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Cited by 58Diabetes and associated disordersDiabetes Management and ResearchDiabetes Treatment and Management

The epidemiology of type 1 diabetes mellitus in older adults

Open access
Tomic, Dunya, Harding, Jessica L., Jenkins, Alicia J., Shaw, Jonathan E., Magliano, Dianna J.·2025·Nature Reviews Endocrinology
DOI 10.1038/s41574-024-01046-zPMC PMC12240003
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Abstract

Although type 1 diabetes mellitus (T1DM) is traditionally viewed as a youth-onset disorder, the number of older adults being diagnosed with this disease is growing. Improvements in the average life expectancy of people with T1DM have also contributed to the growing number of older people living with this disease. We summarize the evidence regarding the epidemiology (incidence, prevalence and excess mortality) of T1DM in older adults (ages ≥60 years) as well as the genetics, immunology and diagnostic challenges. Several studies report an incidence peak of T1DM in older adults of a similar size to or exceeding that in children, and population prevalence generally increases with increasing age. Glutamic acid decarboxylase antibody positivity is frequently observed in adult-onset T1DM. Guidelines for differentiating T1DM from type 2 diabetes mellitus in older adults recommend measuring levels of C-peptide and autoantibodies, including glutamic acid decarboxylase antibodies. However, there is no gold standard for differentiating T1DM from type 2 diabetes mellitus in people aged 60 years and over. As such, the global variation observed in T1DM epidemiology might be in part explained by misclassification, which increases with increasing age of diabetes mellitus onset. With a growing global population of older adults with T1DM, improved genetic and immunological evidence is needed to differentiate diabetes mellitus type at older ages so that a clear epidemiological picture can emerge. This Review discusses the incidence, prevalence and disease burden of type 1 diabetes mellitus in older adults in diverse geographical regions. The challenges involved in defining and diagnosing type 1 diabetes mellitus in this population and the implications of these challenges for epidemiological studies of this disease are also addressed. The increasing population of older adults with type 1 diabetes mellitus (T1DM), including those with late-onset T1DM together with those with early-onset T1DM reaching older ages, necessitates a stronger research focus in this age group. Incidence and prevalence of T1DM at older ages vary across the world, partly due to different definitions as well as population characteristics. Given the considerably greater incidence of type 2 diabetes mellitus (T2DM) than of T1DM at older ages, even low levels of misclassification of T2DM as T1DM can lead to major uncertainty in the epidemiology of T1DM. Although survival among older adults with T1DM has improved, older adults with T1DM still have substantially reduced life expectancy compared with those of the same age in the general population. Although glutamic acid decarboxylase positivity and low C-peptide are indicative of T1DM among older adults presenting with new-onset diabetes mellitus, there is no gold standard in differentiating T1DM from T2DM at older ages. A more accurate definition of T1DM in older adults should be developed and applied to epidemiological studies globally to understand the true burden of T1DM among older adults compared with that in other age groups. The increasing population of older adults with type 1 diabetes mellitus (T1DM), including those with late-onset T1DM together with those with early-onset T1DM reaching older ages, necessitates a stronger research focus in this age group. Incidence and prevalence of T1DM at older ages vary across the world, partly due to different definitions as well as population characteristics. Given the considerably greater incidence of type 2 diabetes mellitus (T2DM) than of T1DM at older ages, even low levels of misclassification of T2DM as T1DM can lead to major uncertainty in the epidemiology of T1DM. Although survival among older adults with T1DM has improved, older adults with T1DM still have substantially reduced life expectancy compared with those of the same age in the general population. Although glutamic acid decarboxylase positivity and low C-peptide are indicative of T1DM among older adults presenting with new-onset diabetes mellitus, there is no gold standard in differentiating T1DM from T2DM at older ages. A more accurate definition of T1DM in older adults should be developed and applied to epidemiological studies globally to understand the true burden of T1DM among older adults compared with that in other age groups.

AI snapshot

Written from the paper’s full text.

TL;DR

This review summarizes the epidemiology of type 1 diabetes mellitus (T1DM) in adults aged ≥60 years, reporting that incidence in older adults may equal or exceed childhood incidence in some European studies, prevalence generally rises with age, and mortality is elevated versus the general population. It emphasizes that diagnostic misclassification, especially increasing with age of onset, and the lack of gold-standard definitions limit certainty about the true burden.

Key findings

  • Incidence in older adults is inconsistent across regions: in Kronoberg, Sweden (1998–2001), the highest incidence was at ages 70–79 years at 55.0 per 100,000 (95% CI 51.4–58.7), exceeding children aged 0–9 years at 47.2 per 100,000; women aged 70–79 years had 65.1 per 100,000 versus 38.3 for men. In Ireland in 2016, incidence was 54.2 per 100,000 (95% CI 45.3–63.0) at ≥75 years versus a youth peak of 31.7 per 100,000 at 0–14 years. By contrast, Denmark in 2016 reported incidence of 13 per 100,000 in men and 8 in women aged 60–69 years, lower than youth <20 years (33 and 27 per 100,000), and Asian estimates were much lower (e.g., Japan ≥60 years: 3.48 men and 3.31 women per 100,000 person-years).
  • Prevalence generally increases with age: US National Health Interview Survey 2016 self-reported T1DM was 0.65% (95% CI 0.48–0.88) at ≥65 years versus 0.45% (95% CI 0.27–0.75) at 18–29 years; Ireland reported 0.74% (95% CI 0.71–0.77) at ≥75 years. In Australia in 2024, 33.4% of people with T1DM were aged ≥60 years and 63.2% were aged ≥40 years. Some studies, however, showed prevalence peaking at younger ages or declining after age 80.
  • Mortality is higher in older adults with T1DM than in the general population: in Scotland (2008–2010), death rates rose from 31.9 per 1,000 person-years in men and 24.2 in women aged 60–64 years to 142.7 in men and 171.3 in women aged ≥80 years. In Australia, standardized mortality ratios were 2.60 (95% CI 2.36–2.87) for men and 3.40 (95% CI 3.00–3.87) for women aged 60–69 years, and life expectancy at 60–64 years was 6.5 years shorter for men and 8.5 years shorter for women.
  • Adult-onset T1DM is characterized by lower frequency of high-risk HLA types, more protective genotypes, lower genetic risk scores, and frequent glutamic acid decarboxylase antibody (GADA) positivity. Misclassification of T1DM increases with age of onset, with rates of <1%, 7.2%, and 14.2% in those aged <18, 18–30, and >30 years, respectively; C-peptide ≤0.20 mmol/l was reported as supportive of T1DM and ≥0.30 mmol/l as suggestive of T2DM.

