Chances are you or someone you know has diabetes. So, you may recognize the terms type 1, type 2 or gestational diabetes since that’s how we’ve traditionally categorized the variations of this condition. And while these still remain the condition’s main types, the medical community has recently begun to further describe or “label” several more subtypes.
AdventHealth Medical Group Endocrinologist, Noriecel Mendoza, MD further explains, “We help our patients understand these clusters really are subtypes. They don’t change the diagnosis or overall terminology for the diagnosis of diabetes.”
However, these new classifications on the diabetes spectrum may offer a greater understanding that can help you gain more control over your — or your loved one’s — condition.
Diabetes Type 1
If you have type 1 diabetes, your body’s pancreas doesn’t make the insulin your body needs to get glucose (blood sugar) from your bloodstream to your body’s cells. So, it’s critical to manage your insulin therapy and diet closely. You may be prescribed slow-acting insulin to help regulate your glucose levels between meals and fast-acting insulin to regulate your glucose levels after meals.
Symptoms can be severe and life threatening, and may include:
- Bed-wetting in children who’ve never wet the bed before
- Blurred vision
- Excessive thirst
- Extreme hunger
- Frequent urination
- Mood changes and irritability
- Unintended weight loss
- Weakness and fatigue
It’s very important to talk to your primary care provider if you have any of these symptoms.
Type 2 Diabetes
Type 2 diabetes accounts for the majority of people on the diabetes spectrum and means your body is insulin resistant (your pancreas still makes insulin, but your cells no longer respond the way they should). Your pancreas increases insulin production trying to force your cells to work.
Type 2 diabetes has serious health complications. Your endocrinologist will work closely with you to help you best manage your condition — ensuring:
You’re prescribed (and correctly take) several medications including slow- and fast-acting insulin
Use a glucose monitor and test strips for daily testing of your blood sugar before and after meals
Achieve and maintain a healthy weight using a diabetes-friendly diet and run routine lab tests
You may be at risk for type 2 diabetes if you:
- Are African American, Hispanic /Latino American, American Indian, Alaska Native
- Are over age 45
- Are overweight
- Don’t get enough physical activity
- Have a parent, sister or brother with diabetes type 2
- Have been diagnosed as pre-diabetic
- Have had gestational diabetes
Common symptoms include blurry vision, dry mouth, extreme thirst and hunger, fatigue, frequent urination, headaches and unexplained weight loss.
Pregnancy may cause you to become insulin resistant, resulting in high sugar levels. But since gestational diabetes doesn’t commonly have any symptoms, testing for it is a routine part of your prenatal care. It usually happens during weeks 24 –28 of pregnancy, but your obstetrician may test you sooner if he thinks you’re at increased risk.
You may be at risk for gestational diabetes if you:
- Are African American, Hispanic /Latino American, American Indian, Alaska Native, Native Hawaiian or Pacific Islander
- Are older than 25
- Are overweight
- Gave birth to a baby weighing over 9 pounds
- Had gestational diabetes with a previous pregnancy
- Have polycystic ovary syndrome
Treatment of your gestational diabetes means keeping all prenatal appointments and following the treatment plan prescribed by your obstetrician. This may include checking your blood sugar, eating healthy meals created by your obstetrician or dietitian, staying active (follow your doctor’s guidelines) and having your baby’s growth and development checked at prenatal examinations.
Luckily, having gestational diabetes doesn’t mean you’ll have diabetes after your pregnancy.
Cluster 1: Severe Autoimmune Diabetes (SAID)
SAID is similar to type 1 diabetes and is characterized by insulin deficiency and the presence of antibodies. This type of diabetes has a greater risk for diabetic ketoacidosis (DKA) and patients generally have a higher A1c (average blood sugar level) at the time of diagnosis.
Treatment includes making lifestyle changes by:
- Eating a healthy diet established by your primary care physician or nutritionist
- Losing weight (even a few pounds makes a big difference)
- Monitoring your A1c levels regularly
- Starting an exercise program approved by your primary care physician
- Taking prescribed medications, such as insulin
Cluster 2: Severe Insulin-Deficient Diabetes (SIDD)
You are classified as having SIDD when your body doesn’t produce much insulin on its own — but you aren’t overweight, and your immune system isn’t the cause of your condition. It usually happens at a younger age than the onset of other types. This type of diabetes has a greater risk for diabetic ketoacidosis (DKA) and retinopathy. Patients generally have a higher A1C at the time of diagnosis.
Unique symptoms of insulin deficient diabetes may include dark skin under your chin, groin or armpits. Your endocrinologist may prescribe a combination of both slow- and fast-acting insulin.
Cluster 3: Severe Insulin-Resistant Diabetes (SIRD)
SIRD is characterized by severe insulin resistance and occurs mostly in people who are overweight. This type of diabetes has a much higher risk of kidney disease. Your endocrinologist may prescribe a combination of both slow- and fast-acting insulin.
Cluster 4: Mild Obesity-Related Diabetes (MOD)
MOD is most common in people who are overweight but don’t have insulin resistance. Treatment includes diet and exercise, daily monitoring of your blood sugar, fast-acting and long-acting insulin therapy and oral medications.
Cluster 5: Mild Age-Related Diabetes (MARD)
MARD is the most common form of diabetes. Onset occurs later in life as age increases insulin resistance. Treatment includes management of high and low blood sugar through lifestyle modifications such as diet and exercise, oral medications and insulin therapy.
Treatments for Diabetes
Your primary care physician will serve as your centralized care manager with your endocrinologist (the specialist that treats diabetes), a registered dietitian or nutritionist, eye doctor, foot doctor, dentist, diabetes educator and pharmacist. Failing to treat diabetes of any type can cause blindness, stroke, heart disease, nerve damage, amputations of limbs and kidney failure.
No matter which type of diabetes you may have, the tests used to diagnose diabetes are:
- Oral Glucose Tolerance Tests (OGTT)compare your blood sugar before and after you drink a sugary solution. A result of 140 or above suggests you have pre-diabetes and a result over 200 shows you have diabetes.
- A1C (A-One-C) Tests measure your average blood sugar over the past two to three months. Pre-diabetes is indicated if your result is over 5.7, and a result of over 6.5 shows diabetes.
- Fasting Plasma Glucose (FPG) Tests measure your blood sugar after you’ve fasted for at least eight hours. A result over 100 shows pre-diabetes and a result over 126 indicates diabetes.
Check Your Diabetes Risk
Dr. Mendoza explains, “With diabetes it is important to take action now, not tomorrow, because of the complications that diabetes could bring later. I listen to and get to know each patient since one size does not fit all in the treatment options. Individualization is the key, but you cannot do that unless you know the individual well.”
While diabetes has no cure, the good news is it’s very treatable if managed properly. Learning about the risks, symptoms, complications and treatments of each type allows you more control over the disease and quicker medical treatment that can prevent long-term complications. To protect your health, lean on AdventHealth’s advanced diabetes care.