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Types of Diabetes

What is Diabetes?

Diabetes is a serious disease in which the body does not properly break down food for energy. Most of the food that we eat is broken down into sugar/glucose for the body to use as energy. When a person has diabetes, the body either doesn't make insulin or cannot use insulin as well as it should. Insulin is produced in the pancreas and helps get sugar/glucose into the cells of the body. When it is not working properly, a buildup of sugar/glucose occurs in the blood, causing high blood glucose.

When diabetes is not managed properly, it can cause complications such as blindness, kidney failure, heart disease, nerve damage, and loss of toes, feet, and even legs. Diabetes can be controlled by working with a physician to keep blood sugar/glucose levels within a normal range, eating well, and being physically active. When steps are taken to control diabetes, the risk of developing complications may become lower.

Use the tabs below to learn more about diabetes.

Type 1 Diabetes

Previously known as juvenile-onset diabetes, Type 1 diabetes is a chronic disease in which the pancreas does not produce insulin. The disease usually develops in children and young adults, but can occur at any age, when the body’s immune system attacks and destroys the insulin producing cells in the pancreas. The cause of developing Type 1 diabetes is unknown; however, it is believed that there are both genetic and environmental factors that may trigger the onset (Source: Juvenile Diabetes Research Fund). There is no known way to prevent Type 1 diabetes; however, the disease can be managed through daily insulin injections, blood glucose monitoring, healthy eating, and moderate physical activity.

What Causes Type 1 Diabetes?

According to the Centers for Disease Control and Prevention (CDC), the causes of Type 1 diabetes appear to be much different than those for Type 2 diabetes, although the exact mechanisms for developing both diseases are unknown. The appearance of Type 1 diabetes is suspected to follow exposure to an "environmental trigger," such as an unidentified virus, stimulating an immune attack against the beta cells of the pancreas (that produce insulin) in some genetically predisposed people.

 


Prediabetes

Prediabetes is a condition in which individuals have blood sugar/glucose levels higher than normal but not high enough to be diagnosed with Type 2 diabetes. Individuals who are diagnosed with prediabetes are at an increased risk of developing Type 2 diabetes within 10 years along with other health problems such as heart disease and stroke. 

The CDC estimates that about 96 million Americans now have prediabetes. That is more than one out of three adults. Of those 96 million, eight out of 10 don’t even know they have it.

Am I At Risk for Prediabetes?

According to CDC and the American Diabetes Association (ADA), individuals who have the following risk factors may be at higher risk for prediabetes and Type 2 diabetes:

  • Overweight.
  • 45 years of age or older.
  • Has a parent, brother, or sister with type 2 diabetes.
  • Physically active less than three times per week.
  • Gave birth to a baby that weighed more than 9 pounds.
  • Had gestational diabetes.
  • High blood pressure.
  • High or low cholesterol.
  • Diagnosed with polycystic ovary syndrome.

Race and ethnicity can also affect your risk. People who are Black, Hispanic or Latino, American Indian, Pacific Islander, or Asian American are at particularly high risk for prediabetes and Type 2 diabetes.

 

Do I Have Prediabetes?

According to the ADA, prediabetes can be diagnosed through one of the following tests:

  1. Hemoglobin A1c (A1c) – Measures average blood glucose for the past three months. Prediabetes is diagnosed at an A1c between 5.7% - 6.4%.
  2. Fasting plasma glucose (FPG) – Measures fasting blood sugar/glucose levels after not having anything to eat or drink for at least eight hours. Prediabetes is diagnosed at a FPG level of 100 - 125 mg/dl.
  3. An oral glucose tolerance test (OGTT) – Measures blood glucose levels before and two hours after the consumption of a special sweet drink. Prediabetes is diagnosed at a two-hour blood glucose level of 140 mg/dl - 199mg/dl.

The U.S. Preventive Services Task Force (USPSTF) recommends that healthcare providers test all adults between ages 35-70 years who are overweight or obese, and are not pregnant, for prediabetes or diabetes. The full recommendation can be found on the U.S. Preventive Services Task Force website. 

 Could You Have Prediabetes? Take the Risk Test

 

Can I Prevent Prediabetes/Type 2 Diabetes?

