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Types of Diabetes

Overall, there are four kinds of diabetes. The three most common types are type 1, type 2, and gestational diabetes. Also, diabetes can develop as a result of different conditions, such as certain rare genetic disorders or medical conditions such as cystic fibrosis. It can also occur after treatment with medications such as steroids.

What is type 1 diabetes?

Most children with diabetes have type 1 diabetes. Before, this was known as insulin-dependent diabetes mellitus (IDDM) or juvenile diabetes. In type 1 diabetes, the pancreas loses its ability to produce any or enough insulin. By the time the symptoms of diabetes have developed, at least 80% of the beta cells in the pancreas that produce insulin have already been destroyed. Nobody knows for certain how long this destruction has been happening. It is probably many months or years.

What Happens Without Insulin?

The only way that the body can once again use sugar for energy is to replace the missing insulin. At the moment, the only way to give back insulin is by injection. Most children take insulin injections several times a day. Some use a pump to infuse insulin under their skin continuously. Daily home management also involves attention to meal planning, and careful monitoring of blood, urine, and other factors.

Type 1 diabetes can be diagnosed at any age, but most commonly happens in children and teenagers. Only one in 10 of all people with diabetes have type 1 diabetes. Half of these are children.

In Canada and the United States, about one in 300 to 400 school-aged children have diabetes.

What is type 2 diabetes?

Type 2 diabetes is the most common form of diabetes. It is estimated that about nine in 10 of people with diabetes have type 2. Most people who have it are adults. In fact, it used to be called adult-onset diabetes because it usually affected middle-aged adults. But things are changing. Type 2 diabetes is now being diagnosed in growing numbers of children and teens.

In type 2 diabetes, the pancreas still makes insulin. However, either the pancreas doesn’t make enough insulin to keep blood sugar levels stable, or the body’s cells and tissues do not properly use the insulin. This is known as insulin resistance. As a result, glucose in the bloodstream can’t enter the cells. The cells “starve” and glucose levels in the blood rise. The pancreas keeps pumping out more insulin to try and move the glucose into the cells. Over time, the pancreas may become “exhausted” and start producing less insulin.

When there isn’t enough insulin, the sugar builds up in the blood instead. This starves the cells of energy. Over time, high levels of blood sugar can hurt the eyes, kidneys, nerves, and heart.

It is hard to diagnose type 2 diabetes in young people, because it usually begins with mild symptoms or even no symptoms at all. We don’t yet know how common type 2 diabetes is in young people. What is known is that the number of cases is growing, probably because more young people are overweight and are not getting enough exercise.

Some people with type 2 diabetes can manage their diabetes with diet and exercise, while others will also require diabetes pills (oral hypoglycemic agents) and/or insulin injections. Other healthy lifestyle changes, such as exercising more and quitting smoking, are also important. Treatments will usually change over the course of a person’s life.

Type 1

Type 2

Also called:

Insulin-dependent diabetes mellitus (IDDM)

Juvenile diabetes

Childhood diabetes

Non-insulin-dependent diabetes mellitus (NIDDM)

Maturity-onset diabetes

Adult-onset diabetes

Usually
diagnosed in:

Younger people (between infancy and 40)

Older people (over 40; incidence increases with age); often people with a significant weight problem

Insulin is:

Eventually totally absent

Produced, but too little or too ineffective to deal with the demands of the body

Accounts for:

About 10% of all people with diabetes

90% of all people with diabetes

Is treated by:

Insulin injections (plus a meal plan and careful monitoring)

Diet first to reduce weight; medications taken by mouth to either stimulate more insulin production or make the available insulin work better; or insulin, if the first two methods are unsuccessful

What is gestational diabetes?

Some women develop diabetes during pregnancy. This is called gestational diabetes. Women with gestational diabetes need the help of an expert team to achieve excellent blood sugar control. This will give them the best possible chance of having a healthy baby. Treatment involves careful monitoring, some changes in meal planning, and in some cases, insulin injections. After the baby is born, the mother’s pancreas usually begins functioning normally again. The infants of mothers with gestational diabetes are no more likely to develop diabetes than any other babies. However, women who have had gestational diabetes are at increased risk of developing type 2 diabetes later in life.