Types of Diabetes

Broadly there are three types of diabetes, categorized on the basis of the conditions they produce.

Diabetes Mellitus Type 1 or simply diabetes:It is caused when the body is unable to produce insulin necessary to manage blood sugar.

Diabetes Mellitus Type 2: This results from insulin resistance, a condition in which even though the body is producing sufficient insulin, the cells are unable to utilize it. But generally it occurs with Type 1 that is body is neither able to produce insulin properly nor utilize it.

The most common of these is diabetes insipidus in which large amounts of urine are produced (polyuria), which is not sweet (insipidus meaning "without taste" in Latin); it is generally caused by damage to either kidney or pituitary gland.

Pre-diabetes: It is a condition in which a person's blood sugar levels are higher than normal but not high enough for Type 2 diabetes.

Gestational diabetes: Gestational diabetes occurs in pregnant women with no history of diabetes. But it generally disappears after childbirth

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Children and Teens with Diabetes

Raising children is challenging under the best of circumstances. When a child has a chronic disease such as diabetes, the challenges become even greater. Fortunately today, advances in treatment and monitoring of blood glucose levels have made diabetes far less difficult to deal with than it used to be. Still, it is a serious condition with potentially critical complications and requires lifelong monitoring and treatment.

On this site we offer information for parents and other caregivers as well as teachers, coaches, and others who will interact with children and teenagers who have diabetes. We cover these aspects:

• The child with diabetes - with emphasis on the importance of monitoring blood glucose levels regularly and establishing healthy eating and exercise habits in your child, and answers to your questions about school and family issues.
• Type 2 diabetes in children and teenagers - this is a recent phenomenon that is not yet fully understood.
• The teenager with diabetes - adolescence brings its own special challenges to any family, and diabetes adds another layer to these trying years.

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Ways to Prevent Diabetes

We do not yet know of a way to prevent type 1 diabetes. Type 2 diabetes, however, can be prevented in some cases.

• Control weight to normal or near-normal levels by eating a healthy low-fat, high-fiber diet.
  
  
• Regular exercise is crucial to the prevention of type 2 diabetes.
  
  
• Keep alcohol consumption low.
  
  
• Quit smoking.
  
  
• If you have high blood fat levels (such as high cholesterol) or high blood pressure, take your medication as directed.
  
  
• Lifestyle modification and/or certain medications can be used in people with prediabetes to prevent progression to diabetes. Pre-diabetes can be diagnosed by checking fasting glucose and two hours after ingesting 75 grams of glucose.

If you or someone you know already have diabetes, your focus should be on preventing the complications, which can cause serious disabilities such as blindness, kidney failure requiring dialysis, amputation, or even death.

• Tight glucose control: The single best thing the patient can do is to keep their blood sugar level within the suggested range every day. The only way to do this is through a combination of regular blood sugar checks, a balanced diet low in simple sugars and fat and high in complex carbohydrates and fiber, and appropriate medical treatment. Please consult a nutritionist or check with the doctor with questions in regard to diet.
  
  
• Quit smoking
  
  
• Maintain a healthy weight
  
  
• Increase physical activity levels. Aim for moderately vigorous physical activity for at least 30 minutes every day.
  
  
• Drink an adequate amount of water and avoid taking too much salt.
  
  
• The skin should be taken care of; keep it supple and hydrated to avoid sores and cracks that can become severely infected.
  
  
• Brush and floss the teeth every day. See a dentist regularly to prevent gum disease.
  
  
• The feet should be washed and examined daily, looking for small cuts, sores, or blisters that may cause problems later. The toenails should be filed rather than cut to avoid damaging the surrounding skin. A specialist in foot care (podiatrist) may be necessary to help care for the feet.

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Good News: Diabetes-Related Amputation Rate Falls

The rate of foot and leg amputations among people with diabetes fell by as much as 36 percent in one four-year period, according to a study of patients at Veterans Affairs clinics. Taking patients' age and sex into account, amputations-major and minor-dropped from about seven per 1,000 patients in 2000 to between four and five per 1,000 by 2004. The latter figure is a reduction of around 36 percent, with the biggest decrease coming in above-the-knee amputations.

To gather its data, the VA tracked all patients at its clinics who had diabetes, including those who later underwent amputations paid for by Medicare. Experts are not sure why amputation rates declined over the four-year period, although some say that it might be due to earlier detection of diabetes and the introduction of aggressive medical therapies and lifestyle changes to treat it.

Amputations lie at the end of a long chain of diabetic side effects, include the deadening of nerves from inflammation, which can result in patients' inattention to serious limb injuries. Diabetes also slows the healing process, which can lead to ulcers so badly infected that gangrene sets in.

