Diabetes Types

Defining Diabetes Types

"Misdiagnosis or an unclear diagnosis of diabetes can create problems in treatment. Misunderstanding the causes and changes in the disease as you age also can lead to mistreatment. For these reasons, a clear understanding of the types of diabetes is essential."

"Beginning in the mid 1920s, those who got diabetes when young (juvenile onset) were put on insulin, and those who got it when older (adult onset) often were not. However, the mechanisms that led to this difference in treatment were unknown."

"In the early 1980s a breakthrough was made in understanding childhood onset diabetes. It became clear that this early onset form was actually an autoimmune disease in which the body destroyed its own beta cells. The antibodies that the immune system put out during this attack distinguished it from adult onset diabetes. For the first time, one type of diabetes had a clear cause that made it different."

"Definitions became clearer. Type 1, called IDDM (insulin-dependent diabetes mellitus), now was recognized as an autoimmune disease that appeared primarily in childhood or adolescence."

"Type 2 or NIDDM or non-insulin-dependent diabetes mellitus, on the other hand, was described as high blood sugars occurring in a person over 40 who is overweight and sedentary and also has a family history of this type of diabetes."

"In the early 1990s the definition of Type 2 was further refined to distinguish those with and without Syndrome X. Syndrome X is strongly associated with insulin resistance and with high total cholesterol (over 200), high triglycerides (also over 200), low HDL (under 40 mg/dl), high blood pressure, and gout."

"When 'Type 2' occurs without insulin resistance, it may be referred to as Type 1.5 or Type 2-s (for insulin sensitive) or Type 2-d (for insulin deficient).... Of all the people with diabetes, roughly 10% will have classic Type 1, 75% will have Type 2 (insulin resistant), and another 15% will have Type 1.5."

"Other forms of insulin resistant diabetes also can be seen in gestational diabetes, polycystic ovary disease, acanthosis nigricans, and maturity-onset diabetes of the young or MODY. Insulin resistant diabetes can also be unmasked by medications like prednisone. In rare cases, nonresistant forms of diabetes may also be seen following trauma to the pancreas or pancreatic surgery. This last form is insulin dependent because no insulin can be produced once the pancreas is removed or severely damaged."

"Most people with diabetes have Type 1, Type 1.5 or Type 2. As more is known about the causes of diabetes and more treatments are developed, more types or sub types are certain to be defined."

Diagnosing Diabetes Types

"When a person does not fit into a clear profile, a diagnosis of Type 1, Type 1.5, or Type 2 is not obvious. A variety of lab tests and clinical signs help to provide the critical information needed to correctly determine which type of diabetes the person has."

"In summary, our understanding of diabetes and the lab tests useful to us continues to evolve. To understand your situation as information changes, you want to ask specific questions about your diagnosis and treatment. An informed, questioning approach will increase your likelihood of receiving the best care."

Ruth Roberts, MA

[Only excerpts were presented here. The whole article provides lots of information on defining, diagnosing, and treating different diabetes types. Please take a moment and read the full article. Thank you. diabetesnet.com/diabetes_types/whatype.php]