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Types of Diabetes

Types of Diabetes

Types of Diabetes

A Guide to the Different Types of Diabetes

There are two major kinds of diabetes: diabetes mellitus and diabetes insipidus. Diabetes mellitus involves problems with the body’s ability to control blood sugar levels, either due to insufficient or nonexistent insulin production (types 1 and 1.5) or due to the patient’s body developing insulin reistance (type 2). Diabetes insipidus, which is much less common, involves the kidneys’ inability to properly regulate blood dilution/fluid levels, whether due to insufficient vasopressin (anti-diuretic hormone or ADH) production (central DI) or due to the kidneys not responding properly to ADH (nephrogenic DI).

Diabetes mellitus is what most people think of when they hear the word “diabetes.” Diabetes mellitus can be treated with insulin injections (most common with type 1 diabetes) or a variety of prescription medications designed to address blood sugar levels either by altering the way the body metabolizes food, increasing natural insulin production, or minimizing insulin resistance. Many of these other medications can only be used for type 2 diabetes.

Some women develop insulin resistance during pregnancy, which is known as gestational diabetes. Women who experience gestational diabetes once have a much higher incidence of gestational diabetes in subsequent pregnancies, and more frequently develop diabetes mellitus later in life, but in the short term gestational diabetes generally resolves spontaneously after the pregnancy is over. Gestational diabetes should be treated promptly, due to potential complications it can cause with the baby, and the mother’s health and safety.

Central diabetes insipidus is treated fairly simply, with vasopressin (ADH) prescribed to compensate for the body’s lack of ADH production. Nephrogenic diabetes insipidus can not be treated with vasopressin, so patients must increase their fluid intake to prevent dehydration, and may also take medications to inhibit urine output. In some cases, nephrogenic DI may be a side-effect of another prescription medication (lithium, for instance), and the DI will often disappear when the other medication is discontinued. Nephrogenic diabetes inspidius is best treated by addressing the underlying cause of the condition, when it can be determined.

Although diabetes inspidus and diabetes mellitus share a name, the two disorders are almost totally unrelated. The symptoms of increased thirst and frequent urination are seen in both types of diabetes, insipidus (both central and nephrogenic) and mellitus (type 1 and type 2), but that is almost the only commonality between diabetes inspidus and mellitus.

Diabetes Mellitus

Diabetes Mellitus is what most people think of when they hear the word “diabetes”. Diabetes mellitus is the diagnosis given when the body either does not produce insulin (or not enough insulin), or when the body develops a resistance to the effects of insulin. This leads to dangerously high blood sugar levels, and can lead to many serious and/or fatal long term health effects if the diabetic patient does not adequately control their blood sugar levels.

Doctors distinguish between two main types of diabetes mellitus: Type 1 Diabetes, where the body does not produce insulin, and Type 2 Diabetes, where the body develops a resistance to the effects of insulin. Some references are also made to Type 1.5 Diabetes, where the body still produces *some* insulin, but not enough to adequately control blood sugar levels. While the mechanics of each type of diabetes mellitus is different, the end result is the same: The body’s blood glucose levels cannot be regulated properly.

Type 1 diabetes mellitus, also often called “insulin-dependent diabetes,” is usually diagnosed very early in life, and patients self-administer insulin injections throughout the day to control their blood sugar levels. Aside from insulin, type 1 diabetics can also benefit from medications that help prevent blood sugar spikes by slowing the body’s digestion of carbohydrates. Individuals with low insulin production (sometimes called “Type 1.5″) are generally treated with the same medications.

Type 2 diabetes mellitus, sometimes called “adult-onset diabetes” (although increasing numbers of young people in industrialized nations are being diagnosed with type 2 diabetes in their teens), develops over time, and has been correlated with both heredity and diet and exercise habits. The body develops a resistance to the effects of insulin, so even though the body is still producing insulin, it cannot regulate bloodsugar levels properly. Type 2 diabetes can be treated with the same medications as type 1, but also with a variety of medications that either increase the body’s production of insulin or improve insulin sensitivity.

Diabetes Insipidus

Diabetes Insipidus (DI) is characterized by the body being unable to properly conserve water. In a normal individual, the kidneys respond to the endocrine system’s output of antidiuretic hormone (ADH), also known as vasopressin, to eliminate excess water while the blood is filtered. In diabetes insipidus, the kidneys eliminate more water than they should, leaving patients constantly thirsty, in danger of electrolyte imbalance and other dehydration-related complications, and urinating more frequently than normal.

