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When Phyllisa Deroze was told she had diabetes in a Fayetteville, North Carolina, emergency department years ago, she was handed pamphlets with information on two types of the disease. One had pictures of children on it, she recalled, while the other had pictures of seniors.

Deroze, a 31-year-old English professor at the time, was confused about which images were meant to depict her. Initially, she was diagnosed with Type 2 diabetes, as shown on the pamphlet with older adults. It would be eight years before she learned she had a different form of diabetes one that didnt fit neatly on either pamphlet.

The condition is often called latent autoimmune diabetes of adults, or LADA for short. Patients with it can be misdiagnosed with Type 2 diabetes and spend months or years trying to manage the wrong condition. As many as 10% of patients diagnosed with Type 2 diabetes might actually have LADA, said Jason Gaglia, an endocrinologist at the Joslin Diabetes Center in Boston.

Deroze and three other LADA patients who spoke with KFF Health News, all Black women, are among those who were initially misdiagnosed. Without the correct diagnosis which can be confirmed through blood tests they described being denied the medicines, technology, and tests to properly treat their diabetes. Three of them wonder if their race played a role. Phyllisa Deroze first asked to have her blood tested for antibodies associated with Type 1 diabetes six years after being diagnosed with Type 2 diabetes. Two years later, after two endocrinologists denied her requests, she persuaded her gynecologist to run a test. The results came back positive, showing she indeed had diabetes, but not Type 2.(Kathryn Pitts)

That does seem to happen more frequently for African American patients and for other minoritized groups, said Rochelle Naylor, a pediatric endocrinologist at the University of Chicago who researches atypical forms of diabetes. Doctors, like any other person walking this planet, we all have implicit biases that impact our patient experiences and our patient care delivery.

Black patients have long struggled with bias across the U.S. health care system. In a recent KFF survey, for example, 55% of Black adults said they believed they needed to be careful at least some of the time about their appearances to be treated fairly during medical visits. Hospital software used to treat patients has been investigated for discrimination. Even a common test used to manage diabetes can underestimate blood sugar levels for patients who have sickle cell trait, which is present in nearly 1 in 10 African Americans.

LADA ostensibly has nothing to do with race, but misconceptions about race, weight, and age can all lead doctors to misdiagnose LADA patients with Type 2 diabetes, said Kathleen Wyne, an endocrinologist who leads the adult Type 1 diabetes program at Ohio State University. Email Sign-Up

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Type 2 diabetes develops in people, often over age 45, whose bodies cannot properly regulate their blood sugar levels. Type 2 accounts for at least 90% of diabetes cases in the U.S. and has a high prevalence among African Americans, Native Americans, and Hispanic populations. It can often be managed with lifestyle changes and oral medications.

LADA is more akin to, or even thought to be another form of, Type 1 diabetes, an autoimmune condition once dubbed juvenile diabetes because it was most often diagnosed in children. Type 1 occurs when the body attacks its cells that produce insulin the naturally occurring hormone that regulates blood sugar by helping turn food into energy. Without insulin, humans cant survive.

LADA is difficult to diagnose because it progresses slowly, Gaglia said. Typical LADA patients are over 30 and dont require injectable insulin for at least six months after diagnosis. But, like Type 1 patients, most will eventually depend on injections of pharmaceutical insulin for the rest of their lives. That delay can lead physicians to believe their patients have Type 2 diabetes even as treatment becomes less effective.

If you have someone who comes into your office who is obese and/or overweight and may have a family history of Type 2 diabetes if youre a betting person, you bet on them having Type 2 diabetes, Gaglia said. But thats the thing with LADA: It unmasks itself over time. In the health care system, it’s really hard to vocalize your needs when you are a woman of color because you come off as aggressive, or you come off as a know-it-all, or you come off as disrespectful, Mila Clarke says. My intuition was right this whole time, but nobody believed me. (Brandon Thibodeaux for KFF Health News)

Mila Clarke, who lives in Houston, finally saw an endocrinologist in November 2020, more than four years after being diagnosed with Type 2 diabetes. During that visit, she recounted her struggles to manage her blood sugar despite taking oral medications and making significant changes to her diet and exercise regimens.

What you just explained to me, I believe, is a classic case of LADA, Clarke recalled being told. Has anybody ever tested you for Type 1 antibodies?

Because both Type 1 diabetes and LADA are autoimmune conditions, patients will have antibodies that Type 2 patients typically dont. But, as Clarke recounted, getting tested for those various antibodies isnt always easy.

Clarke, now 34, had leaned into her Type 2 diagnosis when she received it in 2016 at age 26. She started a blog with nutrition and lifestyle tips for people with diabetes called Hangry Woman, and garnered tens of thousands of followers on Instagram. Clarke said she wanted to fight the stigma around Type 2 diabetes, which stereotypes often associate with being overweight.

