetes in adults aged 20-40 years
The review also found that the overall rates of adult-onset type 1 diabetes are significantly higher in men than women. Among the 26 studies which reported rates in males and females, 92% of the studies reported a higher incidence in adult males.
Most notably, there was no clear relationship between age and the rates of adult-onset type 1 diabetes, highlighting the significant incidence of type 1 diabetes diagnosed later in life.
“This contrasts with the traditional thinking that cases of type 1 diabetes rarely present in adulthood,” says Ma,
“Most adults presenting with diabetes are likely to be diagnosed with type 2 diabetes, which can be controlled by oral medications in the early stages. The key challenge now becomes how best to identify the significant numbers who in fact have underlying type 1 diabetes, to ensure they receive appropriate treatment, in particular early insulin therapy.”