There are many different forms of diabetes, each with distinct characteristics, causes, and treatment options. The main types of diabetes are:
- Type 1 Diabetes: Previously known as insulin-dependent or juvenile diabetes, type 1 diabetes is an autoimmune condition where the immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. As a result, the body cannot produce insulin, leading to elevated blood sugar levels. Type 1 diabetes typically develops in childhood or early adulthood and requires lifelong insulin treatment.
- Type 2 Diabetes: Type 2 diabetes is the most common form of diabetes, accounting for the majority of cases. It occurs when the body becomes resistant to insulin or does not produce enough insulin to maintain normal blood sugar levels. Type 2 diabetes is often associated with lifestyle factors such as obesity, physical inactivity, and poor diet. It can be managed through lifestyle changes, oral medications, and, in some cases, insulin therapy.
- Gestational Diabetes: Gestational diabetes develops during pregnancy and affects some women who did not previously have diabetes. Hormonal changes during pregnancy can lead to insulin resistance, resulting in high blood sugar levels. Gestational diabetes usually resolves after giving birth, but it increases the risk of developing type 2 diabetes later in life. Managing blood sugar levels during pregnancy is crucial to minimize potential complications.
- Prediabetes: Prediabetes refers to a condition where blood sugar levels are higher than normal but not yet high enough to be classified as type 2 diabetes. It is a warning sign that individuals are at an increased risk of developing type 2 diabetes in the future. Prediabetes can often be reversed or delayed through lifestyle modifications such as adopting a healthy diet, increasing physical activity, and losing weight if necessary.
- Other Types: There are several less common types of diabetes, including monogenic diabetes (caused by a genetic mutation affecting insulin production), cystic fibrosis-related diabetes, steroid-induced diabetes (resulting from prolonged steroid use), and others. These types have specific underlying causes or associations with other medical conditions.
It’s important to note that the classification of diabetes may evolve as research progresses, and new subtypes or variations may be identified. If you have concerns about your health or suspect you may have diabetes, it’s best to consult a healthcare professional for an accurate diagnosis and appropriate management.
Treatment for type 1 diabetes involves insulin injections or the use of an insulin pump, frequent blood sugar checks, and carbohydrate counting. For some people with type 1 diabetes, pancreas transplant or islet cell transplant may be an option.
Treatment of type 2 diabetes mostly involves lifestyle changes, monitoring of your blood sugar, along with oral diabetes drugs, insulin or both.
Monitoring your blood sugar
Depending on your treatment plan, you may check and record your blood sugar as many as four times a day or more often if you’re taking insulin. Careful blood sugar testing is the only way to make sure that your blood sugar level remains within your target range. People with type 2 diabetes who aren’t taking insulin generally check their blood sugar much less often.
People who receive insulin therapy also may choose to monitor their blood sugar levels with a continuous glucose monitor. Although this technology hasn’t yet completely replaced the glucose meter, it can lower the number of fingersticks necessary to check blood sugar and provide important information about trends in blood sugar levels.
Even with careful management, blood sugar levels can sometimes change unpredictably. With help from your diabetes treatment team, you’ll learn how your blood sugar level changes in response to food, physical activity, medications, illness, alcohol and stress. For women, you’ll learn how your blood sugar level changes in response to changes in hormone levels.
Besides daily blood sugar monitoring, your provider will likely recommend regular A1C testing to measure your average blood sugar level for the past 2 to 3 months.
Compared with repeated daily blood sugar tests, A1C testing shows better how well your diabetes treatment plan is working overall. A higher A1C level may signal the need for a change in your oral drugs, insulin regimen or meal plan.
Your target A1C goal may vary depending on your age and various other factors, such as other medical conditions you may have or your ability to feel when your blood sugar is low. However, for most people with diabetes, the American Diabetes Association recommends an A1C of below 7%. Ask your provider what your A1C target is.
People with type 1 diabetes must use insulin to manage blood sugar to survive. Many people with type 2 diabetes or gestational diabetes also need insulin therapy.
Many types of insulin are available, including short-acting (regular insulin), rapid-acting insulin, long-acting insulin and intermediate options. Depending on your needs, your provider may prescribe a mixture of insulin types to use during the day and night.
Insulin can’t be taken orally to lower blood sugar because stomach enzymes interfere with insulin’s action. Insulin is often injected using a fine needle and syringe or an insulin pen — a device that looks like a large ink pen.
An insulin pump also may be an option. The pump is a device about the size of a small cellphone worn on the outside of your body. A tube connects the reservoir of insulin to a tube (catheter) that’s inserted under the skin of your abdomen.
A continuous glucose monitor, on the left, is a device that measures blood sugar every few minutes using a sensor inserted under the skin. An insulin pump, attached to the pocket, is a device that’s worn outside of the body with a tube that connects the reservoir of insulin to a catheter inserted under the skin of the abdomen. Insulin pumps are programmed to deliver specific amounts of insulin continuously and with food.
A tubeless pump that works wirelessly is also now available. You program an insulin pump to dispense specific amounts of insulin. It can be adjusted to give out more or less insulin depending on meals, activity level and blood sugar level.
A closed loop system is a device implanted in the body that links a continuous glucose monitor to an insulin pump. The monitor checks blood sugar levels regularly. The device automatically delivers the right amount of insulin when the monitor shows that it’s needed.
The Food and Drug Administration has approved several hybrid closed loop systems for type 1 diabetes. They are called “hybrid” because these systems require some input from the user. For example, you may have to tell the device how many carbohydrates are eaten, or confirm blood sugar levels from time to time.
A closed loop system that doesn’t need any user input isn’t available yet. But more of these systems currently are in clinical trials.
Oral or other drugs
Sometimes your provider may prescribe other oral or injected drugs as well. Some diabetes drugs help your pancreas to release more insulin. Others prevent the production and release of glucose from your liver, which means you need less insulin to move sugar into your cells.
Still others block the action of stomach or intestinal enzymes that break down carbohydrates, slowing their absorption, or make your tissues more sensitive to insulin. Metformin (Glumetza, Fortamet, others) is generally the first drug prescribed for type 2 diabetes.
Another class of medication called SGLT2 inhibitors may be used. They work by preventing the kidneys from reabsorbing filtered sugar into the blood. Instead, the sugar is eliminated in the urine.
Supreme Medical Center in Houston
When it comes to getting better fast, the best thing you can do is schedule an appointment with your physician at the first sign of illness. At Supreme Medical Center our doctors work with you to treat your symptoms and get you back to feeling like yourself in no time.