Some of the harshest comments that I had gotten were from people with Type 1 who were like, We’re not the same. I didn’t cause this. I didn’t do this to myself, Clarke said. Well, neither did I.

Clarke also felt her initial doctor thought she just wasnt working hard enough.

When she learned about continuous glucose monitors, wearable electronic devices that allow patients to track their blood sugar around the clock, she asked her primary care doctor to prescribe one. The monitors are recommended for patients with Type 1 and, more recently, some with Type 2. He flat-out told me, No. Its going to be too much information, too much data for you, she recalled.

Clarke switched to a different primary care doctor who she felt listened better and who prescribed a continuous glucose monitor. (Clarke later became a paid ambassador for the company that manufactures her device.) The new doctor eventually referred Clarke to the endocrinologist who asked if shed been tested for antibodies. The test came back positive. Clarke had LADA.

In the health care system, it’s really hard to vocalize your needs when you are a woman of color because you come off as aggressive, or you come off as a know-it-all, or you come off as disrespectful, Clarke said. My intuition was right this whole time, but nobody believed me. Mila Clarke inserts a syringe into a vial of insulin, which she uses to treat her diabetes.(Brandon Thibodeaux for KFF Health News)

Immediately, Clarke noticed an eye-opening difference in how she was treated. She started insulin injections and was referred to a dietitian and a diabetes educator. She wondered: Why wasnt it easier to get tested for antibodies?

Those tests are imperfect and can have false positives, said Gaglia of the Joslin center. Still, Ohio States Wyne argued that every diabetes patient should be tested for at least the most common antibody associated with Type 1.

Aren’t you saving lives if you’re identifying the Type 1 before they come in with DKA and die? Wyne asked, referring to diabetic ketoacidosis, a serious complication of diabetes most commonly associated with Type 1.

Deroze started asing her doctor for antibodies tests in 2017 after reading about a Type 2 bloggers experience being newly diagnosed with LADA.

Her endocrinologist denied her requests. She thinks the doctor thought it was impossible for her to have an autoimmune form of diabetes because of her race and weight. She sought a second opinion from a different endocrinologist, who also refused to test her.

I just felt unseen, Deroze said.

After a bout with diabetic ketoacidosis in 2019, Deroze finally persuaded her gynecologist to test her for antibodies. The results came back positive. One of the endocrinologists apologetically prescribed insulin and, later, an insulin pump, another ubiquitous piece of technology for people with Type 1.

And for the first time, she encountered the words diabetes is not your fault while reading about Type 1 diabetes. It felt like society was caring for her in a way it hadnt when she was misdiagnosed with Type 2. Thats troubling, she said, and so is how long it took to get what she needed.

My PhD didnt save me, said Deroze, who now lives in the Miami area. You just see the color of my skin, the size of my body, and it negates all of that.

Bram Sable-Smith: brams@kff.org, @besables Related Topics Health Care Costs Health Industry Race and Health States Diabetes Florida North Carolina Texas Contact Us Submit a Story Tip

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Panthers-Hurricanes Game 5 preview: Can Carolina force another game?

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Panthers-Hurricanes Game 5 preview: Can Carolina force another game?

All signs pointed to the Florida Panthers finishing off the Carolina Hurricanes in Game 4, but the Canes kept the series rolling with a 3-0 win on Monday.

Will the Panthers finish the story in Game 5? Or will the Hurricanes send the festivities back to South Florida again?

Here are matchup notes heading into Wednesday’s Game 5 from ESPN Research, as well as betting intel from ESPN BET:

More on Game 4: Recap | Grades

Matchup notes

Florida Panthers at Carolina Hurricanes
Game 5 | 8 p.m. ET | TNT

The Panthers’ odds to win the series are now -1600, adjusted from -5000 heading into Game 4. The Hurricanes’ odds have shifted to +750 (adjusted from +1500) after their win. The Panthers’ odds to win the Cup are now +105 (previously -110), while the Canes’ are now +1800. Sergei Bobrovsky is the leading Conn Smythe candidate in this series at +200, followed by Aleksander Barkov (+800).

Game 4 was the Canes’ first win in the round since Game 7 of the 2006 Eastern Conference finals against the Buffalo Sabres, snapping a 15-game conference finals losing streak. It was the longest losing streak in NHL playoff history for a team in the round preceding the Stanley Cup Final. The Hurricanes are now 4-4 all-time in Game 4s when trailing 3-0 in a best-of-seven series.

Frederik Andersen made 20 saves for his fifth career playoff shutout, his second with the Hurricanes. He joins Cam Ward (four), Kevin Weekes (two) and Petr Mrazek (two) as goaltenders with multiple playoff shutouts in Whalers/Hurricanes Stanley Cup playoffs history.