Diabetes Insipidus is caused in one of two ways. In some patients, the body does not produce enough ADH, leaving the kidneys without the correct “check” on their diuraetic functions. This is known as “central” diabetes inspidus. In other cases, the kidneys fail to properly reabsorb fluid back into the bloodstream, while the endocrine system is working normally. This is called “nephrogenic” diabetes insipidus.

In central diabetes insipidus, treatment is fairly straightforward. Patients are prescribed vasopressin, usually administered via nasal spray, to replace the ADH their bodies do not produce. Treatment for central diabetes insipidus is usually very sucessful, and petients are generally able to lead near normal lives.

With nephrogenic diabetes insipidus, the prognosis for the patient depends very much on what is causing their kidneys to malfunction in the first place. In some cases, it may be a side effect of certain medications (such as: lithium, demeclocycline or amphotericin B). Doctors may then find an alternate medication to prescribe, or attempt to adjust the patient’s dose to minimise the DI side effect. However, in other cases, nephrogenic diabetes insipidus is caused by damage from a kidney disease, or hereditary factors, and the only option for the patient is to make sure their fluid intake is sufficient to prevent dehydration.

In any case of diabetes insipidus, long term side effects or serious complications are virtually never seen, as long as the patient diligently avoids dehydration.

Type 1 Diabetes

Type 1 diabetes, also known as “insulin-dependent” diabetes or “juvenile” diabetes, is a congenital condition where the pancreas doesn’t produce insulin. This effectively means the body has no ability to regulate blood sugar levels, which can lead to a great number of very serious health effects. Patients with type 1 diabetes must take replacement insulin to regulate their blood glucose.

In addition to insulin, type 1 diabetics can also take medications designed to alter the way the body metabolizes carbohydrates (Alpha-glucosidase inihibitors aka: “starch blockers”) or which slow the liver’s production of glucose (Biguanides). Other diabetic medications work to enhance or boost the body’s production of insulin or work to combat insulin resistance, and are only of help to those with type 2 diabetes.

Most type 1 diabetics take insulin delivered via injection, which can cause some problems with patient compliance, as injuections are certainly neither fun nor pleasant. However, insulin needles are available in various lengths, so most patients can administer their medication with the minimum needed discomfort. Other patients may use an insulin pump, which eliminates the need for injections but can cause problems if the patient does not maintain a strictly regular eating schedule.

In exciting news for diabetics in the US, inhalable insulin will soon be available (Exubera inhalable insulin has been approved by the FDA), reducing the need for painful or cumbersome delivery methods for some patients. Particularly for users with insulin pumps, inhalable insulin could be used to manage deviations in normal eating habits, to help prevent hyperglycemia when the pump cannot be adjusted.

Type 1 diabetics must be diligent in following the medication regimen set out by their doctors, because the complete lack of insulin in the body leaves type 1 patients particularly susceptible to side-effects and complications of diabetes, including potential blindness, and permanent nerve damage in the extremities, sometimes leading to amputation. But medica science continues to devise new treatment methods that make living with Type 1 diabetes much easier to manage.

Type 2 Diabetes

Type 2 diabetes (also know as “adult onset diabetes”) is the most common form of diabetes. Unlike Type 1 diabetes, where the patient’s body does not produce any insulin, Type 2 patients’ still produce insulin, but either their bodies have developed insulin resistance, or there is not enough insulin to adequately control blood sugar levels. (Some people refer to insufficient insulin production as “type 1.5 diabetes”.) In long-standing type 2 insulin-resistant diabetes cases, especially where blood sugar levels have not been adequately controlled, the pancreas may begin to lose it’s ability to produce insulin, further complicating the situation.

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While Type 2 diabetics can benefit from taking insulin as a blood glucose control measure, many doctors prefer to treat Type 2 diabetes with other medications. Starch blockers, and medications that impair glucose production are two options shared with type 1 diabetics. However, asl ong as the diabetic patient is still naturally producing insulin, other medications which boost the body’s insulin production are perhaps the most common primary treatments for type 2 diabetes. A newer option is medication which actually works to improve insulin sensitivity, thereby addressing the underlying problem in insulin-resistant diabetes.

While many people think type 2 diabetes is not as serious as Type 1 diabetes, because diet and excercise changes can have significant impacts on early Type 2 diabetes in some cases, the long-term side effects are thhe same. So while type 2 diabetics may have more treatment options, and a greater ability to lead a comparatively “normal” life, keeping close watch on blood sugar levels, and strictly adhering to prescribed treatments is of the utmost importance. If Type 2 diabetes is caught early, and treated properly, the lucky type two diabetic may avoid serious complications altogether.

