Diabetes is a chronic disease characterized by abnormally high levels of glucose in the blood—sugar derived from carbohydrates that are the body’s main source of energy.
There are five types of diabetes: type 1 diabetes, type 2 diabetes, latent autoimmune diabetes in adults (LADA), gestational diabetes, and monogenic diabetes. Some experts also consider Alzheimer’s disease a form of diabetes, calling it type 3.
Some forms of diabetes are genetic in origin, while others are related to lifestyle or other factors. Regardless, the disease requires lifelong management to avoid serious and even life-threatening complications.
what do they have in common
All types of diabetes are characterized by changes in the function of insulin, a hormone produced by the pancreas that helps move glucose from the blood to cells, where it is used as fuel.
Depending on the type of diabetes, the pancreas does not produce insulin or the body cannot use it properly. Either way, without adequate insulin or a healthy response to it, the sugar circulating in the blood cannot enter the cells.
Early symptoms of either type of diabetes include fatigue, extreme thirst, and frequent urination.
If the disease progresses, many complications can occur, including vision changes or loss (diabetic retinopathy), diabetic neuropathy (nerve damage), increased risk of heart disease, kidney damage, and more.
type 1 diabetes
Type 1 diabetes occurs when the pancreas stops or almost stops producing insulin. Type 1 diabetes is also known as insulin-dependent diabetes and juvenile diabetes.
Type 1 diabetes usually occurs in childhood, most commonly between the ages of 4 and 14. Symptoms tend to develop rapidly and may range from mild to extreme.
Before diagnosis, children may wet the bed, feel sleepy frequently, and/or have impaired growth and learning. Some children have seizures or lose consciousness due to extremely high blood sugar.
What causes type 1 diabetes is not fully understood. Family members are at increased risk of developing type 1 diabetes, suggesting that there may be a genetic component to the disease. It is also considered an autoimmune disease because the body is fighting its own pancreatic cells. In some cases, type 1 diabetes can be caused by a virus.
People with type 1 diabetes must change their insulin daily, either by injection or through an insulin pump. Ideally, blood glucose should be continuously measured by an automatic monitor, and insulin doses adjusted based on blood glucose levels and food intake at each meal, as well as other factors such as physical activity and sleep.
Management methods may also include regular exercise and a balanced diet rich in whole grains, lean meats, nuts, legumes, and plenty of fruits and vegetables.
Type 1 Diabetes Overview
Latent autoimmune diabetes in adults (LADA)
Like type 1 diabetes, LADA is an autoimmune disease. LADA, also known as type 1.5 diabetes, is most common around age 30. For this reason, it is sometimes initially misdiagnosed as type 2 diabetes. A clear difference between the two is that LADA is not associated with weight gain.
With LADA, the body attacks the insulin-producing beta cells of the pancreas, severely limiting the body’s insulin production over time. This may happen quickly or over a longer period of time.
People affected by LADA may have a family history of autoimmune disease or a genetic predisposition to type 1 or type 2 diabetes.
Treatment for LADA involves supporting the body’s existing insulin production as long as it persists, then transitioning to regular insulin, other medications (if necessary), a healthy diet, and regular physical activity.
Overview of Latent Autoimmune Diabetes in Adults (LADA)
type 2 diabetes
Type 2 diabetes occurs when the body cannot use insulin effectively. This is often called insulin resistance. Type 2 diabetes is also known as non-insulin dependent diabetes.
Some people may experience fatigue or increased urination as initial symptoms, but many people with type 2 diabetes have no symptoms at all in the early stages. Later, if the disease is not controlled, complications such as vascular disease, heart attack and stroke can occur.
Type 2 diabetes often precedes a condition described as prediabetes or another condition called metabolic syndrome. There is a lot of overlap between these conditions. Both are characterized by elevated blood sugar, high blood pressure, high cholesterol and a high body mass index (BMI) or obesity.
