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Review
. 2024 Feb 10;23(1):62.
doi: 10.1186/s12933-024-02145-x.

Double diabetes-when type 1 diabetes meets type 2 diabetes: definition, pathogenesis and recognition

Weronika Bielka  1 , Agnieszka Przezak  2 , Piotr Molęda  2 , Ewa Pius-Sadowska  3 , Bogusław Machaliński  3
Affiliations
Review

Double diabetes-when type 1 diabetes meets type 2 diabetes: definition, pathogenesis and recognition

Weronika Bielka et al. Cardiovasc Diabetol. .

Abstract

Currently, the differentiation between type 1 diabetes (T1D) and type 2 diabetes (T2D) is not straightforward, and the features of both types of diabetes coexist in one subject. This situation triggered the need to discriminate so-called double diabetes (DD), hybrid diabetes or type 1.5 diabetes, which is generally described as the presence of the insulin resistance characteristic of metabolic syndrome in individuals diagnosed with T1D. DD not only raises the question of proper classification of diabetes but is also associated with a significantly greater risk of developing micro- and macroangiopathic complications, which was independent of glycaemic control. When considering the global obesity pandemic and increasing incidence of T1D, the prevalence of DD may also presumably increase. Therefore, it is of the highest priority to discover the mechanisms underlying the development of DD and to identify appropriate methods to prevent or treat DD. In this article, we describe how the definition of double diabetes has changed over the years and how it is currently defined. We discuss the accuracy of including metabolic syndrome in the DD definition. We also present possible hypotheses connecting insulin resistance with T1D and propose possible methods to identify individuals with double diabetes based on indirect insulin resistance markers, which are easily assessed in everyday clinical practice. Moreover, we discuss adjuvant therapy which may be considered in double diabetic patients.

Keywords: Diabetes; Double diabetes; Indirect insulin resistance markers; Insulin resistance; Metabolic syndrome; Type 1 diabetes; Type 2 diabetes.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Title: Pathophysiology of double diabetes. Descriptions in the text above. IR, insulin resistance; T2D, type 2 diabetes
See this image and copyright information in PMC

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