Gestational Diabetes Mellitus? (Diabetes During Pregnancy)

Gestational Diabetes Mellitus is a type of glucose intolerance that is developed by most women during pregnancy. Learning about what Gestational Diabetes Mellitus is can help mothers be prepared in managing  this condition and aid in avoiding the risks associated to it.

Gestational Diabetes Mellitus Defined

Gestational diabetes mellitus is a form of endocrine disorder developed by mothers during pregnancy.  This is caused by the increase in the levels of blood sugar known as glucose at the time of actual pregnancy.  In the United States alone, 4% of women who are pregnant are diagnosed with gestational diabetes mellitus every year which is about 135,000 pregnant women.  This type of diabetes is one of the most common pregnancy related problems in the US today with about 2 to 7 percent of pregnant women suffering from such medical condition

Causes of Gestational Diabetes Mellitus

When the body can no longer produce enough insulin which is needed during pregnancy diabetes develops.  Insulin which is produced by the pancreas plays a vital function in the conversion of glucose to energy.  When there is lack or insufficiency of insulin, glucose can no longer be turned into energy hence it remains in the blood.  This results to impaired glucose absorption which leads to the increases of glucose levels in the body.  Such a condition is known as hyperglycemia.

During digestion, the body breaks down the food consumed turning them into a form of sugar known as glucose.  As glucose enters the bloodstream, insulin helps in the process by converting it to energy to be used by the cells as its fuel.  In diabetes, the glucose remains in the blood because there is a lack or insufficient production of insulin in the pancreas.  There are however two types of diabetes mellitus – type 1 (absence of insulin production) and type 2 (insufficient production of insulin).

Gestational diabetes mellitus occurs when a pregnant woman’s body can no longer produce insulin or it only produces an amount insufficient to convert glucose to energy.  There are hormonal changes during pregnancy and it is natural for a pregnant woman’s body to produce more insulin as glucose absorption becomes difficult.  For some women their pancreas can no longer keep up with their body’s insulin demand resulting to an increase in the glucose levels in the blood.

In most cases gestational diabetes mellitus spontaneously resolves after delivery.  This means that after delivery the body will produce sufficient amounts of insulin hence she will no longer be diabetic.  But in most cases this type of diabetes reoccurs in future pregnancies.

Post-Gestational Diabetes Mellitus

Although a woman may no longer suffer from gestational diabetes mellitus after she has given birth, such a condition may occur again if she gets pregnant in the future.  Study shows that out of the 3 pregnancies of a woman 2 of which she may again develop gestational diabetes mellitus.  A pregnant woman may either have and develop type 1 or type 2 diabetes.  In such cases continuous treatment after delivery should be observed.

There is a common connection between type 2 diabetes and gestational diabetes mellitus as they both involve insulin resistance.  Research reveals that there is a greater possibility that those women who had gestational diabetes during previous pregnancies may later develop type 2 diabetes. To avoid such situation, a woman should try adopting a much healthier way of living.

Gestational Diabetes Symptoms

Because Gestational Diabetes Mellitus is very hard to detect, most pregnant women carry the condition, unaware about the risks it could bring until complications occur symptomatically. To avoid detrimental risks that may happen due to lack of awareness and misdiagnosis, one should be able to determine what theGestational Diabetes Symptoms are.

Gestational Diabetes symptoms are very hard to detect, because it doesn’t usually have evident manifestations. You may have symptoms of gestational diabetes that come from high blood sugar, but those are actually similar to expected pregnancy manifestations. Listed below are what you might expect if you had high blood sugar:

  • increased thirst and urination
  • nausea and/or vomiting
  • insatiable appetite and weight loss
  • various infections (bladder, vagina, skin, acne)
  • tired and achy, blurry vision

These are not necessarily Gestational Diabetes symptoms, but if you do have these symptoms you should get yourself checked out. Symptoms of Gestational Diabetes generally don’t pose an immediate threat to the mother, but it could put her at risk for complications such as early labor, pre-eclampsia, or an excessive production of amniotic fluid.  It also increases a mother’s chances of having Gestational Diabetes in her subsequent pregnancies, or even developing type 2 diabetes herself.

