Sure, we've all heard "oh, you have diabetes? My aunt/grandpa/cat had diabetes." We can't really blame them, can we?
It's frustrating. But how are they to know that one type can be so different from the other?
The main types
- Type 1 diabetes
- Type 2 diabetes
- Gestational diabetes
- Type 3c / Pancreatogenic / Cystic fibrosis-related diabetes (CFRD) / Pancreatitis / Pancreatic cancer
- Special forms / surgical / drug induced / etc.
- Type 3 diabetes
Type 1 diabetes
With this type, your pancreas is unable to make enough insulin, the hormone required to move blood sugar into your cells. For whatever reason, the bodies own immune system attacks the cells in the pancreas that make insulin. The cause is unknown, although research points to a combination of certain genes and an unknown environmental trigger. There is currently no known cure.
People with type 1 diabetes have to take insulin. Period. If their body isn’t producing any insulin, it has to come from injections or perhaps an insulin pump. Without insulin, it won’t be long before someone with type 1 diabetes develops diabetic ketoacidosis, and if not treated appropriately and soon enough, they will die.
While type 1 diabetes can happen at any time, most cases are discovered before the age of 20. This is why type 1 used to be called childhood diabetes or juvenile diabetes. However, it’s important to emphasize that it can happen at any age. Beyond Type 1 has a great resource about the warning signs of type 1 diabetes such as excessive thirst, frequent urination, sudden weight loss, fatigue, vision problems, and more. This cluster of symptoms usually happens suddenly, so most doctors will know to check blood sugars.
The symptoms can be mistaken for the stomach flu or virus, strep throat, a growth spurt (in youth), or a urinary tract infection. A little knowledge can save your (or your child’s) life if the docs aren’t picking up the symptoms fast enough. A blood sugar check is quick, easy, and not at all expensive. Ask for it, even if you’re not getting any other labs or tests done.
Type 2 diabetes
Type 2 diabetes happens when your body’s cells do not respond to insulin as well as they should. The body responds by adding more insulin to force a response. In extreme cases, this vicious cycle can lead to your pancreas losing the ability to make enough insulin.
Type 2 diabetes is often preceded by a stage called pre-diabetes. It is a slow rise in the average amount of blood sugar in your body. It’s not enough to cause symptoms, but it’s a sign that you’re on your way to developing type 2 diabetes. Being overweight or obese can increase your risk of developing pre-diabetes, but weight is not the only risk factor.
Genetic predisposition is another big factor. If it were as simple as weight, everyone with extra weight would be diagnosed with pre-diabetes and diabetes, and that's not the case. Unlike type 1 diabetes, type 2 can often be managed for a long time with diet and exercise alone, especially when diagnosed early. Staying aware and educated, managing your diet, staying active, and regularly monitoring your blood sugars, you can put diabetes management on autopilot.
While all the symptoms of type 1 can be present with a type 2, they are less severe unless there’s a serious problem. However, there are some symptoms that are a sign of chronic high blood sugar. These include increased infections, slower healing, impotence, and regular yeast infections or itching in the groin. In both types, chronic high blood sugars can cause long-term complications. The sugar causes damage to your body over time, especially to your nerves and vision.
Your endocrinologist (a type of doctor that specializes in diabetes) can assess whether you’re dealing with any complications and what treatment options are available.
LADA stands for "latent autoimmune diabetes in adults." People diagnosed with LADA are usually misdiagnosed with type 2 diabetes. They have the same islet antibodies as those with type 1 diabetes, but the progression of autoimmune destruction of the insulin-creating cells is much slower.
That means someone diagnosed with LADA can often manage blood sugars with diet, exercise, or maybe oral medications for some time after diagnosis (thus also contributing to the confusion and being misdiagnosed type 2).
A recent mySugr Spotlight blog post features Blanca, who tells the story of being diagnosed with LADA. Notable diabetes advocate Cherise Shockley has a great video on Science 37 about being diagnosed with LADA. And famous diabetes yogi, Rachel Zinman shares her story with LADA in a recent episode of "Live, with Scott!"
You can probably already guess that this has something to do with gestation and pregnancy. Gestational diabetes is usually diagnosed between the 24th and 28th week of pregnancy. Some of the hormones involved in raising a healthy baby also make the body more resistant to insulin. It's important for the health of the baby that blood sugars are kept in a healthy range, so blood sugars are usually monitored closely during this time.
Gestational diabetes can often be treated with a combination of diet and exercise, but if blood sugars continue to rise, your doctor might prescribe additional medication (including insulin if necessary).
Typically, gestational diabetes disappears after childbirth, but some women do go on to develop type 2 diabetes. It is possible to be diagnosed with type 1 diabetes during pregnancy, however, if there is an autoimmune attack on the insulin-producing cells as described above.
MODY stands for "Maturity Onset Diabetes of the Young" and may sometimes be called monogenic diabetes. It refers to several hereditary forms of diabetes caused by gene mutations that disrupt insulin production. To date, there are 11 different MODY variants of gene mutations known.
MODY usually occurs in children and young adults under 25 and can often be treated with diet and exercise and/or oral medications. Diabetes Forcast recently published a great article with even more information – What to Know About Maturity Onset Diabetes of the Young (MODY).
Type 3c / Pancreatogenic / Cystic fibrosis-related diabetes (CFRD) / Pancreatitis / Pancreatic cancer
This type(s) refers to diabetes resulting from different types of tissue damage to the pancreas. It's often difficult to diagnose and often quite challenging to manage. There are erratic swings from low to high caused by metabolic irregularities from tissue damage of the pancreas. There's an informative article here which provides much more background: Pancreatogenic Type 3c Diabetes: underestimated, Underappreciated and Poorly Managed
Special forms of diabetes
Did you know it's possible to get diabetes for a few other reasons, too? For example, if there's an acute injury to the pancreas from an accident or if some portion of the pancreas needs to be removed in surgery (children with certain types of hyperinsulinism). Some drugs, like steroids, statins, antipsychotics, and some high blood pressure meds, can also induce diabetes.
The two type 3s
Type 3 diabetes is often used to describe a friend, family, or loved one of someone living with diabetes implying that since the relationship is so close that much of the diabetes management is lovingly shared. However, this term has also been used to describe a relationship between diabetes and Alzheimer's disease. But this is controversial and most health care professionals are not ready to adopt the term until more research is done.