Prediabetes is a serious medical condition, so don’t let the “pre” in prediabetes fool you into thinking that it is a problem that does not need to be addressed. Before people develop Type 2 diabetes, they almost always have prediabetes. Taking action right away by losing 5-7% of body weight and increasing physical activity can help prevent prediabetes from becoming Type 2 diabetes. An early prediabetes diagnosis can prevent or minimize some of the serious health concerns of Type 2 diabetes, like:

  • Heart attack.
  • Stroke.
  • Blindness.
  • Kidney failure.
  • Loss of toes, feet, or legs.

Also, according to CDC, if you do have prediabetes, research shows that lifestyle change programs like the National Diabetes Prevention Program (National DPP) can help prevent or delay Type 2 diabetes.

What is the National Diabetes Prevention Program?

The CDC's National DPP is a lifestyle change program developed specifically to prevent Type 2 diabetes.  The structure of the class, offered in person or virtually, is based on research conducted by the National Institutes of Health (NIH), which showed that individuals can decrease their risk of developing Type 2 diabetes by 58% when they lose a small amount of weight (5% - 7% of total body weight) through healthy eating and being physically active for 150 minutes per week.

The National DPP lifestyle change program is not a quick fix. It provides yearlong support that focuses on making long-lasting modifications. Classes are delivered by professionally trained lifestyle change coaches, in a group setting either in person or virtually, over a 12-month period. Sessions take place weekly for six months, followed by a second six months of maintenance.

According to CDC, during the first six months of the program, participants will learn how to:

  • Eat healthy.
  • Add or increase physical activity.
  • Deal with stress.
  • Make healthy choices when dining out.
  • Get back on track.

During the second six months, participants will enhance skills learned to help maintain changes. Sessions will review key ideas such as tracking food and physical activity, goal setting, staying motivated, and overcoming barriers.

The cost of the National DPP lifestyle change program varies depending on the location, organization offering the program, as well as the type of program (online or in person). For details on the cost, contact the program directly. You can find a local program on the Centers for Disease Control and Prevention website. Also, some employers and insurance companies cover the costs of the program, so check with your employer or insurance company to see if this applies to you.

 

 

Type 2 Diabetes

Previously known as non-insulin-dependent diabetes mellitus (NIDDM) or adult onset, Type 2 diabetes is the most common form of diabetes accounting for 90 to 95% of all diagnosed cases of diabetes. With Type 2 diabetes, the body either is not able to use insulin correctly (a hormone that regulates sugar/glucose) or doesn’t produce enough insulin to maintain a normal glucose level.

Am I at Risk for Type 2 Diabetes?

You are at risk for developing type 2 diabetes if you:

  • Have prediabetes.
  • Are overweight.
  • Are 45 years or older.
  • Have a parent, brother, or sister with Type 2 diabetes.
  • Are physically active less than three times per week.
  • Have ever had gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed more than 9 pounds.
  • Are Black/African American, Hispanic/Latino, American Indian, or Alaska Native (some Pacific Islanders and Asian Americans are also at higher risk).
  • Have high blood pressure.
  • Have a low level of HDL (“good”) cholesterol, or a high level of triglycerides.
  • Have a history of heart disease or stroke.
  • Have polycystic ovary syndrome (PCOS).

Do I Have Type 2 Diabetes?

The following symptoms of type 2 diabetes are typical. However, some individuals with Type 2 diabetes have symptoms so mild that they go unnoticed, so it is best to get tested, especially if you have any of the risk factors identified above.

Look for these common symptoms of Type 2 diabetes:

  • Increased thirst.
  • Frequent urination.
  • Increased hunger.
  • Weight loss.
  • Fatigue.
  • Blurry vision.
  • Cuts/bruises that are slow to heal.
  • Tingling, pain, or numbness in the hands/feet.

