Diabetes, Metabolic Syndrome and Obesity

Global Trends in Type 1 and Severe Insulin Sufficient Diabetes: Incidence, Diagnosis and Management

Recent years have seen a change in the diagnostic classification scheme for type 1 diabetes, such that persons with severe insulin deficiency and presentation with diabetic ketoacidosis at diagnosis, but in the absence of classic type 1 diabetes autoantibodies, are now classified as having type 2 diabetes rather than type 1 diabetes. How this may influence the treatment, or change the treatment, of persons with diabetes is of great importance in terms of the acute care of individuals with diabetes. Further, it is of great importance in terms of financial and other resources made available to both the individual and the broader regions affected by these changes, as the reclassification largely affects persons in African or South Asian countries or with predominant ancestry from those countries. Recent years have also seen an increase in the use of electronic medical record systems in the surveillance of diabetes. The incidence of Type 1 diabetes continues to rise; the new classification scheme which now places individuals who would formerly have been classified as having type 1 diabetes as type 2 diabetes may underestimate the increases in incidence rates. Conversely, the widespread trend of using EHR systems as surveillance systems for the incidence of diabetes may overestimate these rates as well as increase the misclassification of disease types.

Although acute treatment and even long-term management should be based on the clinical presentation, not diabetes type, in reality diabetes type or perceived diabetes type influences clinical decision-making. Further, while diabetes genotype or phenotype, does not discriminate based on the patient’s phenotype (for example, type 1 diabetes does not discriminate based on obesity or race/ethnicity), with widespread emphasis placed on classical phenotypes of type 1 diabetes, clinical classification decisions may eventually follow suit. While clinical treatment should be based on clinical presentation, the perceived seriousness of that presentation, and thus its treatment, including life-threatening diabetic ketoacidosis (DKA) may be influenced by the type of diabetes the individual is diagnosed with. Long-term diabetes treatment and management, financial aid from government insurance and charitable organizations and other health care services, including health care navigation services, may also be influenced by diagnosis type.

To provide a comprehensive overview, we invite submissions covering, but not limited to, the following areas:

• Trends in the incidence of Type 2 diabetes
• Trends in the Incidence of severe insulin deficient Type 2 diabetes
• Trends in the classification of diabetes types
• Antibody use in the classification of diabetes type
• Trends in the treatment of Type 1 diabetes vs. severe insulin deficient Type 2 diabetes at diagnosis and long-term management
• Advanced diabetes technology in the treatment of type 1 diabetes and severe insulin deficient Type 2 diabetes
• The cost benefit ratio of changing diabetes classification criteria

All manuscripts submitted to this Article Collection will undergo desk assessment and a full peer-review.

Please review the journal scope and author submission instructions  prior to submitting a manuscript as it will be rejected if it does not fall within the scope of the journal.

The deadline for submitting manuscripts is the 28th of February 2027

Please contact Menghan Li at [email protected] with any queries and discount codes regarding this Article Collection.