Methods

  • Design: narrative review of published evidence on the epidemiology (incidence, prevalence, excess mortality), genetics, immunology, and diagnostic challenges of T1DM in adults aged ≥60 years.
  • Data: the review reports identifying 23 studies for incidence, with 12 combinations of diagnostic methods used; prevalence and mortality evidence came mainly from North America, Europe, Australia, and some Asian studies. No new primary data were collected.
  • Analysis: narrative synthesis with summary tables; no meta-analysis or pooled effect estimates are reported.

Limitations

  • Stated: there is a paucity of data and no gold standard for differentiating T1DM from T2DM in people aged ≥60 years; global variation may be partly explained by misclassification, which increases with age of diabetes onset and may inflate incidence and prevalence while reducing mortality estimates.
  • Stated: existing studies often do not differentiate T1DM from latent autoimmune diabetes in adults (LADA), most data come from Europe and North America, and stratification by characteristics other than sex was limited in ages ≥60 years due to limited data; the extent of misclassification remains uncertain.
  • Evident from the text: the review is not systematic and reports no formal risk-of-bias assessment or meta-analysis; the 12 diagnostic combinations and inconsistent age groupings or cut-offs mean studies could not be directly compared.

Model-written summary. Check it against the paper before relying on it.

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Crossref · 10.1038/s41574-024-01046-z

Cites

100 of 100 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

71 of 107 cited sources checked · 29 supported · 2 flagged · accuracy not yet measured

  • Premisecitation

    Several studies report an incidence peak of type 1 diabetes mellitus in older adults of a similar size to or exceeding that in children.

    “Several studies report an incidence peak of T1DM in older adults of a similar size to or exceeding that in children”
    • Also stated in: § Incidence · plain
      “Some studies report an incidence peak in older adults of a similar size to or, in two studies from Sweden12 and Ireland13, exceeding the incidence peak in childhood.”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [12] Thunander, M. et al. Incidence of type 1 and type 2 diabetes in adults and children in Kronoberg, Sweden. Diabetes Res. Clin. Pract. 82, 247–255 (2008). This was the first study to describe incidence of T1DM in older adults that exceeded that in all age groups, including in children. source
    • cites [13] Gajewska, K. A., Biesma, R., Sreenan, S. & Bennett, K. Prevalence and incidence of type 1 diabetes in Ireland: a retrospective cross-sectional study using a national pharmacy claims data from 2016. BMJ Open 10, e032916 (2020). This study followed from Thunander et al. (ref. 12) to also report the highest incidence of T1DM in older adults out of all age groups, strengthening the evidence for a possible second incidence peak after age 70 years. source

      The Results (Incidence; page not provided) identify people aged 75 and over and children aged 14 and under among the groups with the highest incidence. But this paper provides only one older-adult incidence finding: the Italian study discussed has no data for older age groups. The Discussion also cautions that double-counting may help explain its high incidence estimate for older adults, so it does not establish that several studies report such a peak. (LLM, conf=0.86)

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  • Premisecitation

    In the USA, type 1 diabetes mellitus prevalence using a stringent definition was 0.08% (95% CI 0.02-0.18) in those aged ≥60 years.

    “Using a more stringent definition of T1DM (previous diagnosis of diabetes mellitus before age 30 years, currently taking insulin and starting insulin within 1 year of diagnosis), an analysis of National Health and Nutrition Examination Survey data saw a significantly lower prevalence of 0.08% (95% CI 0.02–0.18) in those aged ≥60 years34.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [34] Menke, A. et al. The prevalence of type 1 diabetes in the United States. Epidemiol 24, 773–774 (2013). source

      The ‘To the Editor’ section describes the NHANES analysis and confirms the stringent definition: diagnosis before age 30, insulin started within one year, and current insulin use. It says prevalence was calculated by age, but the available passages do not give the 0.08% estimate or 95% CI for adults aged ≥60, nor establish that it was significantly lower; those parts cannot be verified from our copy. (LLM, conf=0.83)

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  • Premisecitation

    In Finland, mortality in 2017 ranged from 25.5 per 1,000 persons with type 1 diabetes mellitus aged 60-64 years to 76.4 per 1,000 persons aged 75-79 years.

