Golf champion’s story highlights importance of screening for type 1 diabetes in adults

Photo Credit: USGA/Jason E. Miczek

J.J. Spaun drew cheers from golf fans and people with type 1 diabetes (T1D) alike with his unbelievable 64-foot birdie putt on the final hole to win the 125th U.S. Open at Oakmont in Pennsylvania. 

While his rally and win were an amazing, once-in-a-lifetime experience—and exemplify how people with T1D can accomplish anything—his diagnosis with T1D as an adult, which he has shared publicly, was unfortunately all too common: he was first wrongly diagnosed with type 2 diabetes (T2D). 

The misdiagnosis led to challenges, including more weight loss, a calorie-restricted diet, and side effects from blood-glucose levels that remained stubbornly less-than-optimal. Eventually, his golf game was affected. Then, he saw a specialist, who correctly diagnosed him with T1D. 

In a 2022 Golf Channel web story about the misdiagnosis, Spaun said, “I went through two years of struggling. I’m not blaming that, but that was another contributing factor. I was doing the wrong things. The regimen for type 2 is a little different than for a type 1; I’m not even getting the right medicine to regulate my blood sugar. … I was eating nothing, probably less than 1,500 calories a day, and still having high glucose side effects as a ‘type 2,’ so that’s why I needed the insulin to help level that out and be able to eat more calories in general.” 

Recognizing type 1 diabetes in adults 

As evidenced by Spaun and other adults diagnosed with type 1 diabetes, the condition can strike anyone at any age. The idea that T1D is only diagnosed in children is antiquated and inaccurate, yet misdiagnoses in adults continue to happen. According to an article published in the journal The Lancet, Regional Health: Europe, it is estimated that nearly 40 percent of adults older than age 30 with T1D may have been misdiagnosed with T2D, which is far more prevalent in adults than T1D.   

A simple blood test can detect T1D in the earlier stages. The biggest challenge is educating clinicians and the general population about it.  

Endocrinologists, pediatricians, and some other specialty physicians learn about T1D screening and monitoring during their residencies, but it’s not a part of the general curriculum of the first four years of medical school. As such, many healthcare professionals know to order an HbA1c test for T2D but do not know what test to order for T1D. In addition, many clinicians understandably hesitate to order unfamiliar tests—especially if they are unsure what to do with the results. 

Screening and monitoring for more accurate diagnoses 

Breakthrough T1D’s new healthcare professional resources aim to advance the knowledge of T1D screening and monitoring to clinicians whose patients could most benefit from it, which turns out to be just about everyone. According to a paper published in the journal US Endocrinology, roughly 85 percent of people diagnosed with type 1 diabetes do not have a blood relative with the autoimmune disease.  

Spaun’s experience and the experiences of all adults with type 1 diabetes who were first misdiagnosed with T2D point to the importance of T1D screening and monitoring for accurate diagnoses in people of all ages.

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