While more than 30 million people in the United States live with diabetes, not all diabetes types are the same. There are varying underlying disease processes which result in different forms of diabetes. No matter the type of diabetes a person has, the result is the same – hyperglycemia, or elevated blood sugar. Because the underlying cause of the disease can vary, the treatments and standards of care differ.
It is important for everyone to be aware of the symptoms of diabetes so they can report them to their doctor for further evaluation.
The most common form of diabetes is Type 2 diabetes, as it accounts for about 90-95 percent of all diagnosed cases. Type 2 diabetes most often develops in adulthood; however, due to rising obesity trends in our youth, it is now commonly diagnosed in childhood as well. Type 2 diabetes risk factors include: obesity, a sedentary lifestyle, age, ethnicity, gestational diabetes, and/or genetic predisposition. In Type 2 diabetes, the body still makes insulin, which is the hormone that lowers blood sugar; however, the body’s cells are resistant to insulin. Therefore, the result is an elevated blood sugar. Over time, the body can lose its ability to make insulin.
Type 2 diabetes often develops slowly over time with little warning or symptoms. Approximately 84 million American adults are living with “pre-diabetes;” and 90 percent of them are unaware of their pre-diabetic status. Routine annual physicals are of vital importance to ensure one is aware of their own health history and can thus intervene in order to stay healthier.
Type 2 diabetes is most commonly managed with lifestyle changes including healthy eating, exercise, and weight loss. There are many medications – both oral and injectable – to control Type 2 diabetes. Additionally, some living with Type 2 diabetes require insulin injections coupled with a healthy lifestyle.
Type 1 diabetes is an auto-immune disease, or a self-allergy, and it accounts for only about 5 percent of all diagnosed cases of diabetes. While it is most commonly diagnosed in childhood, it can also be diagnosed in adulthood. Because it is an auto-immune disease, the immune system damages cells in the pancreas that make insulin. As a result of the body’s inability to produce insulin, blood sugar levels are elevated.
While the cause of Type 1 diabetes has not been discovered, there is a component of genetic predisposition. Furthermore, there is likely an environmental trigger – like a virus – that contributes to its development. It may take months or years for this self-allergy to destroy enough cells in the pancreas before symptoms appear. However, once symptoms develop, they can be severe and must be diagnosed and treated quickly in order to prevent serious illness. A diagnosis of Type 1 diabetes requires lifelong insulin injections or insulin pump therapy. And as with Type 2 diabetes, a healthy lifestyle is important to prevent further disease complications.
A form of diabetes that develops in adulthood and tends to have characteristics of both Type 1 and Type 2 diabetes has been termed LADA (Latent Autoimmune Diabetes in Adults), Type 1.5 diabetes, or ADA (Autoimmune Diabetes in Adults). It is estimated that LADA accounts for about 10 percent of all diagnosed cases of diabetes. It can often go misdiagnosed as Type 2 diabetes since it develops in adulthood. Those with this form of diabetes tend to be in a normal weight range and often live an active lifestyle. Despite its more gradual onset, it is an autoimmune disease and is not reversible with changes to diet and lifestyle. Due to its gradual onset, oral medications may be used to treat this disease initially in some cases. Over time, and as the disease progresses, insulin is required.
No matter the type of diabetes, it is manageable. Treatment often includes frequent blood sugar monitoring and/or CGM (Continuous Glucose Monitoring) therapy, medications, insulin injections/insulin pump therapy, and leading a healthy lifestyle. A person with diabetes can live a long and healthy life if managing their disease is a priority.
Make sure to tell your doctor if you or your child are displaying the signs of diabetes, which include excessive thirst/hunger, frequent urination, weight loss, blurry vision, nausea/vomiting, or fatigue. A simple blood test called an A1c can confirm the diagnosis so treatment can get started without delay.
McCall White is a registered nurse and certified diabetes educator with the New Hanover Regional Medical Center Nunnelee Pediatric Specialty Clinics.