The number of Americans diagnosed with diabetes has more than doubled over the past two decades. One in nine people of all ages, and more than one in four over age 65, have diabetes.
Diabetes is more than high blood sugar. It is the leading cause of kidney failure, lower-limb amputations, and vision loss, and our seventh leading cause of death. That’s why it’s important to arm yourself with information so you can recognize diabetes in its earliest stages, know how to treat it, and most importantly, take steps to prevent it.
Let’s look at the different types of diabetes, their causes, symptoms, and the best treatment approaches.
Three Main Types of Diabetes
Diabetes is not one-size-fits-all. There are several types, each with different underlying causes, plus subtypes and a handful of rare forms that are inherited or caused by other diseases. There’s even a condition, called diabetes insipidus, that has nothing to do with blood sugar.
Most types, however, are classified as diabetes mellitus, and they are disorders of glucose metabolism. Glucose is the form of sugar in the blood and the primary fuel used by your cells to produce energy. When blood sugar rises, as it does after eating, it signals the pancreas to release insulin, the hormone that moves glucose out of the blood and into the cells. In healthy people, after a couple of hours, blood levels of glucose and insulin return to baseline.
When glucose cannot get into the cells, blood sugar remains elevated. How and why this happens is where the different types of diabetes come in. There are three main types of diabetes mellitus.
Type 1 Diabetes
Type 1 diabetes is relatively rare, affecting about 5% of patients with diabetes. It used to be called juvenile diabetes because it typically develops at a young age but can also crop up later in life. Some experts refer to this as latent autoimmune diabetes in adults (LADA) or type 1.5 diabetes.
- Causes: In type 1, the pancreas cannot produce enough insulin to move glucose into the cells. This is due to an autoimmune attack on the pancreas that results in severe insulin deficiency. The cause for this is unclear, but both genetic and environmental factors, such as viruses or vitamin D insufficiency, may play a role.
- Symptoms: Extreme thirst or hunger, frequent urination, weight loss, fatigue, blurred vision, confusion, and other symptoms may develop suddenly and should be evaluated at once.
- Treatment: Type 1 diabetes requires lifelong treatment with injected insulin, frequent monitoring of blood sugar levels, and ongoing medical care. A healthy lifestyle with a low-carbohydrate diet, exercise, and nutritional support is also recommended and helps prevent diabetic complications.
Type 2 Diabetes
Nearly 37 million people—11% of our population—have diabetes, and 90% of them have type 2 diabetes. Once called adult-onset or non-insulin dependent diabetes, this condition now affects hundreds of thousands of Americans under age 20. Plus, many patients with type 2 are insulin dependent.
- Causes: Insulin resistance is a primary feature of type 2 diabetes. The pancreas produces enough insulin, but the cells are resistant to its signals to let glucose in. In response, the pancreas produces more insulin, so you end up with high levels of blood sugar and insulin. Over time, the pancreas can no longer keep up and blood sugar remains elevated. The main risk factor for type 2 diabetes is abdominal obesity. Other contributors include metabolic syndrome, inactivity, poor diet, and sleep apnea. Diabetes also tends to run in families and is more common in older people—nearly 30% of seniors have diabetes.
- Symptoms: Type 2 has fewer overt symptoms, which is why nearly a quarter of people have not yet been diagnosed. If you are overweight, have a large waist, get little exercise, or eat a lousy diet, get tested.
- Treatment: Lifestyle changes such as exercise and a low-carb diet that promote weight loss are proven treatments for controlling blood sugar and preventing diabetic complications. However, most patients end up taking oral or injected diabetic medications.
Gestational Diabetes
An estimated 7–10% of women develop diabetes during pregnancy. Untreated gestational diabetes is associated with pregnancy and birth complications, including cesarean section, preterm delivery, and macrosomia (high weight for gestational age). It usually resolves after giving birth, but about half of women go on to develop type 2 diabetes at some time in their lives. Research also suggests that babies born with a high birth weight have an increased risk of obesity and diabetes later in life.
- Causes: Gestational diabetes is related to hormonal changes that interfere with the body’s ability to properly use insulin. Risk factors include maternal obesity, metabolic syndrome, older age, polycystic ovary syndrome, and a close family history of diabetes.
- Symptoms: Because most women experience few noticeable symptoms, doctors recommend that all pregnant women have glucose screening tests between 24 and 28 weeks of pregnancy.
- Treatment: More frequent checkups, especially during the last trimester, are required. Gestational diabetes can often be managed with diet and exercise to control blood sugar, but insulin is sometimes necessary.
Other Types of Diabetes
Monogenic diabetes is a rare form caused by a single gene mutation. It affects younger people and may be referred to as neonatal diabetes or maturity-onset diabetes of the young, depending on when it appears.
Diabetes induced by other medical conditions includes cystic fibrosis-related diabetes, which has features of both type 1 and 2. Pancreatic cancer, pancreatitis, and hemochromatosis can also trigger diabetes. Drugs known to cause diabetes in some patients include corticosteroids and antipsychotics.
Although type 3 diabetes is not an official diagnosis, there is increasing recognition of the close connection between diabetes mellitus and Alzheimer's disease. Some researchers call this type 3 diabetes to highlight this association.
Prediabetes simply means your blood sugar is higher than it should be but not high enough to merit a diagnosis of diabetes. If you are told you have prediabetes, consider it a wake-up call to lose weight, clean up your diet, and exercise, so you won’t have to deal with type 2 diabetes in the future.
Blood Sugar Control Is Essential for All Types of Diabetes
If you have any type of diabetes, take action now. Poorly controlled blood sugar, regardless of the cause, ramps up the risk of diabetic complications, which range from increased risk of infection and sexual dysfunction to heart attack, amputation, and premature death.
Treatment regimens vary according to the type and severity of diabetes, but all patients can benefit from these natural therapies:
- Regular physical activity, which increases insulin sensitivity and helps move glucose out of the blood and into the cells.
- A low-carbohydrate diet centered around whole, unprocessed, nutrient-dense foods.
- A good daily multivitamin and mineral supplement to protect against nutritional deficiencies common in diabetes, such as magnesium, chromium, zinc, B-vitamins, vitamin D, and antioxidants.
- Supplements to protect against diabetic complications of the eyes (lutein, zeaxanthin), nerves (B vitamins, lipoic acid), and heart (fish oil, coenzyme Q10).
In Summary
If diabetes isn’t on your radar, it should be. Understanding the different types of diabetes, recognizing symptoms, and discussing them with your doctor is your best bet for prevention and early intervention—and the earlier diabetes is controlled, the better the health outcomes.
Even if you require insulin or other medications, serious attention to diet, exercise, and nutritional support will enhance blood sugar control, increase your chances of sidestepping the many complications of diabetes, and help you live a longer and healthier life.
