Do you know what type of diabetes you have? It seems pretty obvious: you either have type 1 or type 2 diabetes. Or do you? What if you have another type of diabetes? What if your doctor is scratching his head trying to figure out how to best treat your diabetes? Things aren’t always as they seem.
The American Diabetes Association defines diabetes as “a problem with your body that causes blood glucose (sugar) to rise higher than normal.” This seems straightforward enough, but it’s important to realize that there are many factors than can lead to high blood glucose levels and it’s just not always that clear cut. Here’s a look at some of the variations of diabetes which may give you a better sense of just how complex this condition really is!
Type 1 diabetes
Other terms for type 1 diabetes are “juvenile diabetes” or “insulin-dependent diabetes.” These two terms aren’t accurate because 1) type 1 diabetes occurs in adults, not just in young people, and 2) many people with type 2 diabetes need to take insulin.
What to know about type 1 diabetes
• Type 1 diabetes is an autoimmune disease that destroys the beta cells and halts insulin production in the pancreas.
• The cause of type 1 is unknown but it’s likely due to genetics, a virus or something in the environment.
• It accounts for about 5-10% of diabetes cases.
• Everyone with type 1 needs to take insulin to survive.
• Thirst, weight loss, frequent urination, fatigue and blurry vision are some common symptoms of type 1. The onset of symptoms tends to happen quite quickly.
Type 2 diabetes
Other terms for type 2 diabetes are “adult-onset diabetes” or “non-insulin dependent diabetes.” Again, these terms aren’t correct because kids get type 2 too, and many people with type 2 take insulin.
What to know about type 2 diabetes
• It’s a condition of “insulin resistance” The body can’t use its own insulin properly. And over time, it stops making enough insulin.
• It accounts for 90-95% of diabetes cases.
• Type 2 diabetes has been steadily increasing in children over the past 20 years.
• Most people with type 2 are overweight.
• About 40% of those with type 2 will eventually need to take insulin because the body gradually stops making enough insulin.
• Lifestyle changes (healthy eating, weight loss, exercise) can prevent type 2 diabetes.
• Patients often do not notice any symptoms of type 2 diabetes.
Latent autoimmune diabetes (LADA)
LADA (often called “type 1 ½ diabetes") is considered to be a form of slowly progressing type 1 diabetes.
What to know about LADA
• Like type 1 diabetes, LADA is an autoimmune condition that destroys beta cells.
• It’s often misdiagnosed as type 2 diabetes because it occurs most often in adults and because, in the early stages, the pancreas still makes insulin.
• Suspect LADA and not type 2 diabetes if you’re thin and don’t have a family history of diabetes but do have a family history of other autoimmune conditions, like thyroid disease, lupus or rheumatoid arthritis.
• A positive C-peptide test and a glutamic acid decarboxylase (GAD) antibody test can be indicators of LADA.
• Early on, lifestyle changes and diabetes pills can control LADA but eventually, insulin is needed.
Maturity Onset Diabetes of the Young
Otherwise known as MODY, this type of diabetes is a rarer type of diabetes that results from mutations in a number of different genes.
What to know about MODY
• It’s more common in teens and young adults, but older adults can get MODY, too.
• Gene mutations limit the pancreas’ ability to produce insulin, leading to high blood glucose.
• Between one and five percent of diabetes cases in the U.S. are due to MODY.
• MODY runs in the family.
• It’s common for someone with MODY to be initially diagnosed as having either type 1 or type 2, but suspect MODY if a “type 1” person still makes insulin or has negative antibodies, or if a “type 2” person is lean.
• MODY is usually treated with lifestyle changes and often, diabetes pills.
There are actually several other types of diabetes, such as gestational diabetes (diabetes that occurs during pregnancy); steroid-induced diabetes, which occurs after someone has taken corticosteroids (like prednisone) for an extended period of time; type 3 diabetes which is basically Alzheimer’s disease; and diabetes insipidus, which occurs when the kidneys can’t regulate the excretion of urine (and has nothing to do with blood sugar or insulin). Talk with your doctor if you have questions about your type of diabetes, especially if you believe that your treatment plan isn’t working as it should for you.