    “In Finland, mortality in 2017 ranged from 25.5 per 1,000 persons with T1DM aged 60–64 years to 76.4 per 1,000 persons aged 75–79 years5.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [5] Arffman, M., Hakkarainen, P., Keskimäki, I., Oksanen, T. & Sund, R. Long-term and recent trends in survival and life expectancy for people with type 1 diabetes in Finland. Diabetes Res. Clin. Pract. 198, 110580 (2023). source

      The Results section reports survival and life expectancy for people with type 1 diabetes in Finland, but not the claimed 2017 mortality rates for ages 60–64 and 75–79. Searches for 25.5, 76.4, and those age groups found no matching rates in our copy. No page numbers were available for these passages. (LLM, conf=0.74)

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  • Premisecitation

    In the UK, death rates were 42.4 per 1,000 person-years for men and 44.1 per 1,000 person-years for women with type 1 diabetes mellitus aged 66-75 years.

    “In the UK, death rates were 42.4 (95% CI 29.5–61.0) per 1,000 person-years for men and 44.1 (95% CI 29.8–65.3) per 1,000 person-years for women with T1DM aged 66–75 years40.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [40] Soedamah-Muthu, S. S. et al. All-cause mortality rates in patients with type 1 diabetes mellitus compared with a non-diabetic population from the UK general practice research database, 1992-1999. Diabetologia 49, 660–666 (2006). source
  • Premisecitation

    In Hong Kong, annual type 1 diabetes mellitus incidence varied between 0.73 and 1.83 per 100,000 among men and between 0.64 and 1.09 per 100,000 among women aged ≥60 years between 2013 and 2015.

    “In a population-based Hong Kong study, annual incidence varied between 0.73 and 1.83 per 100,000 persons among men and between 0.64 and 1.09 per 100,000 persons among women aged ≥60 years19 between 2013 and 2015.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [19] Luk, A. O. Y. et al. Secular trends in incidence of type 1 and type 2 diabetes in Hong Kong: a retrospective cohort study. PLoS Med. 17, e1003052 (2020). source

      The Results section (‘Trends in incidence of type 1 diabetes’; page unavailable) reports type 1 diabetes incidence by age and sex in Hong Kong and says incidence among adults remained stable over time. Our copy does not give the claimed 2013–2015 incidence ranges for men and women aged ≥60; the 0.73 in Table 1 is a p-value, not an incidence rate. (LLM, conf=0.82)

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  • May combine two claims. 31
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    Premisecitation

    In China, type 1 diabetes mellitus incidence was 1.49 per 100,000 person-years among those aged ≥75 years, more than four times higher than the 0.37 per 100,000 person-years reported in a separate Chinese study.

    “In China, using a population-based registry, the incidence of T1DM was reported as 1.49 (95% CI 0.97–2.29) per 100,000 person-years among those aged ≥75 years22. This figure is more than four times higher than the incidence of 0.37 per 100,000 person-years (95% CI 0.27–0.51) reported for those aged ≥75 years in a separate Chinese study23.”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [22] Liu, C. et al. Incidence of type 1 diabetes may be underestimated in the Chinese population: evidence from 21.7 million people between 2007 and 2017. Diabetes Care 44, 2503–2509 (2021). source
    • cites [23] Weng, J. et al. Incidence of type 1 diabetes in China, 2010-13: population based study. BMJ 360, j5295 (2018). source

      In Results, Table 2 (page unavailable), the cited paper reports 0.37 (95% CI 0.27–0.51) per 100,000 person-years for people aged ≥75, not the 1.49 (0.97–2.29) attributed to it. The citing sentence assigns the paper’s 0.37 figure to a separate study instead. (LLM, conf=0.95)

      Checked by a reasoning model — may be wrong.

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Latent autoimmune diabetes in adults is considered a variant of type 1 diabetes mellitus that is somewhat enriched for type 2 diabetes mellitus features and typically progresses more slowly than classic autoimmune type 1 diabetes mellitus in children and young adults.

    “It is considered a variant of T1DM that is somewhat enriched for T2DM features and typically progresses more slowly than does classic autoimmune T1DM in children and young adults74.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [74] Jones, A. G., McDonald, T. J., Shields, B. M., Hagopian, W. & Hattersley, A. T. Latent autoimmune diabetes of adults (LADA) is likely to represent a mixed population of autoimmune (type 1) and nonautoimmune (type 2) diabetes. Diabetes Care 44, 1243–1251 (2021). source

      Split into 2 atoms — 0 confirmed, 1 partially supported, 1 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

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    Premisecitation

    In a multi-country study of mortality in type 1 diabetes mellitus from six high-income countries, standardized mortality ratios declined over time (from 2000 to 2016) and with increasing age, but remained >1.0 at all ages examined (40, 50, 60, 70 and 80 years).

    “In a multi-country study of mortality in T1DM from six high-income countries (Spain, Denmark, Australia, Scotland, Latvia and the USA), although SMRs declined over time (from 2000 to 2016) and with increasing age, they remained >1.0 at all ages examined (40, 50, 60, 70 and 80 years)43.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [43] Ruiz, P. L. D. et al. Mortality trends in type 1 diabetes: a multicountry analysis of six population-based cohorts. Diabetologia 65, 964–972 (2022). This multi-country analysis highlighted the increased mortality in older adults with T1DM compared with the general population, reporting standardized mortality ratios greater than 1 in all older adult age groups. source

      Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

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    Premisecitation

    In Taiwan, type 1 diabetes mellitus incidence in women aged ≥60 years was 0.67 per 100,000 in 2009-2010, more than double the incidence of 0.29 per 100,000 in men.

    “One, using National Health Insurance data, found that the incidence in women aged ≥60 years was 0.67 per 100,000 individuals in 2009–2010; this was more than double the incidence of 0.29 per 100,000 in men for the same period20.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [20] Lin, W. H. et al. Incidence of and mortality from Type I diabetes in Taiwan from 1999 through 2010: a nationwide cohort study. PLoS One 9, e86172 (2014). source

      Table 1 in the Results lists 0.67 per 100,000 for women aged 60 or older in 2009–10, as claimed. It lists 0.39, not 0.29, for men in that age group and period; 0.67 is therefore not more than double the male rate. (LLM, conf=0.94)

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    Premisecitation

    Misclassification rates were <1%, 7.2% and 14.2% in those aged <18, 18-30 and >30 years, respectively.