Often, weight and diet management can reverse prediabetes or metabolic syndrome, thereby preventing type 2 diabetes.
Type 2 diabetes is treated with drugs designed to improve the uptake of glucose by cells or increase the body’s sensitivity to insulin, but counteracting this with diet and lifestyle changes such as weight loss, exercise, and stress reduction has done well . Insulin may be required in later stages of the condition.
Type 2 Diabetes Overview
If you have high fasting blood sugar during pregnancy but have not been diagnosed with diabetes before, you may have gestational diabetes.
This condition can make your baby prone to growth and development problems and complicate pregnancy and delivery. It is necessary to regularly monitor your blood sugar, weight, and your baby’s growth during pregnancy to minimize complications.
During pregnancy, placental hormones cause glucose levels to rise. If the pancreas can’t keep up with this production, you may end up with persistently elevated blood sugar. Gestational diabetes can develop if you are genetically predisposed, if you are overweight, or simply because insulin resistance may sometimes increase during pregnancy.
The American Diabetes Association (ADA) recommends that women planning pregnancy be screened for diabetes if they have risk factors for diabetes. It also recommends undiagnosed diabetes testing for all women planning to become pregnant.
In addition, the ADA recommends testing pregnant women with risk factors before 15 weeks of gestation and, if preconception screening is not performed, recommends testing for undiagnosed diabetes at the first prenatal visit.
After the baby is born, many women’s blood sugar returns to normal. However, having gestational diabetes does put some women at a higher risk of developing type 2 diabetes. If you have or have had gestational diabetes, be sure to check your blood sugar at your annual doctor’s appointment.
Treatment for gestational diabetes begins with lifestyle changes, as many medications can have adverse side effects for both mother and baby during pregnancy. Reducing refined carbohydrate intake and increasing activity levels (especially low-intensity weight-bearing exercises such as walking and yoga) can help balance blood sugar levels.
Monogenic diabetes is a lesser-known type of diabetes because it is rare, accounting for only 1 to 4 percent of diabetes cases.
This form is caused by specific known genetic mutations that normally reduce the body’s ability to make insulin. Sometimes these are inherited from parents, sometimes they are spontaneous.
There are two forms of monogenic diabetes:
- Neonatal diabetes mellitus (NDM), which occurs in the first 6 to 12 months of life
- Adult-onset diabetes of the young (MODY), diagnosed in late childhood or adolescence
Both forms can be misdiagnosed as type 1 diabetes, and MODY can be confused with type 2 diabetes.
These conditions can be diagnosed with genetic testing, which can be done if risk factors such as a family history of diabetes or early onset are present. An accurate diagnosis is important so that children with monogenic diabetes can receive the correct treatment.
Babies with NDM may need insulin or other medicines temporarily or for life. MODY treatment may vary, depending on the severity of a person’s diabetes.
type 3 diabetes
Many studies have shown that having diabetes or prediabetes is a risk factor for Alzheimer’s disease, A form of progressive dementia that affects more than 6 million Americans age 65 or older.
Research centered on the link between type 2 diabetes and Alzheimer’s disease has led some experts to refer to Alzheimer’s disease as type 3 diabetes. The link appears to be that the characteristic amyloid plaques that form on the brains of Alzheimer’s patients are linked to the effects of insulin resistance that appears to be confined to the brain.
Some studies show that having diabetes increases the risk of Alzheimer’s by 65%, and that 50% of people with type 2 diabetes go on to develop Alzheimer’s.
While the immediate cause is still being studied, there is a strong correlation between long-term blood sugar imbalances and inflammation in the brain, which can severely impact cognitive function.
Thankfully, commonly used drugs often used as a first-line defense against type 2 diabetes also appear to reduce the impact on the brain and may help slow decline or even improve function.
If you have type 2 diabetes, be sure to discuss this link and any other risk factors you may have for Alzheimer’s disease with your healthcare provider.
Why Alzheimer’s is called Type 3 Diabetes