Carolina’s Logan Stankoven scored playoff goal No. 5 in the second period. He joins Erik Cole (six in 2002) and Warren Foegele (five in 2019) as the only rookies in Whalers/Hurricanes history to score at least five goals in a single Stanley Cup playoffs year.

Sebastian Aho scored an empty-net goal in the third period, his 32nd career playoff tally. That extends his own franchise record for career goals in the Stanley Cup playoffs.

The Panthers were shut out for the second time this postseason; both games were at home — the other instance was Game 6 of the second-round series against the Toronto Maple Leafs.

Florida went 0-4 on the power play in Game 4, and the team is now 0-8 with the man advantage in the last two games of this series after going 4-for-5 in Games 1 and 2.

Though he hasn’t scored a goal in the past two games, Sam Bennett has a team-leading nine this postseason. That is two shy of the franchise record in a single playoff year, currently held by Matthew Tkachuk (2023) and Carter Verhaeghe (2024).


Scoring leaders

GP: 16 | G: 6 | A: 9

GP: 14 | G: 5 | A: 9

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Liverpool fan says his baby was flung 15ft in his pram and his partner run over during trophy parade

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Liverpool fan says his baby was flung 15ft in his pram and his partner run over during trophy parade

A father has told Sky News how his partner was driven over, and his baby son was flung 15ft in his pram, after they were hit by a vehicle during the Liverpool parade collision.

Daniel Everson, 36, had been with Sheree Aldridge and their five-month-old baby, Teddy, at Liverpool FC’s victory parade on Monday.

“The best day of my life turned into worst”, said Daniel, a lifelong fan of ‘The Reds’.

Daniel described the moment the car came towards him and his family.

“I tried to hold on to the front of the car and try and stop it, push it, do whatever I could [to stop it] from hitting my partner and my baby.

'The best day of my life turned into worst', Daniel Everson told Sky News.
Image:
Daniel Everson was in the crowd for the Liverpool trophy parade when the incident took place

“Me and my partner were flat on the roof, on the bonnet… we were just both trying to hold on for dear life with Ted next to us.

“And my partner went under the wheels of the car, of the front of the car, and it rolled over her leg, and I just bounced off to the side, but my boy and his pram got bounced totally in the opposite direction – about 15ft down the road.

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“As soon as that happened, I just started screaming for my partner, and I found her and I asked where Teddy was, and she didn’t know… and I found him and he was okay, thank God.

“He was in the road, in his pram, on his back, and I grabbed him. I chucked the pushchair to the side and I ran up to some paramedics with him.”

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The suspect is being held on suspicion of attempted murder, dangerous driving and drug driving.

Daniel, from Telford, said he felt like he was in “hell” as he rushed back to find Sheree.

“I had to carry her up the road with four police officers holding her while she was screaming and crying. At that point, I didn’t know what was wrong with her, but I could see the injuries to her leg,” he explained.

Sheree, 36, is recovering at Aintree University Hospital after suffering muscle tissue damage. Daniel has been allowed to return home with Teddy after he was assessed at Alder Hey Children’s Hospital.

“I feel a lot of emotions right now. Upset, angry, traumatised. A lot of unanswered questions that need to be answered.

To me, it just wasn’t handled properly – the situation with the car getting that far into the crowd, in my opinion, he should not have got anywhere near us.”

Merseyside Police have now been given more time to question a 53-year-old arrested after a car struck a crowd at Liverpool FC’s victory parade on Monday.

The suspect, who police have described as a white British man from the local area, is being held on suspicion of attempted murder, dangerous driving, and drug driving.

Police have said the extra time they have been given to question the suspect runs into Thursday.

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Politics

Pakistan announces Bitcoin strategic reserve

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Pakistan announces Bitcoin strategic reserve

Pakistan announces Bitcoin strategic reserve

Bilal Bin Saqib, head of Pakistan’s crypto council, announced on May 28 that the country is moving to establish a strategic Bitcoin reserve.

Speaking at the Bitcoin 2025 conference in Las Vegas, Nevada, Saqib said the government of Pakistan followed the United States’ lead in establishing a Bitcoin strategic reserve and is embracing pro-crypto regulatory policies. The government official told the audience:

“Today is a very historic day. Today, I announce the Pakistani government is setting up its own government-led Bitcoin Strategic Reserve, and we want to thank the United States of America again because we were inspired by them.”

The announcement represents a significant departure from the government of Pakistan’s previous stance on cryptocurrencies, holding that crypto would never be legal in the country.

Pakistan’s shift reflects the broader trend of nation-states adopting pro-crypto policies following the regulatory shift in Washington, DC under the President Donald Trump administration.

Government, Bitcoin Reserve, Bitcoin2025
Bilal Bin Saqib at the Bitcoin 2025 conference announcing a Bitcoin strategic reserve. Source: Cointelegraph

Related: Pakistan appoints special assistant to PM on blockchain and crypto

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