Diabetes types
Diabetes mellitus, commonly known as diabetes, is a
metabolic disease that causes high blood sugar. The hormone insulin moves sugar
from the blood into your cells to be stored or used for energy. With diabetes,
your body either doesn’t make enough insulin or can’t effectively use the
insulin it does make.
Untreated high blood sugar from diabetes can damage
your nerves, eyes, kidneys, and other organs.
There are a few different types of diabetes:
- Type 1 diabetes is an autoimmune
disease. The immune system attacks and destroys cells in the pancreas,
where insulin is made. It’s unclear what causes this attack. About 10
percent of people with diabetes have this type.
- Type
2 diabetes occurs
when your body becomes resistant to insulin, and sugar
builds up in your blood.
- Prediabetes occurs when your blood sugar is
higher than normal, but it’s not high enough for a diagnosis of type 2
diabetes.
- Gestational diabetes is high blood sugar
during pregnancy. Insulin-blocking hormones produced by the placenta cause
this type of diabetes.
A rare condition called diabetes insipidus is
not related to diabetes mellitus, although it has a similar name. It’s a
different condition in which your kidneys remove too much fluid from your body.
Each type of diabetes has unique symptoms, causes,
and treatments.
Symptoms of diabetes
Diabetes symptoms are caused by rising blood sugar.
General symptoms
The general symptoms of diabetes include:
- increased hunger
- increased thirst
- weight loss
- frequent urination
- blurry vision
- extreme fatigue
- sores that don’t heal
Symptoms in men
In addition to the general symptoms of
diabetes, men with diabetes may have a decreased sex drive, erectile
dysfunction (ED), and poor muscle strength.
Symptoms in women
Women with diabetes can also have symptoms
such as urinary tract infections, yeast infections, and dry,
itchy skin.
Type 1 diabetes
Symptoms of type 1 diabetes can include:
- extreme hunger
- increased thirst
- unintentional weight loss
- frequent urination
- blurry vision
- tiredness
It may also result in mood changes.
Type 2 diabetes
Symptoms of type 2 diabetes can include:
- increased hunger
- increased thirst
- increased urination
- blurry vision
- tiredness
- sores that are slow to heal
It may also cause recurring infections. This is
because elevated glucose levels make it harder for the body to heal.
Gestational diabetes
Most women with gestational diabetes don’t have any
symptoms. The condition is often detected during a routine blood sugar test or
oral glucose tolerance test that is usually performed between the 24th and 28th
weeks of gestation.
In rare cases, a woman with gestational diabetes
will also experience increased thirst or urination.
Causes of diabetes
Different causes are associated with each type of
diabetes.
Type 1 diabetes
Doctors don’t know exactly what causes type 1
diabetes. For some reason, the immune system mistakenly attacks and destroys
insulin-producing beta cells in the pancreas.
Genes may play a role in some people. It’s also
possible that a virus sets off the immune system attack.
Type 2 diabetes
Type 2 diabetes stems from a combination of genetics and
lifestyle factors. Being overweight or obese increases your risk too.
Carrying extra weight, especially in your belly, makes your cells more
resistant to the effects of insulin on your blood sugar.
This condition runs in families. Family members
share genes that make them more likely to get type 2 diabetes and to be
overweight.
Gestational diabetes
Gestational diabetes is the result of hormonal
changes during pregnancy. The placenta produces hormones that make a pregnant
woman’s cells less sensitive to the effects of insulin. This can cause high
blood sugar during pregnancy.
Women who are overweight when they get
pregnant or who gain too much weight during their pregnancy are
more likely to get gestational diabetes.
Diabetes risk factors
Certain factors increase your risk for diabetes.
Type 1 diabetes
You’re more likely to get type 1 diabetes if you’re
a child or teenager, you have a parent or sibling with the condition,
or you carry certain genes that are linked to the disease.
Type 2 diabetes
Your risk for type 2 diabetes increases if you:
- are overweight
- are age 45 or older
- have a parent or sibling with the condition
- aren’t physically active
- have had gestational diabetes
- have prediabetes
- have high blood pressure, high cholesterol,
or high triglycerides
- have African American, Hispanic or Latino
American, Alaska Native, Pacific Islander, American Indian, or Asian
American ancestry
Gestational diabetes
Your risk for gestational diabetes increases if
you:
- are overweight
- are over age 25
- had gestational diabetes during a past pregnancy
- have given birth to a baby weighing more
than 9 pounds
- have a family history of type 2 diabetes
- have polycystic ovary syndrome (PCOS)
Diabetes complications
High blood sugar damages organs and tissues
throughout your body. The higher your blood sugar is and the longer you live
with it, the greater your risk for complications.