    “They found misclassification rates of <1%, 7.2% and 14.2% in those aged <18, 18–30 and >30 years, respectively.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [30] Foteinopoulou, E. et al. Impact of routine clinic measurement of serum C-peptide in people with a clinician-diagnosis of type 1 diabetes. Diabet. Med. 38, e14449 (2021). source

      The Results text in our indexed copy (page unavailable) reports an overall reclassification rate of 6.8%, but gives no rates by age group. Searches for 14.2% and the specified age bands found no passage supporting the three claimed rates. (LLM, conf=0.68)

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Type 1 diabetes mellitus is an autoimmune disorder in which immune cells destroy insulin-producing β-cells of the pancreas, resulting in little to no insulin production.

    “Type 1 diabetes mellitus (T1DM) is an autoimmune disorder in which immune cells destroy insulin-producing β-cells of the pancreas, resulting in little to no insulin production1.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [1] Atkinson, M. A., Eisenbarth, G. S. & Michels, A. W. Type 1 diabetes. Lancet 383, 69–82 (2014). source

      The Introduction describes type 1 diabetes as generally thought to involve immune-associated destruction of insulin-producing pancreatic β cells, supporting the claim’s main mechanism. But the Diagnosis section says most—not all—cases are immune-mediated and distinguishes an idiopathic subtype; the categorical description of all T1DM as autoimmune overstates the source. (LLM, conf=0.86)

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    Premisecitation

    In the USA Clinformatics Data Mart Database for 2001-2015, type 1 diabetes mellitus incidence was 29.2 per 100,000 in those aged 60-64 years, the highest among age groups 20-64 years.

    “A longitudinal study using the Clinformatics Data Mart Database in the USA for 2001–2015 reported an incidence of 29.2 per 100,000 people (95% CI 28.0–30.4) in those aged 60–64 years15; no data were available for ages above 64 years. The incidence was highest in the oldest age group (60–64 years) out of all age groups for ages 20–64 years.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [15] Rogers, M. A. M., Kim, C., Banerjee, T. & Lee, J. M. Fluctuations in the incidence of type 1 diabetes in the United States from 2001 to 2015: a longitudinal study. BMC Med. 15, 199 (2017). source

  • May combine two claims.

    Premisecitation

    In Denmark, mortality in people with type 1 diabetes mellitus was 28.5 per 1,000 persons for men and 24.3 for women in 2016 aged 60-69 years, and 175.2 for men and 158.8 for women aged ≥80 years.

    “In Denmark, mortality in people with T1DM was 28.5 per 1,000 persons for men and 24.3 for women in 2016 aged 60–69 years, and 175.2 for men and 158.8 for women aged ≥80 years14.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [14] Carstensen, B., Rønn, P. F. & Jørgensen, M. E. Prevalence, incidence and mortality of type 1 and type 2 diabetes in Denmark 1996-2016. BMJ Open Diabetes Res. Care 8, e001071 (2020). source

      The Results > Mortality and SMR section reports age-specific mortality for Danish patients with type 1 diabetes and distinguishes men from women. However, the figure is evaluated as of 1 January 2015, and our copy does not give the four claimed rates for the specified age groups in 2016 (searched the exact numbers and age-specific rates). (LLM, conf=0.78)

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    Premisecitation

    In Ireland, type 1 diabetes mellitus incidence was 54.2 per 100,000 in those aged ≥75 years and 41.2 per 100,000 in those aged 65-74 years, higher than the youth peak of 31.7 per 100,000 in those aged 0-14 years.

    “The authors reported an incidence of 54.2 per 100,000 people (95% CI 45.3–63.0) in those aged ≥75 years and 41.2 per 100,000 people (95% CI 34.7–47.7) in those aged 65–74 years. These estimates were higher than the incidence observed in youth, which peaked at 31.7 (95% CI 28.2–35.2) per 100,000 people in those aged 0–14 years.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [13] Gajewska, K. A., Biesma, R., Sreenan, S. & Bennett, K. Prevalence and incidence of type 1 diabetes in Ireland: a retrospective cross-sectional study using a national pharmacy claims data from 2016. BMJ Open 10, e032916 (2020). This study followed from Thunander et al. (ref. 12) to also report the highest incidence of T1DM in older adults out of all age groups, strengthening the evidence for a possible second incidence peak after age 70 years. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Geographical variation in type 1 diabetes mellitus incidence in adults mirrors that of children: regions with increased incidence in children are the same as those with increased incidence in adults.

    “It is thought that the geographical variation in incidence of T1DM in adults mirrors that of children: regions with increased incidence in children are the same as those with increased incidence in adults17.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [17] Diaz-Valencia, P. A., Bougnères, P. & Valleron, A.-J. Global epidemiology of type 1 diabetes in young adults and adults: a systematic review. BMC Public Health 15, 255 (2015). source

  • May combine two claims.

    Premisecitation

    In Taiwan, women with type 1 diabetes mellitus aged ≥60 years were at slightly increased risk of mortality compared with women in the general population (SMR 1.28, 95% CI 1.06-1.50), and no increased risk was observed among men (SMR 0.93, 95% CI 0.77-1.10).