If any of the above symptoms are occurring, is it best to follow up with a primary care physician to confirm a diagnosis. According to the American Diabetes Association (ADA), Type 2 diabetes can be diagnosed through one of the following tests:

  1. Hemoglobin A1c (A1c) – Measures average blood glucose for the past three months. Diabetes is diagnosed at an A1C of greater than or equal to 6.5%.
  2. Fasting plasma glucose (FPG) – Measures fasting blood sugar/glucose levels after not having anything to eat or drink for at least eight hours. Diabetes is diagnosed at a FPG level of greater than or equal to 126 mg/dl.
  3. An oral glucose tolerance test (OGTT) – Measures blood glucose levels before and two hours after the consumption of a special sweet drink. Diabetes is diagnosed at a two-hour blood glucose level of greater than or equal to 200 mg/dl.


Early detection and treatment of diabetes can decrease the risk of developing complications. Take the Risk Test to find out if you are at increased risk for having Type 2 diabetes.

The U.S. Preventive Services Task Force (USPSTF) recommends that healthcare providers test all adults between ages 35-70 years who are overweight or obese, and are not pregnant, for prediabetes or diabetes. The full recommendation can be found on the U.S. Preventive Services Task Force website. 

What are the Complications of Undiagnosed Type 2 Diabetes?

Type 2 diabetes can be easily ignored, as there are limited effects on an individual’s outward appearance; however, Type 2 diabetes does affect many major organs. Without proper management, Type 2 diabetes can impact the heart, blood vessels, nerves, eyes, and kidneys. Getting diagnosed if you think you have diabetes and controlling your blood sugar levels if you already have diabetes can help prevent these potential complications:

  • Eye/retina damage.
  • Foot/nerve damage.
  • Hearing impairment.
  • Kidney damage (nephropathy).
  • Nerve damage (neuropathy).
  • Cardiovascular diseases (heart attack, stroke, atherosclerosis, high blood pressure, angina).

How Can I Manage My Type 2 Diabetes?

The management of type 2 diabetes takes a team-based approach between the physician, dietitian, nurse, and other medical staff, with the patient serving as the team coach. While the team is there to help, the day-to-day management is up to the patient.

According to the Mayo Clinic, care/management will include:

  • Healthy Eating - It is important to center eating around wholesome fruits, vegetables, lean meats, and whole grains, while limiting refined carbohydrates (white rice, white bread, rice cereals, etc.), and sweets.
    • Talk with a registered dietitian for additional help on meal planning
  • Physical Activity - Everyone needs regular aerobic exercise. Patients should check with their primary care physician before starting an exercise program, then choose an activity that they enjoy. Aim for at least 30 minutes of exercise for at least five days of the week. If physical activity is not something that a patient is accustomed to, start slowly and gradually build up.
    • Also remember that physical activity lowers blood glucose/sugar, so make sure to check your blood glucose/sugar level before any activity.
  • Monitoring Blood Glucose/Sugar - Depending on the management plan, checking and recording blood glucose/sugar may be necessary to determine glucose/sugar levels, keeping in mind that blood glucose/sugar levels can be unpredictable.  A physician will recommend the frequency of monitoring, as glucose/sugar levels change in response to food, exercise, alcohol, illness, and medication.
  • Medication Management - Some individuals who have Type 2 diabetes can achieve their target blood sugar levels with healthy eating and exercise, but many may also need diabetes medications or insulin. The decision about a patient’s medication depends on many factors, but it is best to consult with a physician and then continue to stick to the determined medication plan, until otherwise determined.
  • Diabetes Education - Living with a Type 2 diabetes diagnosis is not easy, but becoming educated on the disease can help with overall disease management. In Ohio, there are many community resources to help educate individuals with Type 2 diabetes including:

Gestational Diabetes 

Gestational diabetes is a type of diabetes that is first seen in a pregnant woman who did not have diabetes before she was pregnant. Some women develop gestational diabetes in the middle of pregnancy. Doctors usually test for it between 24 and 28 weeks of pregnancy. 

Although this form of diabetes usually disappears after the birth of the baby, women who have had gestational diabetes have a 40 to 60% chance of developing Type 2 diabetes within five to 10 years. Maintaining a reasonable body weight and being physically active may help prevent development of Type 2 diabetes. About 3 to 8% of pregnant women in the United States develop gestational diabetes.

As with Type 2 diabetes, gestational diabetes occurs more often in some ethnic groups and among women with a family history of diabetes. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin. Women with gestational diabetes may not experience any symptoms.

More information about Gestational Diabetes can be found on the Gestational Diabetes Collaborative website.