Type 1 Diabetes

Type 1 diabetes is considered an autoimmune disease and a chronic medical condition, in which pancreas produces insufficient amount of insulin or does not produce insulin at all because the body’s immune system mistakenly destroys beta cells, which are responsible for making insulin in the pancreas.

Insulin is a hormone that is needed to help glucose get from your blood into your body’s cells to produce energy. Glucose is sugar that your body gets from the food you eat. Because in type 1 diabetes your body is incapable of processing glucose due to lack or absence of insulin, the glucose cannot pass into your body’s cells and gets accumulated in the blood, resulting in high blood sugar (hyperglycemia), which can lead to serious, and sometimes fatal, health issues.

Type 1 diabetes was formerly called insulin-dependent diabetes or juvenile diabetes because it is most commonly diagnosed in children and young adults and because people with type 1 diabetes must get insulin injections or use insulin pumps, which automatically deliver insulin, for the rest of their lives.

It can take from several months to several years to get a critical number of beta cells destroyed before type 1 diabetes symptoms become noticeable. Those symptoms may include excessive hunger, extreme thirst, fatigue, frequent urination, blurred vision, dry mouth and skin, nausea and vomiting, rapid breathing, and unexplained weight loss.

Although, despite continuous research, the specific cause of type 1 diabetes remains unknown, scientists believe that it can be caused by genes. Scientists discovered that type 1 diabetes can develop in people, who have a specific human leukocyte antigen (HLA) complex – the complex of antigens that trigger an immune response in the body. Besides, type 1 diabetes is also believed to be triggered by viruses and other environmental factors.

Type 1 diabetes is diagnosed by measuring blood sugar level, while also taking into consideration your age and symptoms. The blood tests include Fasting Plasma Glucose (FPG) test that is taken in the morning after overnight fasting; Oral Glucose Tolerance test (OGTT), when blood sugar is measured two hours after you drink 75 grams of glucose; Random blood glucose test; and Hemoglobin A1C (glycohemoglobin) test that measures the average glucose level over the period of past 2-3 months. Besides, test can be done on your urine for glucose and for chemicals that your body produces when your insulin level is insufficient.

If you get diagnosed with type 1 diabetes, it is crucial to take all necessary steps to properly manage it. That mostly involves controlling your blood sugar because high blood sugar can damage various parts of your body and cause disabling or even life-threatening complications, including increased risk of heart attack, blood vessel disease, pregnancy complications, neuropathy (nerve damage), nephropathy (kidney damage), eye damage (including blindness), and feet damage that can cause amputation.

Type 2 Diabetes

Type 2 diabetes is a chronic medical condition and the most common type of diabetes that affects the way your body processes insulin. Insulin is a hormone produced by pancreas that your body needs to help glucose get from your blood into your body’s cells to produce energy. Glucose is sugar that your body gets from the food you eat.

If you have type 2 diabetes, your pancreas makes insulin, but the cells in your body are unable to absorb it properly, which causes the pancreas to produce more insulin. Eventually, the ability of your pancreas to produce insulin decreases. Because of that, your body cells do not get enough glucose and consequently, do not receive a sufficient amount of energy required for proper functioning.

Type 2 diabetes was formerly referred to as non-insulin dependent diabetes or adult-onset diabetes because the disease was mostly diagnosed in adults and the patients usually did not need insulin injections to manage their condition. These definitions are now considered inaccurate because doctors have commonly diagnosed type 2 diabetes in children and insulin is often required to manage the disease.

Symptoms of type 2 diabetes are similar to those of type 1 diabetes, but they develop rather slowly and they are often mild enough to be easily disregarded for years. The symptoms include excessive hunger and thirst, fatigue, frequent urination, blurred vision, dry mouth, itchy skin, slow healing wounds, unexplained weight loss, numbness in your hands or feet, frequent infections, and dark rash around your armpits and neck.

The exact reason why human body stops processing insulin normally and becomes insulin resistant is unknown, but genes and certain risk factors may contribute to developing type 2 diabetes. Those risk factors include having little or no physical activity, being overweight or obese, having a history of heart disease or stroke, having high blood pressure, being 45 years of age or older, having a high level of triglycerides or a low level of “good” (HDL) cholesterol, having polycystic ovary syndrome, and having a history of gestational diabetes.

Type 2 diabetes is a progressive condition, which means that the longer a person has it unattended, the higher the chance that the patient will be needing insulin over time to manage blood glucose level. That is why early diagnosis is very important. Type 2 diabetes is diagnosed by the following tests: Fasting blood sugar test that measures how much glucose is in your plasma and is taken after at least 8 hours of fasting; Random blood sugar (glucose) test; A1C (glycated hemoglobin) test that measures the average glucose level over the period of past 2-3 months; and Oral glucose tolerance test, which is most commonly used during pregnancy.