    “In Taiwan, women with T1DM aged ≥60 years were at slightly increased risk of mortality compared with women in the general population of the same age (SMR 1.28, 95% CI 1.06–1.50), and no increased risk was observed among men (SMR 0.93, 95% CI 0.77–1.10)20.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [20] Lin, W. H. et al. Incidence of and mortality from Type I diabetes in Taiwan from 1999 through 2010: a nationwide cohort study. PLoS One 9, e86172 (2014). source

      Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

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    Premisecitation

    In Denmark, type 1 diabetes mellitus incidence in 2016 was higher in those aged 60-69 years than in those aged 70-79 years and ≥80 years.

    “this figure was higher than the incidence reported in those aged 70–79 years (5 for men and 10 for women per 100,000 individuals) and ≥80 years (0 for men and 2 for women per 100,000 individuals).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [14] Carstensen, B., Rønn, P. F. & Jørgensen, M. E. Prevalence, incidence and mortality of type 1 and type 2 diabetes in Denmark 1996-2016. BMJ Open Diabetes Res. Care 8, e001071 (2020). source

      The Conclusions (page unavailable) say that type 1 diabetes incidence declined after about age 20 in women and age 40 in men, supporting the general comparison of older age groups. The Results > Incidence (page unavailable) describe age-specific rates as of January 2015, but the available text does not give the claimed rates for ages 70–79 and ≥80 or establish the comparison specifically for 2016. (LLM, conf=0.78)

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    Premisecitation

    In Scotland, type 1 diabetes mellitus prevalence was 0.41% among those aged 60-79 years but only 0.18% among those aged ≥80 years.

    “By contrast, in Scotland, the prevalence was 0.41% among those aged 60–79 years butonly 0.18% among those aged ≥80 years35.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [35] Campbell, R. A. S. et al. Socio-economic status and mortality in people with type 1 diabetes in Scotland 2006-2015: a retrospective cohort study. Diabet. Med. 37, 2081–2088 (2020). source

  • May combine two claims.

    Premisecitation

    In an Indian study, the average age at diabetes mellitus onset in those with LADA was 33.4 years, significantly lower than in those with T2DM at 48.0 years.

    “An Indian study found that the average age at diabetes mellitus onset in those with LADA (33.4 years) was significantly lower than in those with T2DM (48.0 years)82.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [82] Brahmkshatriya, P. P., Mehta, A. A., Saboo, B. D. & Goyal, R. K. Characteristics and prevalence of latent autoimmune diabetes in adults (LADA). ISRN Pharmacol. 2012, 580202 (2012). source

  • May combine two claims.

    Premisecitation

    Latent autoimmune diabetes in adults is the most common form of autoimmune diabetes mellitus diagnosed in adults, with a prevalence in Europe, China and the United Arab Emirates between 3 and 12 times higher than that of adult-onset type 1 diabetes mellitus.

    “LADA is the most common form of autoimmune diabetes mellitus diagnosed in adults, with a prevalence in Europe, China and the United Arab Emirates between 3 and 12 times higher than that of adult-onset T1DM77–79.”
    Quote in the paperNot a substantial claim3 of 3 sources checked
    • cites [77] Hawa, M. I. et al. Adult-onset autoimmune diabetes in Europe is prevalent with a broad clinical phenotype: action LADA 7. Diabetes Care 36, 908–913 (2013). source

      The Results section (page unavailable) reports that LADA was more prevalent than classic adult-onset autoimmune type 1 diabetes in the European cohort, with an odds ratio of 3.3. The paper does not establish the claimed comparison for China or the United Arab Emirates, or a 12-fold difference. (LLM, conf=0.89)

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    • cites [78] Maddaloni, E. et al. Latent autoimmune diabetes in adults in the United Arab Emirates: clinical features and factors related to insulin-requirement. PLoS One 10, e0131837 (2015). source

      Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

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    • cites [79] Xiang, Y. et al. Glutamic acid decarboxylase autoantibodies are dominant but insufficient to identify most Chinese with adult-onset non-insulin requiring autoimmune diabetes: LADA China study 5. Acta Diabetol. 52, 1121–1127 (2015). source

      Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.

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    Premisecitation

    Levels of C-peptide can be useful in distinguishing diabetes mellitus type and guiding treatment.

    “Although levels of C-peptide can be useful in distinguishing diabetes mellitus type and guiding treatment, which is the ultimate purpose of classification, C-peptide assays are expensive and difficult to perform, limiting their utility outside high-income settings92.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [92] Kuhtreiber, W. M. et al. Low levels of C-peptide have clinical significance for established type 1 diabetes. Diabet. Med. 32, 1346–1353 (2015). source

      The Introduction (page unavailable) says biomarkers predicting vulnerability to complications might enable targeted therapeutic strategies, and the Abstract Conclusions describe C-peptide as a possible marker of at-risk patients with established Type 1 diabetes. This supports a potential role in guiding care, but the study includes only people already classified as having Type 1 diabetes and does not show that C-peptide distinguishes diabetes types. (LLM, conf=0.84)

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    Premisecitation

    A 2023 study showed that, among people with recent-onset clinically suspected T2DM, 5% would be expected to be GADA positive but only half of these would genuinely have T1DM.

    “A 2023 study showed that, among people with recent-onset clinically suspected T2DM, 5% would be expected to be GADA positive but only half of these would genuinely have T1DM, which reflects the 2.5% prevalence of GADA positivity in the general population without diabetes mellitus59.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [59] Thomas, N. J. & Jones, A. G. The challenges of identifying and studying type 1 diabetes in adults. Diabetologia 66, 2200–2212 (2023). This 2023 review described the challenges of diagnosing T1DM in older adults. source

  • May combine two claims.