So how can the condition affect the baby if the mother has Gestational Diabetes symptoms?  If a woman has high blood sugar, the baby is more likely to grow quite large. This can cause complications with birthing or a necessary c section.  The baby is at risk for having hypoglycaemia (low blood sugar). While inside the womb, the baby produces extra insulin since the mother has high blood sugar. After the baby is born, he or she continues to produce extra insulin, causing his or her blood sugar to be too low. You should get your baby’s blood sugar check often if you have gestational diabetes. Usually a good diet of breast milk can stabilize the problem. Formula does not work as well as breast milk. If this doesn’t work, the baby may need direct injections of glucose.

The baby may also develop jaundice. The symptoms of jaundice are yellowing skin and yellowing eyes (the white part). This is not serious, but still important to note.  Babies may have birth defects. Some examples would be a heart defect or a respiratory problem. Sometimes these things go away over time, but in some other cases they need more treatment.  Later on in life, the child has a greater risk of becoming obese and developing type 2 diabetes himself or herself. For females, they have a higher chance of getting gestational diabetes during their own pregnancies.

If you have Gestational Diabetes symptoms, make sure to get tested for the disease. Even if you don’t have Gestational Diabetes symptoms, you may want to get checked anyway just to rule it out. Knowledge will help you avoid future complications.

Do I Need A Gestational Diabetes Test ?

Gestational diabetes is an ailment that happens to women during pregnancy. The woman’s blood sugar level is elevated and this can cause complications and put the woman (and the baby) at risk for several problems. To minimize risk from being unprepared and unaware of this condition, all women should ask themselves the question, “Do I Need A Gestational Diabetes Test ?“. If you are in that position now, let us try to help you decide.

The general rule is that you should absolutely get a gestational diabetes test if you are overweight, have been overweight in the past or have had weight issues, are over fifty, or of a certain ethnicity. There are people who are more prone to be at risk for developing Gestational Diabetes Mellitus than others.

The good news is that the Gestational Diabetes Test can be easily done, and you can even do it at home. You just have to simply take your blood glucose (sugar) level with either a small sample of urine or a small blood sample (pin prick). To be safe though, you should probably double check your results with a professional test, but this is a good starting point. Your doctor can do a more definitive Gestational Diabetes test and give you the correct diagnosis. Once you determine if you have Gestational Diabetes, you can use various methods such as modifying your diet and executing proper exercises to manage the disease and reduce your risk.

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The first Gestational Diabetes Test happens between weeks 24 and 28 of your pregnancy. If you have any of the the risk factors such as being overweight, over 50, etc., then you should be screened at this time. The doctor gives you sugar water and then test your levels an hour later with a blood sample. Normal levels are less than 140 mg/dl. If your level is over 140 mg/dl, you should get further Gestational Diabetes testing to confirm if you have the condition. The follow up Gestational Diabetes Test is called the OGTT: oral glucose tolerance test and takes about three hours to complete.

The OGTT or Oral Glucose Tolerance Test is more intensive compared to the simple Gestational Diabetes Test. In the 3 days leading up to the OGTT, the woman must eat only 150 grams of carbs each day. Then she has to fast before the test for 10-14 hours. During this fasting time, she is only allowed to drink water. The OGTT test is normally done in the morning after sleeping. The test is performed in a doctor’s office or lab. They draw blood to measure the fasting levels, then administer the sugar drink (as in the Gestational Diabetes Test), and then take more blood samples at 1 hour increments for the next 3 hours. If levels are high for 2 or more of the readings, then the woman has gestational diabetes. Here are the levels indicated by the American Diabetes Association as guideline for reading results:

  • fasting: greater than 95 mg/dl
  • 1 hour: greater than 180 mg/dl
  • 2 hour: greater than 155 mg/dl
  • 3 hour: greater than 140 mg/dl

The doctor will then decide if more than one Gestational Diabetes test is needed to be done so that he can confirm the diagnosis. After which, you can then decide with your doctor what the next steps to managing the condition will be.

What is The Best Diet for Gestational Diabetes?

There are several recommended diets for Gestational Diabetes patients. However, keep in mind that even though this plan below is a good start to make up a Gestational Diabetes Diet, you should always consult a registered dietitian or your doctor for approval. This Gestational Diabetes Diet can help to manage a mother’s blood sugar while she is pregnant.

The body runs on sugar. Almost everything you eat or drink is converted by the body into glucose. Glucose is essentially sugar. This sugar is what gives you energy for everything you do – breathing, walking, and primarily to keep your heart beating. In order for your body to use the glucose, it produces insulin. Insulin is like a key that unlocks cells to let the glucose in. When you don’t have enough insulin, or the insulin doesn’t work, the blood sugar (glucose) will rise. This condition (high blood sugar/glucose) is diabetes and if it happens during pregnancy will then be called as Gestational Diabetes. Because the concept behind the disease deals with how the body uses up glucose which comes from the food that the mother eats, a Gestational Diabetes Diet should be vitally planned out.