Complications associated with diabetes include:
- heart disease, heart attack, and stroke
- neuropathy
- nephropathy
- retinopathy and vision loss
- hearing loss
- foot damage such as infections and sores
that don’t heal
- skin conditions such as bacterial and fungal infections
- depression
- dementia
Gestational diabetes
Uncontrolled gestational diabetes can lead to problems
that affect both the mother and baby. Complications affecting the baby can
include:
- premature birth
- higher-than-normal weight at birth
- increased risk for type 2 diabetes later in life
- low blood sugar
- jaundice
- stillbirth
The mother can develop complications such as high
blood pressure (preeclampsia) or type 2 diabetes. She may also require cesarean
delivery, commonly referred to as a C-section.
The mother’s risk of gestational diabetes in future
pregnancies also increases.
Treatment of diabetes
Doctors treat diabetes with a few different
medications. Some of these drugs are taken by mouth, while others are
available as injections.
Type 1 diabetes
Insulin is the main treatment for type 1
diabetes. It replaces the hormone your body isn’t able to produce.
There are four types of insulin that are most
commonly used. They’re differentiated by how quickly they start to work, and
how long their effects last:
- Rapid-acting insulin starts to work within 15
minutes and its effects last for 3 to 4 hours.
- Short-acting insulin starts to work within 30
minutes and lasts 6 to 8 hours.
- Intermediate-acting insulin starts to work within
1 to 2 hours and lasts 12 to 18 hours.
- Long-acting insulin starts to work a few hours
after injection and lasts 24 hours or longer.
Type 2 diabetes
Diet and exercise can help some people manage type
2 diabetes. If lifestyle changes aren’t enough to lower your blood sugar,
you’ll need to take medication.
These drugs lower your
blood sugar in a variety of ways:
Types of drug
|
How they work
|
Example(s)
|
Alpha-glucosidase
inhibitors
|
Slow your body’s
breakdown of sugars and starchy foods
|
Acarbose (Precose)
and miglitol (Glyset)
|
Biguanides
|
Reduce the amount
of glucose your liver makes
|
Metformin (Glucophage)
|
DPP-4 inhibitors
|
Improve your blood sugar
without making it drop too low
|
Linagliptin (Tradjenta),
saxagliptin (Onglyza), and sitagliptin (Januvia)
|
Glucagon-like peptides
|
Change the way your body
produces insulin
|
Dulaglutide (Trulicity),
exenatide (Byetta), and liraglutide (Victoza)
|
Meglitinides
|
Stimulate your pancreas
to release more insulin
|
Nateglinide (Starlix) and
repaglinide (Prandin)
|
SGLT2 inhibitors
|
Release more glucose into
the urine
|
Canagliflozin (Invokana)
and dapagliflozin (Farxiga)
|
Sulfonylureas
|
Stimulate your pancreas
to release more insulin
|
Glyburide (DiaBeta,
Glynase), glipizide (Glucotrol), and glimepiride (Amaryl)
|
Thiazolidinediones
|
Help insulin work better
|
Pioglitazone (Actos) and
rosiglitazone (Avandia)
|
You may need to take more than one of these drugs.
Some people with type 2 diabetes also take insulin.
Gestational diabetes
You’ll need to monitor your blood sugar level several
times a day during pregnancy. If it’s high, dietary changes and exercise may or
may not be enough to bring it down.
According to the Mayo Clinic, about 10 to 20
percent of women with gestational diabetes will need insulin to lower
their blood sugar. Insulin is safe for the growing baby.
Diabetes and diet
Healthy eating is a central part of managing
diabetes. In some cases, changing your diet may be enough to control the
disease.
Type 1 diabetes
Your blood sugar level rises or falls based on the
types of foods you eat. Starchy or sugary foods make blood sugar levels rise
rapidly. Protein and fat cause more gradual increases.
Your medical team may recommend that you limit
the amount of carbohydrates you eat each day. You’ll also need to balance
your carb intake with your insulin doses.
Work with a dietitian who can help you design a
diabetes meal plan. Getting the right balance of protein, fat, and carbs can
help you control your blood sugar.
Type 2 diabetes
Eating the right types of foods can both control
your blood sugar and help you lose any excess weight.
