Islets of Hope for persons newly diagnosed with diabetes
Article by Lahle Wolfe. For reprint information e-mail: Editor@isletsofhope.com
From our "Newly Diagnosed" section
Types of Diabetes (Primary, secondary, and diabetes causes)
Fast click to more comprehensive diabetes medical information
Other forms of diabetes
Important Medical Disclaimer
Material on this site is intended for informational purposes only and should not be used for self- diagnosis or treatment. IOH strongly recommends you seek the advice of a competent medical professional for diagnosis and treatment options, or before making changes to your diabetes care plan.
Q: What type of doctor diagnoses and treats diabetes?
A: An endocronologist, diabetologist, or other physician specializing in endocrine disorders.
According to the Juvenile Diabetes Research Foundation (JDRF) there are approximately 18.2 million people with diabetes. Someone is diagnosed every 40 seconds and someone dies from diabetes related complications every 3 minutes.
Want to know more about how genes play a role in diabetes?
To learn more about the genetics of all forms of diabetes read the National Institutes of Health’s online book “The Genetic Landscape of Diabetes.” This book, written both for professionals and laypersons, provides an overview of the genetics of type 1 and type 2 diabetes, as well other less common forms of diabetes.
Different types of diabetes
Mini site index
What is diabetes?
What is diabetes?diabetes mellitus (deye-uh-bee-teez, deye-uh-bee-tuhs mel-uh-tuhs) is a chronic disease in which carbohydrates cannot be properly metabolized (used by the body's cells and tissues) because the pancreas fails to secrete an adequate amount of insulin. This can be due to a relative of absolute insulin deficiency, but both cause hyperglycemia (high blood sugar)
"Diabetes" means polyuria (excessive urination) and the term "mellitus" (from the Latin word for honey) was added in 1675 by Thomas Willis when he discovered that the urine of diabetics was sweet.
The two main types of diabetes most people have heard of are type 1 and type 2. There are actually more than two types of diabetes and the cause of diabetes varies. Primary diabetes is when someone becomes diabetic unrelated to the onset of another disease. Secondary diabetes can occur as a result of damage or disease to the pancreas from another disease such as hemochromatosis (iron overload) or cystic fibrosis (CF). If the pancreas is damaged from disease, an injury, or surgically removed and can no longer produce insulin a person will develop secondary type 1 diabetes.
Different types of diabetes
There are many forms and subtypes of diabetes and they can occur for different reasons. The two main forms of diabetes are type 1 and type 2 diabetes. A third type, which is does not affect insulin production is called diabetes insipidus.
Type 1 Diabetes (insulin-dependent)
Persons with type 1 diabetes require insulin by injection (most commonly administered by shots or an insulin pump) for the rest of their life because the pancreas, the organ that produces insulin, no longer makes insulin. When a person has type 1 diabetes they usually end up having "absolute insulin deficiency." This simply means that at some point, the pancreas will produce no insulin at all. There are many forms of type 1 diabetes and the causes may vary, but basic treatment is essentially the same for all forms of type 1 diabetes (daily injection of insulin and blood glucose monitoring).
Type 2 Diabetes (non-insulin dependent, or adult-onset)
In type 2 diabetes, the pancreas may produce too little insulin or the person is resistant to the insulin that is produced by the pancreas. Persons with type 2 diabetes may be able to control their disease with lifestyle changes and oral medications. Not all type 2 diabetes require insulin, but some do.
Diabetes Insipidus (DI)
Diabetes insipidus is a type of diabetes is sometimes called "water diabetes." It does not affect the pancreas or interfere with carbohydrate metabolism (how the body uses and stores energy). There are many forms of DI and most are treated with oral medications.
Forms of type 1 diabetes
Juvenile Diabetes (insulin-dependent diabetes mellitus)
This primary form of type 1 diabetes is usually diagnosed between infancy and prior to age 25 or 30. The onset is rapid (over days or weeks). It is the most commonly diagnosed form of all type 1 diabetes and all persons with juvenile type 1 diabetes require daily injections of insulin each day.
Latent Autoimmune Diabetes in Adults (LADA)
LADA is a form of type 1 diabetes is similar to juvenile diabetes, however, it occurs in adults typically over the age of 25. It has a slower onset than juvenile diabetes (which usually occurs over days or weeks) and may initially be misdiagnosed as type 2 diabetes because it takes longer for the pancreas to stop producing insulin.