If you have been diagnosed with type 2 diabetes, you need to take it under control to avoid complications because otherwise the disease can affect all organs of the body. Complications may include cardiovascular diseases, nerve damage, kidney damage, poor blood circulation to your feet, retinal damage, fungal or bacterial infections, and sleep apnea.

When it comes to management of type 2 diabetes, the ideal scenario is to prevent it from happening. Although you cannot do anything about your age or genetics, a diet that is low on sugar, refined carbohydrates, and fatty meats, as well as getting regular exercise and implementing proper weight management strategy, can help you keep your blood sugar level within the healthy limits and lower your chances of getting the disease.

Type 3 Diabetes

Type 3 diabetes is a term that has been proposed by researchers to describe the association of diabetes with Alzheimer's disease, which develops when neurons in the brain become resistance to insulin. Insulin is a hormone produced by pancreas that your body needs to help glucose get from your blood into your body’s cells to produce energy. While muscle cells have an ability to utilize glucose and fats to fuel their activity, brain cells get their energy solely from glucose. In type 3 diabetes, neurons (the brain cells) do not get enough energy, which causes the brain to become unable to properly perform a number of cognitive functions, including memory, attention, concentration, organization, self-monitoring, awareness, alertness, decision-making, motor skills, and speaking. The progressive reduction in performing these functions characterizes Alzheimer’s disease.

The symptoms of type 3 diabetes are those found in early stages of Alzheimer’s disease. They include memory loss that affects social interactions and disrupts daily life, challenges in making judgements based on information, trouble performing familiar tasks, often getting confused about dates, names, and places, having vision problems, misplacing things, having difficulties finding the right words when speaking or writing, experiencing personality and mood changes and difficulties in problem solving.

People have a higher chance to develop type 3 diabetes when they have type 2 diabetes. So type 2 diabetes risk factors can also be relevant for type 3 diabetes and include the following: genes, having little or no physical activity, being overweight or obese, having a history of heart disease or stroke, having high blood pressure, being 45 years of age or older, having a high level of triglycerides or a low level of “good” (HDL) cholesterol, having polycystic ovary syndrome, and having a history of gestational diabetes.

Diagnosis of type 3 diabetes is different from diagnosis of type 1 and type 2 diabetes in that there are no specific tests for type 3 diabetes. Diagnosis can be made based on a patient’s medical history, a neurological examination (to identify if the nervous system has been affected), and neurophysiological testing, such as DTI (Diffusion Tensor Imaging), which is performed to detect abnormalities in the brain tissue.

Gestational Diabetes

Gestational diabetes, also known as gestational diabetes mellitus (GDM), is a medical condition that some women develop during pregnancy (gestation). The condition is associated with having higher than normal blood sugar level that usually shows up between the 24th and 28th weeks of pregnancy.

Similarly to other types of diabetes, gestational diabetes occurs when the cells in your body are unable to process insulin normally and your body becomes insulin resistant. Insulin is a hormone produced by pancreas that your body needs to help glucose (sugar) get from your blood into your body’s cells to make energy. During pregnancy, your placenta produces large amount of hormones that are necessary to sustain your pregnancy, but also cause sugar to build up in your blood. Normally, insulin takes care of the situation, helping sugar to get into your body cells. However, if pancreas does not produce enough insulin or your body cells stop absorbing insulin properly, the level of sugar in your blood rises, which triggers development of gestational diabetes that may affect your pregnancy and the health of your baby as well.

Although in most cases women with gestational diabetes do not have any symptoms of the disease, there is a number of risk factors for gestational diabetes. Women, who do not have those factors, can also develop gestational diabetes, but women, who do have one or more of the risk factors, have a higher chance of getting gestational diabetes. The risk factors include: having a family history of diabetes, being overweight during pregnancy or before, having high blood pressure, being diagnosed with gestational diabetes in the past, having prediabetes, previously having a baby over 9 pounds, expecting more than one baby, having PCOS (polycystic ovary syndrome), being physically inactive, and having a history of heart disease.

Having gestational diabetes does not necessarily mean that you had diabetes before getting pregnant or that you will continue having diabetes after pregnancy, but it is still a risk factor for developing type 2 diabetes later in life. Besides, if gestational diabetes is left unattended or poorly managed, it can also raise your child’s risk of developing diabetes and increase the risk of complications for you and your baby during pregnancy and childbirth, including stillbirth, birth trauma, labor difficulties, cesarean delivery, heavy post-delivery bleeding, and severe vaginal tear. That is why it is important to diagnose and treat gestational diabetes as early as possible.

Gestational diabetes is diagnosed with two tests. Sometimes, doctors start with glucose challenge test that involves drinking a sugar solution followed by a blood test in an hour. If the test result is unsatisfactory, your doctor might perform Oral Glucose Tolerance test (OGTT), when blood sugar is measured two hours after you drink an even sweeter glucose solution than the one provided for glucose challenge test. In some cases, doctors only perform Oral Glucose Tolerance test. This test can be done with and without prior fasting.