Carb counting is an important part of eating for
type 2 diabetes. A dietitian can help you figure out how many grams of
carbohydrates to eat at each meal.
In order to keep your blood sugar levels steady,
try to eat small meals throughout the day. Emphasize healthy foods such as:
- fruits
- vegetables
- whole grains
- lean protein such as poultry and fish
- healthy fats such as olive oil and nuts
Certain other foods can undermine efforts to keep
your blood sugar in control.
Gestational diabetes
Eating a well-balanced diet is important
for both you and your baby during these nine months. Making the right food
choices can also help you avoid diabetes medications.
Watch your portion sizes, and limit sugary or salty
foods. Although you need some sugar to feed your growing baby, you should avoid
eating too much.
Consider making an eating plan with the help of a
dietitian or nutritionist. They’ll ensure that your diet has the right mix of
macronutrients.
Diabetes diagnosis
Anyone who has symptoms of diabetes or is at risk
for the disease should be tested. Women are routinely tested for gestational
diabetes during their second or third trimesters of
pregnancy.
Doctors use these blood tests to diagnose
prediabetes and diabetes:
- The fasting plasma glucose (FPG) test measures
your blood sugar after you’ve fasted for 8 hours.
- The A1C test provides a snapshot of
your blood sugar levels over the previous 3 months.
To diagnose gestational diabetes, your doctor
will test your blood sugar levels between the 24th and 28th weeks
of your pregnancy.
- During the glucose challenge test, your blood
sugar is checked an hour after you drink a sugary liquid.
- During the 3 hour glucose tolerance test,
your blood sugar is checked after you fast overnight and then drink a
sugary liquid.
The earlier you get diagnosed with diabetes, the
sooner you can start treatment.
Diabetes prevention
Type 1 diabetes isn’t preventable because it’s
caused by a problem with the immune system. Some causes of type 2 diabetes, such
as your genes or age, aren’t under your control either.
Yet many other diabetes risk factors are
controllable. Most diabetes prevention strategies involve making simple
adjustments to your diet and fitness routine.
If you’ve been diagnosed with prediabetes, here are
a few things you can do to delay or prevent type 2 diabetes:
- Get at least 150 minutes per week of aerobic
exercise, such as walking or cycling.
- Cut saturated and trans fats,
along with refined carbohydrates, out of your diet.
- Eat more fruits, vegetables, and whole
grains.
- Eat smaller portions.
- Try to lose 7 percent of your body
weight if you’re overweight or obese.
These aren’t the only ways to prevent
diabetes.
Diabetes in pregnancy
Women who’ve never had diabetes can suddenly
develop gestational diabetes in pregnancy. Hormones produced by the placenta
can make your body more resistant to the effects of insulin.
Some women who had diabetes before they conceived
carry it with them into pregnancy. This is called pre-gestational diabetes.
Gestational diabetes should go away after you
deliver, but it does significantly increase your risk for getting diabetes
later.
About half of women with gestational diabetes
will develop type 2 diabetes within 5 to 10 years of delivery, according to the
International Diabetes Federation (IDF).
Having diabetes during your pregnancy can also lead
to complications for your newborn, such as jaundice or breathing problems.
If you’re diagnosed with pre-gestational or
gestational diabetes, you’ll need special monitoring to prevent
complications.
Diabetes in children
Children can get both type 1 and type 2 diabetes.
Controlling blood sugar is especially important in young people, because the
disease can damage important organs such as the heart and kidneys.
Type 1 diabetes
The autoimmune form of diabetes often starts in
childhood. One of the main symptoms is increased urination. Kids with type
1 diabetes may start wetting the bed after they’ve been toilet trained.
Extreme thirst, fatigue, and hunger are also signs
of the condition. It’s important that children with type 1 diabetes get treated
right away. The disease can cause high blood sugar and dehydration, which
can be medical emergencies.
Type 2 diabetes
Type 1 diabetes used to be called “juvenile
diabetes” because type 2 was so rare in children. Now that more children are
overweight or obese, type 2 diabetes is becoming more common in
this age group.
About 40 percent of children with type 2
diabetes don’t have symptoms, according to the Mayo Clinic. The disease is often
diagnosed during a physical exam.
Untreated type 2 diabetes can cause lifelong
complications, including heart disease, kidney disease, and blindness. Healthy
eating and exercise can help your child manage their blood sugar and prevent
these problems.
Type 2 diabetes is more prevalent than ever in
young people.
Source of Information: Healthline