According to the National Institutes of Health, 65,000 people with diabetes underwent a foot or leg amputation in 2006, the latest year for which reliable figures are available. It is not clear if the trend detected in the VA figures can be applied to the U.S. population in general.

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Type of Diabetes

Type 1 Diabetes

Type 1 diabetes was formerly known as juvenile-onset or insulin-dependent diabetes. It occurs when the beta cells in the pancreas, which are responsible for producing insulin, no longer do so. Most commonly, the actions of a person's own immune system damage the beta cells.

Type 1 diabetes usually occurs between childhood and young adulthood, but it is possible for adults of any age to develop type 1 diabetes. Less than 10 percent of people with diabetes have type 1.

Many women, when they develop diabetes, worry about whether their children will also develop the condition. In fact, statistics show that if the mother has type 1 diabetes, there is a two percent chance that her child will develop it. If the father has type 1 diabetes, the chance is six percent.

Type 2 Diabetes

Type 2 diabetes, previously known as adult-onset or non-insulin dependent diabetes, is the more common type of diabetes. Type 2 diabetes occurs when the following conditions occur in the body:

Lack of sufficient insulin, where the beta cells in the pancreas produce some but not enough insulin in response to a meal.

Insulin resistance, a condition where the body produces insulin but is not able to use it effectively. Insulin resistance often occurs in people who also have high blood pressure, high cholesterol and who are overweight (defined as weighing more than 20 percent above normal body weight). Women with more fat around the waist, versus on the hips or thighs, have a greater risk of developing type 2 diabetes.

These conditions lead to a rise in blood glucose and the diagnosis of type 2 diabetes.

Over 90 percent of people with diabetes have type 2 diabetes. It occurs most commonly in people over the age of 40 but, in recent years, type 2 diabetes has been affecting people at a younger age. In certain ethnic groups, such as aboriginal people and those of African, Oriental and Hispanic origin, type 2 diabetes may occur in childhood or adolescence.

Risk Factors

While the cause of type 2 diabetes is unknown, we do know many of the factors that put women at risk of developing it, namely:

• family history of type 2 diabetes
• overweight
• over the age of 40
• Aboriginal, Hispanic, Asian or African origin
• high blood pressure or high cholesterol
• sedentary lifestyle
• previous gestational diabetes (diabetes that developed during pregnancy)
• having delivered large babies (Over 9 lbs. or 4 kg)

There is a strong hereditary link in type 2 diabetes, that is to say that it "runs" in families. If one parent has type 2 diabetes, there is approximately an 11-14 percent chance of the offspring developing type 2 diabetes in later years. If both parents have type 2 diabetes, the risk rises to about 28 percent.

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What is Diabetes?

The Balance of Glucose and Insulin:

Diabetes is a disorder that affects the way your body uses food for energy. Normally, the sugar you take in is digested and broken down to a simple sugar, known as glucose. The glucose then circulates in your blood where it waits to enter cells to be used as fuel. Insulin, a hormone produced by the pancreas, helps move the glucose into cells. A healthy pancreas adjusts the amount of insulin based on the level of glucose. But, if you have diabetes, this process breaks down, and blood sugar levels become too high.

There are two main types of full-blown diabetes. People with Type 1 diabetes are completely unable to produce insulin. People with Type 2 diabetes can produce insulin, but their cells don't respond to it. In either case, the glucose can't move into the cells and blood glucose levels can become high. Over time, these high glucose levels can cause serious complications.

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What is causes Diabetes?

Diabetes mellitus occurs when the pancreas doesn't make enough or any of the hormone insulin, or when the insulin produced doesn't work effectively. In diabetes, this causes the level of glucose in the blood to be too high.

In Type 1 diabetes the cells in the pancreas that make insulin are destroyed, causing a severe lack of insulin. This is thought to be the result of the body attacking and destroying its own cells in the pancreas - known as an autoimmune reaction.

It's not clear why this happens, but a number of explanations and possible triggers of this reaction have been proposed. These include:

• infection with a specific virus or bacteria;
• exposure to food-borne chemical toxins; and
• exposure as a very young infant to cow's milk, where an as yet unidentified component of this triggers the autoimmune reaction in the body.

However, these are only hypotheses and are by no means proven causes.

Type 2 diabetes is believed to develop when:

• the receptors on cells in the body that normally respond to the action of insulin fail to be stimulated by it - this is known as insulin resistance. In response to this more insulin may be produced, and this over-production exhausts the insulin-manufacturing cells in the pancreas;
• there is simply insufficient insulin available; and
• the insulin that is available may be abnormal and therefore doesn't work properly.

The following risk factors increase the chances of someone developing Type 2 diabetes:

• Increasing age;
• obesity; and
• physical inactivity.

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