This form of diabetes is also called slow-onset diabetes or type 1.5 (one and a half).
Maturity Onset Diabetes of the Young (MODY)
MODY refers to any of several rare hereditary forms of diabetes mellitus due to dominantly inherited defects of insulin secretion. As of 2004, six types have been identified with MODY 2 and MODY 3 being the most common forms. The severity of the different types varies considerably, but most commonly MODY acts like a very mild version of type 1 diabetes, with continued partial insulin production and normal insulin sensitivity. Persons with MODY can have severe hyperglycemia (high blood glucose) but may also only experience mild hyperglycemia (high blood glucose) because some insulin is still produced. They are often of normal body weight, and test negative for thyroid antibodies. They may also have a problem with cystic kidneys.
The three main identifying characteristics of MODY are:
Diseases that can cause secondary type 1 diabetes
Cystic Fibrosis Related Diabetes (CFRD)
Cystic Fibrosis can cause the ducts in the pancreas to become clogged with mucus interfering with insulin production and absorption. Persons with CF may develop a secondary form of type 2 or 1 diabetes.
Hemochromatosis ("bronze diabetes")
Hemochromatosis, also known as "iron overload" causes the body to store excessive amounts of iron. This can cause damage to many parts of the body including the pancreas. If the pancreas is affected, a secondary form of type 1 diabetes can result. Sometimes this form of diabetes is called "bronze diabetes" because persons with hemochromatosis may develop a "bronze" color to their skin. It is treated by following a strict iron-free diet and by periodically removing blood (phlebotomy) from the body until the iron levels return to safe levels. Hemochromatosis requires carefully monitoring by a doctor.
Forms of type 2 diabetes
Type 2 (non-insulin-dependent or adult-onset)
Type 2 diabetes is an autoimmune disease. An autoimmune disease is when the body attacks and destroys good cells and tissues mistaking them as foreign intruders. With type 2 diabetes the insulin-producing beta-cells in the pancreas either do not make enough insulin, or, the person with type 2 is not sensitive to the insulin produced (insulin resistant). Over time, the pancreas may wear out and stop producing insulin altogether. If this happens, a person will be required to inject insulin each day to live.
People with type 2 diabetes have usually inherited the predisposition for diabetes and then something in the environment triggers the disease. With type 2 diabetes the environmental trigger is usually poor diet and a sedentary lifestyle. Type 2 diabetes used to be a disease seen mostly in older adults. Now, it is also seen in epidemic proportion among young adults as well as in children. This is especially true in Westernized cultures where diets tend to consist of high-fat and processed carbohydrate foods.
Twin studies show that genetic predisposition to diabetes is not enough to become diabetic. Only half of identical twins with a diabetic twin sibling will also become type 1 diabetic. However, the likelihood of an identical twin developing type 2 diabetes when a twin sibling has type 2 is much greater, with about a 75% chance of type 2 onset.
Treatment includes diet control, exercise, blood glucose monitoring and, in some cases, oral drugs, or even insulin.
Gestational diabetes occurs during pregnancy. It can occur as a result of extra hormonal demands placed on the mother, an unhealthy lifestyle before and during pregnancy, excessive weight, or a combination of factors. Women who have a family history of diabetes, especially on the maternal side are also more likely to develop gestational diabetes than other women.
Although this type of diabetes usually disappears after the birth of the baby, women who have had gestational diabetes are at high risk of developing type 2 diabetes later in life. Their babies, especially those of a large birth weight, are also at greater risk for becoming type 2 diabetic later in life but these risks for both mother and baby can be reduced with proper medical care and a healthy lifestyle.
Pre-diabetes is a condition where a person is not yet type 2 diabetic but has abnormally elevated blood glucose levels either upon morning fasting (in the morning, before eating) or 2 hours after eating (post prandial).
This is the only form of "diabetes" that may be completely reversed. There is no cure for type 1 or type 2 diabetes, however, with proper lifestyle changes and medical intervention persons with pre-diabetes may not only avoid onset of full-blown diabetes type 2, but may be able to completely reverse their pre-diabetic condition back to a normal state.
Page Updated 09/15/2006