    Premisecitation

    The prevalence of several autoantibodies associated with type 1 diabetes mellitus tends to decrease with increasing age at diagnosis, but glutamic acid decarboxylase antibody remains the dominant autoantibody in adult-onset type 1 diabetes mellitus regardless of ethnicity.

    “Although the prevalence of several autoantibodies associated with T1DM tends to decrease with increasing age at diagnosis61, GADA remains the dominant autoantibody in adult-onset T1DM regardless of ethnicity62–64.”
    Quote in the paperNot a substantial claim4 of 4 sources checked
    • cites [61] Regnell, S. E. & Lernmark, Å. Early prediction of autoimmune (type 1) diabetes. Diabetologia 60, 1370–1381 (2017). source

      Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
    • cites [62] Zampetti, S. et al. GADA titer-related risk for organ-specific autoimmunity in LADA subjects subdivided according to gender (NIRAD study 6). J. Clin. Endocrinol. Metab. 97, 3759–3765 (2012). source

      Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
    • cites [63] Balcha, S. A. et al. Type 1 diabetes in Africa: an immunogenetic study in the Amhara of North-West Ethiopia. Diabetologia 63, 2158–2168 (2020). source

      Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
    • cites [64] Zhou, Z. et al. Frequency, immunogenetics, and clinical characteristics of latent autoimmune diabetes in China (LADA China study): a nationwide, multicenter, clinic-based cross-sectional study. Diabetes 62, 543–550 (2013). source

      Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Pancreatic autoantibodies, low levels of C-peptide and insulin requirement at the time of diagnosis are all suggestive of type 1 diabetes mellitus.

    “Pancreatic autoantibodies, low levels of C-peptide and insulin requirement at the time of diagnosis are all suggestive of T1DM66,67.”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [66] Maddaloni, E. et al. C-peptide determination in the diagnosis of type of diabetes and its management: a clinical perspective. Diabetes Obes. Metab. 24, 1912–1926 (2022). source
    • cites [67] Wenzlau, J. M. et al. The cation efflux transporter ZnT8 (Slc30A8) is a major autoantigen in human type 1 diabetes. Proc. Natl Acad. Sci. USA 104, 17040–17045 (2007). source

      The Results report that islet autoantibodies are used to diagnose type 1 diabetes autoimmunity and are detected in many patients at disease onset. The passages do not address low C-peptide levels or a requirement for insulin at diagnosis, so those parts of the sentence are not supported by this source. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    Some reported age-related differences in the genetic profile of type 1 diabetes mellitus are a consequence of misclassification of diabetes mellitus type.

    “It has been argued that some of the reported age-related differences in the genetic profile of T1DM are a consequence of misclassification of diabetes mellitus type59.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [59] Thomas, N. J. & Jones, A. G. The challenges of identifying and studying type 1 diabetes in adults. Diabetologia 66, 2200–2212 (2023). This 2023 review described the challenges of diagnosing T1DM in older adults. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In Denmark, expected years of life lost to type 1 diabetes mellitus from age 60 years were 6.9 for men and 6.0 for women in 2017.

    “In Denmark, the expected years of life lost to T1DM from age 60 years were 6.9 for men and 6.0 for women in 2017 (ref. 45).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [45] Carstensen, B., Rønn, P. F. & Jørgensen, M. E. Lifetime risk and years lost to type 1 and type 2 diabetes in Denmark, 1996-2016. BMJ Open Diabetes Res. Care 9, e001065 (2021). source

      Table 1 (Results, “Lifetime risk of diabetes”; page not provided) gives 6.0 years lost to T1D for women aged 60 on January 1, 2017, as claimed. For men aged 60, it gives 5.2 years, not 6.9; the 6.9 figure is for women aged 50. (LLM, conf=0.93)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Compared with childhood-onset type 1 diabetes mellitus, adult-onset disease has a lower frequency of high-risk HLA types, lower concordance rates in twins, more protective genotypes, lower genetic risk scores and lower overall genetic load.

    “Evidence suggests that, compared with childhood-onset T1DM, adult-onset (ages ≥18 years) disease has a lower frequency of high-risk HLA types54, lower concordance rates in twins55, more protective genotypes56, lower genetic risk scores57 and lower overall genetic load (with minor differences in HLA class II gene associations)56.”
    Quote in the paperNot a substantial claim3 of 3 sources checked
    • cites [54] Howson, J. M., Rosinger, S., Smyth, D. J., Boehm, B. O. & Todd, J. A. Genetic analysis of adult-onset autoimmune diabetes. Diabetes 60, 2645–2653 (2011). source
    • cites [55] Redondo, M. J. et al. Heterogeneity of type I diabetes: analysis of monozygotic twins in Great Britain and the United States. Diabetologia 44, 354–362 (2001). source

      The Discussion reports substantially lower twin concordance when the index twin was diagnosed at age 25 or older than when diagnosed younger (5% versus 27.3%). This supports the cited concordance comparison, but the paper uses a 25-year cutoff, not the citing sentence’s adult-onset definition of age 18 or older. Page numbers were not available in our copy. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [56] Mishra, R. et al. Genetic discrimination between LADA and childhood-onset type 1 diabetes within the MHC. Diabetes Care 43, 418–425 (2020). source

      The Conclusion (page unavailable) says that protective type 1 diabetes HLA haplotypes are more frequent in LADA than in childhood-onset type 1 diabetes and describes LADA as genetically attenuated. It does not establish a lower overall genetic load for all adult-onset T1DM (ages ≥18); its comparison is specifically with LADA. The other comparisons in the citing sentence have separate citations and are not assessed against this source. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    C-peptide assays are expensive and difficult to perform, limiting their utility outside high-income settings.

