A Guide to Diabetes & The Different Types

A Guide to the Different Types of Diabetes

Diabetes is a serious chronic condition that can cause life-altering complications, from amputations to blindness. Unchecked, diabetes can be fatal. Fortunately, patients and their doctors can manage diabetes with monitoring, medication, and lifestyle changes. There are three different types of diabetes, each significantly different. Use this guide to diabetes to understand the characteristics of each form of this disease.

The most common forms of diabetes fall under the umbrella name “diabetes mellitus,” usually shortened to just “diabetes.” Diabetes mellitus is a chronic condition in which the body either cannot produce insulin, or doesn’t properly respond to insulin in the bloodstream. It is treated with insulin, lifestyle changes, and dietary modifications.

Diabetes insipidus is a rarer condition that has nothing to do with insulin. The hypothalamus and the pituitary gland in the brain malfunction, resulting in the body failing to provide the kidneys with the anti-diuretic hormone (“ADH”) that helps retain water as they cleanse the blood of impurities. When someone has the rare genetic version of the disease, the kidneys don’t respond properly to ADH, causing extremely excessive urination. While this is also a symptom of diabetes milletus, it is unrelated to blood sugar levels and treated with a substitute for ADH.

Diabetes is diagnosed by testing levels of blood glucose. This occurs through a blood test taken after refraining from food for 8 hours (fasting glucose test), or a glycated hemoglobin test, or A1C test, which checks average glucose level over previous months. The A1C test measures the amount of glucose that has attached itself to red blood cells in the bloodstream. Since those cells typically live for about 2 to 3 months, the test provides an average of the glucose level for that time. A fasting glucose result of 100 to 125mg/dL (milligrams per deciliter) indicates a condition called prediabetes. It means that your body is having trouble regulating blood glucose, and you are in danger of developing Type 2 diabetes. A level of 125 or above indicates diabetes outright. Having this guide to diabetes will allow you to better understand any potential diagnosis, giving you a foundation for comprehending future treatment plans and lifestyle changes.

Type 1 Diabetes Mellitus

Formerly called juvenile diabetes, Type 1 diabetes occurs when the body’s immune system inexplicably attacks and destroys insulin-producing cells in the pancreas. The body is permanently unable to produce insulin. Untreated, Type 1 diabetes is fatal. It was called juvenile diabetes because it typically develops in children and teens, though adults can also develop this form of diabetes. People with Type 1 diabetes must take insulin every day and manage their diet and exercise. Symptoms include unexplained weight loss, frequent urination, fatigue, extreme hunger, dry or itchy skin, blurry vision, and cuts or wounds that are slow to heal.

The first sign of Type 1 diabetes is often a medical emergency named diabetic ketoacidosis (DKA). This life-threatening condition is characterized by many of the symptoms listed, but also by extremely high blood sugar levels and high levels of ketones in urine. Ketones are chemicals made by the liver when burning fat, as there is not enough insulin in the bloodstream to turn glucose into energy. Other symptoms include nausea, confusion, fruity-scented breath, rapid breathing, and dry mouth. DKA is a life-threatening condition requiring immediate emergency intervention. DKA should not be confused with ketosis, the condition induced by ketogenic, or “keto” diets. During ketosis, the body has enough insulin, but reduced carbohydrate intake causes the body to burn stored fat for energy, instead of using blood sugar.

People with Type 1 diabetes can use home urine ketone tests when blood sugar levels rise too high. Managing Type 1 diabetes requires commitment by both physician and patient.

Type 2 Diabetes

Far more common than Type 1 diabetes, Type 2 diabetes affects 90% or more of all diabetes patients. Type 2 diabetes describes the condition in which the body produces insulin, but it either doesn’t make enough to cope with the levels of glucose in the blood, or can’t use the insulin effectively (insulin resistance). Risk factors for Type 2 diabetes include obesity, family history, age, a sedentary lifestyle, and location–the frequency of Type 2 diabetes increases in accordance with distance from the Equator. You can lower your risk of developing Type 2 diabetes with exercise and a healthy diet that avoids sugary, highly processed foods. It’s possible to control Type 2 diabetes with lifestyle changes alone, but if your blood sugar levels don’t show improvement, your doctor may prescribe medication to help your body use insulin more effectively. People with Type 2 diabetes must carefully monitor their blood sugar levels to ensure they are managing the disease effectively.

Gestational Diabetes

A rare complication of pregnancy, gestational diabetes is another type of diabetes that comes in two forms—milletus and insipidus. The latter is very rare. Both are caused by hormones or enzymes produced in the placenta. Gestational diabetes only occurs in women who were not previously diabetic. The hormones produced by the placenta can interfere with insulin, causing insulin resistance. The placental enzymes can destroy vasopressin, the hormone that regulates water retention, causing the pregnant woman to not only urinate frequently, but also experience nausea, dizziness, and weakness.

Gestational diabetes milletus is treated with a careful diet, exercise, and medication to regulate blood sugar. Gestational diabetes insipidus may be treated with a synthetic form of vasopressin called desmopressin. Your OB/GYN may decide not to actively treat the condition, but to instead monitor it carefully.

Gestational diabetes is typically a greater risk to the baby than the mother: babies can grow too large or gain too much weight. Undiagnosed and untreated, this disease can cause serious complications like preeclampsia (high blood pressure in pregnancy), strokes during labor, or miscarriage. Your doctor will test for gestational diabetes at some point in the middle of the second trimester or the beginning of the third.

Diagnosing and managing diabetes requires close cooperation and coordination, as well as trust between doctor and patient. Having this guide to diabetes can help you identify potential symptoms, but always consult with your doctor for treatment. Residents of New York can consult a top-rated endocrinologist in New York City for advice and assistance in managing prediabetes, Type 1, or Type 2 diabetes.

A Guide to the Different Types of Diabetes Infographic

Philip Rabito, MD

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