Type 1 Diabetes Name History

This page is sort of a living document about my research into the naming history of autoimmune diabetes mellitus, more commonly known as Type 1 Diabetes.

There are obviously a lot of missing sections but I’ve been promising to get this posted for several years and I figure this is the best way to encourage myself to finish.

Diabetes Mellitus

The name “Diabetes Mellitus” dates back roughly 500 years, and awarness of the disease by other names (e.g. “sugar sickness”) goes back a few thousand.

Until I finish this section, you can read more about Diabetes Mellitus at Wikipedia.

Diapedia also has an extensive writeup about the history of Diabetes Mellitus, which includes the evolution of naming conventions.

Severe and Mild Diabetes

In the early years of modern understanding of diabetes, there was recognition that it occurred in “mild” and “severe” forms. I’m still looking for details about how prevelant these terms were in clinical terminology. So far, my best source is the rather short section from the Diapedia entry on the history from 1900 to 1950, so please let me know more about the early days of classification.

Juvenile and Adult Diabetes

Leading up to the 1970s, it was known that both children and adults could be diagnosed with severe diabetes, and though mild diabetes was more common, adults were still the larger group of new diagnoses of severe diabetes. However, throughout the decade of the 1970s, this perception changed so much that severe diabetes began to be referred to a “juvenile diabetes”. My friend Melitta has done extensive research into this transition, and has published some of her findings in this article about historical references to adult-onset type 1 diabetes, which includes some ideas about how they basically to disappeared in the 1970s.

Type 1 Diabetes (original proposal)

Though not officially approved standardized until 1995 (more on that further down in the timeline), “Type 1 Diabetes” dates back to John Lister from 1951.

I’ll eventually fill in this section, but for now you can read more about the early days of the Type 1 name on Diapedia (links go to the internet archive because Diapedia seems to have gone offline):

Insulin Dependent Diabetes

In 1979, what is now know as Type 1 Diabetes was classified as Insulin Dependent Diabetes. This was partly in recognition that onset of the disease was not limited to children, and that those children eventually grew up to become adults.

Type 1.5

The first appearance of the term “Type 1.5 diabetes” was published in an anonymous editorial in the medical journal The Lancet in 1985 1, which finishes with the passage “When diabetes is again reclassified we may find them accommodated in a new category of type 1 1/2; diabetes – a condition in which insulin sustains not life itself but the quality of life.”

I haven’t been able to determine how quickly use of this term spread to the medical community. The only other significant reference I have been able to find from the time period is a 1988 article about classification of adults as IDDM2, which merely references the original article as an example of why the diagnostic criteria of the day were not sufficient.

Note: I am still looking for evidence for when this term became symonymous with “Double Diabetes” (or “Type 1 DM, with insulin resistance”, as it is currently known). This interpretation seems to be part of the confusion that contributes to the current epidemic of misdiagnosis of Type 1 adults as Type 2.

LADA: Latent Autoimmune Diabetes in Adults

The term LADA was proposed by Toumi, et. al. in 19933 to speak of the same condition, this time with more understanding of the autoimmune process behind the disease: autoimmune diabetes diagnosed in adulthood (which usually presents itself slowly and back then was thought to be treatable with medications intended for people with what was then called non-insulin dependent diabetes).

Note: Yes, I plan to add more details in this section…

Type 1 Diabetes

In 1995, the US caught up with the rest of the world (Note: I’m still looking for references about the worldwide adoption of Type 1) and consolidated all autoimmune diabetes under the “Type 1” name, relegating both “Type 1.5” and “LADA” as unofficial terms that people still want to use as a way to differentiate between childhood-onset and adult-onset T1, or rapid-onset (most commonly diagnosed in children) and slow-onset (most commonly diagnosed in adults). Unfortunately, it’s often difficult to figure out which they mean because some young people develop slow-onset T1, and some adults develop rapid-onset T1.

What’s next?

Still TBD.

For now, check out this article from 2003:

“What’s in a Name: Latent autoimmune diabetes of adults, type 1.5, adult-onset, and type 1 diabetes” in Diabetes Care 2003 Feb; 26(2): 536-538