You’ve probably heard of type 1 and type 2 diabetes, but did you know there are several subtypes of diabetes, too? Researchers continue to make new discoveries about diabetes which helps healthcare professionals determine what kinds of treatments will be most effective for individuals.
Before we talk about diabetes, let’s review how the body works when diabetes is not present.
- When you eat, your food is broken down into sugar, or glucose, to be used for energy.
- Your pancreas produces insulin.
- Insulin moves the glucose from your blood into your cells.
Your body regulates how much glucose is in the blood at one time. High levels of glucose can damage blood vessels throughout the body. Low levels of glucose means you don’t have enough fuel to support your body’s functions. In the presence of diabetes, the body does not properly regulate the amount of glucose in the blood.
Here is an overview of type 1 and 2 diabetes along with some types that may be new to you.
Type 1 Diabetes
This is an autoimmune type of diabetes. The body’s immune system injures the cells that produce insulin in the pancreas. This causes the body to produce little to no insulin. People with type 1 diabetes need to take insulin to move glucose from the blood into cells. Without insulin, people with type 1 diabetes cannot survive.
Type 2 Diabetes
At least 90% of all diabetes cases are type 2. This type of diabetes involves insulin resistance and/or relative insulin deficiency. Insulin resistance means that the body’s cells do not respond to insulin’s efforts to move glucose out of the blood. Over time, the cells in the pancreas may stop producing insulin which causes relative insulin deficiency.
Depending upon its severity, type 2 diabetes can be treated with nutrition and exercise, oral medications, and injectable medications, including insulin. While type 2 diabetes is often associated with obesity, not all people with obesity have type 2 diabetes and not all people with type 2 diabetes have obesity.
Gestational Diabetes (GDM)
Gestational diabetes develops during pregnancy. During pregnancy, the placenta produces hormones that work against insulin. Having a slight increase in blood sugar during pregnancy is normal. However, in some cases, blood sugars rise to levels that are high enough to cause health risks for the woman and her developing baby.
Some women can manage GDM with nutrition and exercise. About 10 to 20% of women will need insulin to lower their blood sugar levels. For most women, GDM disappears after pregnancy. Unfortunately, having GDM increases the risk of developing type 2 diabetes later in life.
Latent Autoimmune Diabetes in Adults (LADA)
Latent autoimmune diabetes in adults is sometimes called “type 1.5 diabetes”. It is a slow progression of an autoimmune disease that injures the cells in the pancreas that produce insulin.
Due to the slow progression, a person with LADA may not need insulin for several months after they have been diagnosed with diabetes. At first, LADA can be managed through nutrition and exercise. For this reason, some people are misdiagnosed with type 2 diabetes. Over time, the pancreas will no longer be able to produce insulin and a person with LADA will need to take insulin.
Maturity-Onset Diabetes of the Young (MODY)
This name is an umbrella term for six types of diabetes that are caused by a single gene mutation. The gene mutation limits the pancreas from making enough insulin. If you have a parent with MODY, you have a 50% of having MODY yourself.
Many people with MODY have no symptoms or such mild symptoms that they may not be diagnosed with diabetes. Once your doctor suspects diabetes based on your blood glucose levels, they may suggest genetic testing to determine whether you have MODY and which type. Knowing which type of MODY you have will help your doctor determine whether or not you need medications such as sulfonylureas or insulin.
Researchers are continuing to learn about new types of diabetes and how to better treat the types of diabetes we already know about. Getting the correct diabetes diagnosis is essential to ensure you receive the most effective treatment for your diabetes. If you think you may not have the right diabetes diagnosis, talk to your health care provider as soon as possible so you can get started on the best plan for managing your diabetes.
Written by Laura Andromalos, MS, RD, CD, CDE