    “Although levels of C-peptide can be useful in distinguishing diabetes mellitus type and guiding treatment, which is the ultimate purpose of classification, C-peptide assays are expensive and difficult to perform, limiting their utility outside high-income settings92.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [92] Kuhtreiber, W. M. et al. Low levels of C-peptide have clinical significance for established type 1 diabetes. Diabet. Med. 32, 1346–1353 (2015). source

      The Patients and methods section describes the C-peptide assays used but does not discuss their cost, difficulty, or availability by setting. The Discussion calls a decades-long longitudinal study expensive to perform—not the assays themselves. Searches for assay cost and access outside high-income settings found no supporting passage in our copy. (LLM, conf=0.76)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingreasoning

    Even studies that shared the same variables for definition did not necessarily use the same cut-offs and presented data differently, meaning they could not be directly compared.

    “Even those studies that shared the same variables for definition did not necessarily use the same cut-offs (for example, for age at diagnosis) and presented data differently (for example, some included adults aged ≥60 years as a single age group whereas others stratified by 10-year age groups), meaning that they could not be directly compared.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    In Australia in 2024, 33.4% of those with type 1 diabetes mellitus were aged ≥60 years and 63.2% were aged ≥40 years.

    “In Australia, 33.4% of those with T1DM in 2024 were aged ≥60 years and 63.2% were aged ≥40 years38 (Fig. 1).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [38] National Diabetes Services Scheme. Type 1 Diabetes as at 30 June 2024 https://www.ndss.com.au/wp-content/uploads/Diabetes-Type-1-1.pdf (2024).

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    A 2023 systematic review and meta-analysis suggested a fasting or random plasma level of C-peptide of ≤0.20 mmol/l was supportive of type 1 diabetes mellitus and a level of ≥0.30 mmol/l was suggestive of type 2 diabetes mellitus.

    “A 2023 systematic review and meta-analysis suggested a fasting or random plasma level of C-peptide of ≤0.20 mmol/l was supportive of T1DM and a level of ≥0.30 mmol/l was suggestive of T2DM31.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31] Iqbal, S., Jayyab, A. A., Alrashdi, A. M. & Reverté-Villarroya, S. The predictive ability of C-peptide in distinguishing type 1 diabetes from type 2 diabetes: a systematic review and meta-analysis. Endocr. Pract. 29, 379–387 (2023). source

  • May combine two claims.

    Premisecitation

    In Sweden Kronoberg, type 1 diabetes mellitus incidence was higher among women than men in all age groups above 60 years, peaking at 65.1 per 100,000 in women aged 70-79 years.

    “The incidence was higher among women than men in all age groups above 60 years, peaking at 65.1 (95% CI 55.9–66.4) per 100,000 individuals in women aged 70–79 years.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] Thunander, M. et al. Incidence of type 1 and type 2 diabetes in adults and children in Kronoberg, Sweden. Diabetes Res. Clin. Pract. 82, 247–255 (2008). This was the first study to describe incidence of T1DM in older adults that exceeded that in all age groups, including in children. source

  • May combine two claims.

    Premisecitation

    In Sweden Kronoberg, type 1 diabetes mellitus incidence was highest in those aged 70-79 years at 55.0 per 100,000 persons, exceeding the highest incidence in children aged 0-9 years of 47.2 per 100,000.

    “The study found that, across all age groups of children and adults, the incidence of T1DM was highest in those aged 70–79 years, with an incidence of 55.0 (95% CI 51.4–58.7) per 100,000 persons (Table 1 and Supplementary Table 1). Meanwhile, the highest incidence in children aged 0–9 years was 47.2 (95% CI 44.3–50.1) per 100,000 people.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [12] Thunander, M. et al. Incidence of type 1 and type 2 diabetes in adults and children in Kronoberg, Sweden. Diabetes Res. Clin. Pract. 82, 247–255 (2008). This was the first study to describe incidence of T1DM in older adults that exceeded that in all age groups, including in children. source

  • May combine two claims.

    Interpretationcitation

    Misclassification of type 2 diabetes mellitus as type 1 diabetes mellitus would have flow-on effects for reported prevalence, which would also be inflated, and reported mortality would probably be reduced due to the lower death rates of those with type 2 diabetes mellitus than of those with type 1 diabetes mellitus.

    “This misclassification would have flow-on effects for reported prevalence, which would also be inflated, and reported mortality would probably be reduced due to the lower death rates of those with T2DM than of those with T1DM29.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29] Harding, J. L. et al. Mortality trends among people with type 1 and type 2 diabetes in Australia: 1997-2010. Diabetes Care 37, 2579–2586 (2014). source

  • May combine two claims.

    Premisecitation

    The insulin requirement rate in youth with antibody positivity who have typical T1DM is 100%, which is higher than in GADA-positive LADA.

    “However, this figure is still less than the 100% rate of insulin requirement seen in youth with antibody positivity who have typical T1DM86.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [86] Turner, R. et al. UKPDS 25: autoantibodies to islet-cell cytoplasm and glutamic acid decarboxylase for prediction of insulin requirement in type 2 diabetes. UK Prospective Diabetes Study Group. Lancet 350, 1288–1293 (1997). source

  • May combine two claims.

    Interpretationreasoning

    Misclassification is more likely at older ages, which might in part be driving some of the vast differences observed in incidence across various regions, flowing through to prevalence and mortality estimates.

    “Misclassification is more likely at older ages, which might in part be driving some of the vast differences observed in incidence across various regions, flowing through to prevalence and mortality estimates.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    HLA DR3-DQ2 and HLA DR4-DQ8 haplotypes were found to be present in approximately 90% of Scandinavian children diagnosed with type 1 diabetes mellitus.

