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Recent epidemiological data shows that more than half of all new cases of type 1 diabetes occur in adults. Key genetic, immune, and metabolic differences exist between type 1 diabetes in adults and children, many of which are not well understood. This results in a substantial risk of misclassification of diabetes type. Notably, some adults with type 1 diabetes may not require insulin at diagnosis – their clinical phenotype can masquerade as type 2 diabetes, and the consequent misclassification may result in an inappropriate treatment trajectory.
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