    “These haplotypes are most common in people of European ancestry who have T1DM and were found to be present in approximately 90% of Scandinavian children diagnosed with T1DM47.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [47] Sanjeevi, C. B. et al. Polymorphic amino acid variations in HLA-DQ are associated with systematic physical property changes and occurrence of IDDM. Members of the Swedish Childhood Diabetes Study. Diabetes 44, 125–131 (1995). source

  • May combine two claims.

    Interpretationnone given

    The number of older adults with T1DM is growing due, in part, to increased survival to older ages as well as to new-onset T1DM in middle-aged and older adults.

    “The number of older adults with T1DM is growing due, in part, to increased survival to older ages as well as to new-onset T1DM in middle-aged and older adults.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationreasoning

    The extent to which misclassification is an issue in the available literature is not known but it is unlikely to be trivial.

    “The extent to which this is an issue in the available literature is not known but it is unlikely to be trivial.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    The lack of agreement around diagnostic definitions might be contributing to the vast observed differences in T1DM epidemiology across populations.

    “The lack of agreement around diagnostic definitions might be contributing to the vast observed differences in T1DM epidemiology across populations.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Including the false positives in the T1DM group for characterization of the phenotype of older-onset T1DM will probably lead to an overestimation of incidence and prevalence at older ages and to a described phenotype which, incorrectly, tends towards T2DM.

    “Thus, including the false positives in the T1DM group for characterization of the phenotype of older-onset T1DM will probably lead to an overestimation of incidence and prevalence at older ages and to a described phenotype which, incorrectly, tends towards T2DM.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    Until there is more convincing genetic and immunological evidence to clearly distinguish T1DM from T2DM in older adults compared with other age groups, the epidemiology will remain unclear.

    “Until there is more convincing genetic and immunological evidence to clearly distinguish T1DM from T2DM in older adults compared with other age groups, the epidemiology will remain unclear.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationreasoning

    As the life expectancy of people with T1DM continues to improve, the demography of T1DM will shift further towards an increased number of older adults with complex care needs.

    “As the life expectancy of people with T1DM continues to improve, the demography of T1DM will shift further towards an increased number of older adults with complex care needs.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationnone given

    Genetic associations of adult-onset T1DM include reduced frequency of high-risk HLA types and more protective genotypes.

    “Genetic associations of adult-onset T1DM include reduced frequency of high-risk HLA types and more protective genotypes; however, this observation might also be influenced by misclassification of diabetes mellitus type.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Until a more accurate definition of T1DM in older adults can be developed and applied consistently in epidemiological studies, the incidence in older adults compared with children cannot be truly known.

    “Until a more accurate definition of T1DM in older adults can be developed and applied consistently in epidemiological studies, the incidence in older adults compared with children cannot be truly known.”
    Quote in the paperNot a substantial claim
40 of 40

  • The paper relies on this without support.

    T2DM is much more common than T1DM in older adults.

    “As T2DM is much more common than T1DM in older adults, small errors in classifying those with T2DM can have major effects on the observed phenotype of T1DM.”
1 of 1

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Type 1 diabetes is increasingly diagnosed in older adulthood, with higher incidence in Western countries.

    “Type 1 diabetes is increasingly diagnosed in older adulthood as well, with greater awareness of and attention to appropriate diabetes classification across the life course, with higher incidence in Western countries (4).”

    From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [4]

    The Introduction says substantial numbers of older adults are diagnosed with type 1 diabetes, and the Incidence section reports substantially lower incidence in Asia than in Europe and North America. The Conclusions attribute the growing number of older adults with type 1 diabetes partly to improved survival and new-onset disease; they do not establish that diagnoses in older adulthood are increasing over time. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Danish incidence rates conflict with the reported case counts

    Minor

    The paper reports 2,121 new T2DM cases and 10 new T1DM cases in the same age group, but then assigns the higher incidence rate to T1DM. The rates also have a ratio of about 21, whereas the case counts have a ratio of about 212.

  • Danish incidence did not fall for women aged 70-79

    Minor

    The stated incidence for women rises from 8 to 10 per 100,000 between these age groups, contrary to the claim that the earlier figure was higher.

2 of 2

Cites

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Related

Authors
Tomic, D., Harding, J. L., Jenkins, A. J., Shaw, J. E., & Magliano, D. J.
Affiliations
  • Monash University (AU)
  • Emory University (US)
  • Baker Heart and Diabetes Institute (AU)
Corresponding author
Tomic, Dunya
ORCID
Venue
Nature Reviews Endocrinology
Publisher
Springer Science and Business Media LLC
Published
2024-10-24
Volume
21
Issue
2
Pages
92-104
ISSN
  • 1759-5029 (ISSN-L)
  • 1759-5037
DOI
10.1038/s41574-024-01046-z
PMC
PMC12240003
OpenAlex
W4403703765
Semantic Scholar
d87f43ca024f1544834fbe7997e7dc302e2f8f29
Cited by
58
References
99
Citations by year
2026: 32 · 2025: 26
FWCI
4.04
Type
journal article
Language
en
Open access
Licence
Locations
  • Nature Reviews Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (P30DK111024)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
type 1 diabetes, older adults, incidence, prevalence, excess mortality, adult-onset type 1 diabetes, glutamic acid decarboxylase antibodies, C-peptide, autoantibodies, diabetes diagnosis, disease burden, genetic susceptibility
MeSH terms
Aged, Aged, 80 and over, Autoantibodies, Diabetes Mellitus, Type 1, Glutamate Decarboxylase, Humans, Middle Aged, Incidence, Prevalence

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-27.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-27.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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