Gestational diabetes is when a woman has high blood glucose during pregnancy. Before pregnancy, her blood glucose levels were generally normal. Gestational diabetes is caused by hormone fluctuations that come with all pregnancies. Some women are more susceptible to the disease than others. Sometimes hormones that come from the placenta can inhibit glucose’s capability to unlock the cells and get the sugar out of the blood stream. When insulin does not work properly, a person is said to have “insulin resistance”. In normal women, the pancreas offsets the actions of the placenta hormones, but if not, a woman will develop high blood glucose and she may get gestational diabetes. For these reasons, a Gestational Diabetes Diet should be considered in order to manage the disease process itself.

High levels of sugar in the mother’s blood can be harmful for the baby, and put him or her at risk for birth defects, obesity later in life, grow too much (difficult delivery), and some other health problems. After a woman gives birth, the high blood sugar generally goes back to normal. Unfortunately these women are at risk of being stricken with type 2 diabetes in the future.

Here are some recommendations of a good Gestational Diabetes Diet:

  1. Like we said earlier, the body runs on sugar. Carbohydrates are converted directly into sugar, so for a Gestational Diabetes Diet, it is important to avoid eating carbohydrates alone.
  2. Women need food sources of folic acid, such as beans, fruits, dark green leafy veggies, and fortified whole grains.
  3. Vitamin A is important. Good sources are usually orange (carrots, sweet potatoes, squash, but also spinach, dark leafy greens, and cantaloupe).
  4. Make sure you get enough iron (lean meats, dark leafy greens, eggs).
  5. Get enough calcium and dairy (nuts, yogurt, milk, dark green leafy vegetables).

If you follow this Gestational Diabetes Diet, you will be able to manage the symptoms well and reduce your risk.

A Good Gestational Diabetes Menu

Pregnant women need a healthy diet. This is even more important for women with Gestational Diabetes.  A proper Gestational Diabetes Menu needs to nourish the mother properly so she can get enough calories without compromising the amount of sugar in her blood.

When a woman is pregnant she needs to eat on average, about 300 additional calories per day during the last 2 trimesters of her pregnancy. This applies if the woman is at a healthy weight to begin with. If she is over or under her ideal weight, she should ask her doctor for the best plan. This additional 300 calories built into a Gestational Diabetes Menu will allow the baby to thrive and the mother to gain the necessary weight. She should focus on foods packed with nutrients – the essential vitamins and minerals must be consumed every day. She needs to increase her protein intake by 10 grams per day as well.

The best Gestational Diabetes Menu will spread out meals into 5-6 small meals each day. This will keep the blood sugar at a stable level. Eating a lot in one sitting will throw off the blood sugar. Carbohydrates should never be eaten alone, as these will cause a spike in blood sugar. Avoid processed and refined sugars at all costs.

Day 1 Gestational Diabetes Menu:

Breakfast

– 2 pieces of whole grain toast

– 2 tablespoons all-natural peanut butter

– 3/4 cup of grapes

Morning Snack

– 1 fruit (example: apple, nectarine)

– 1 cup Greek yogurt

Lunch

– 1 cup vegetarian chili

– 1 small whole grain pita

– 1-2 ounces grated cheese (for the chili)

– 1 cup vegetables (example: celery, cucumber, baby carrots)

Afternoon Snack

– 1/4 cup nuts of choice (almonds, peanuts, cashews)

– 1 medium orange

Dinner

– 4-6 ounces grilled lean chicken breast

– 1 cup steamed cauliflower (or other favorite vegetable)

– 1 cup whole grain couscous (or: bulgar, quinoa, brown rice, wild rice, brown basmati rice)

– 1-2 ounces parmesan for topping the veggies, couscous, and chicken

Night snack/dessert

– healthy smoothie of 1 banana, 1/2 cup orange juice, and as much ice as you want

Day 2 Gestational Diabetes Menu:

Breakfast

– omelette: 2 egg whites + 1 whole egg, 2 tablespoons cheese of choice, 1/2 cup leftover veggies (from dinner last night)

– 1/2 cup grapes

Morning Snack

– 1 cup chopped melon or pineapple

– 1/2 cup cottage cheese

Lunch

– 2 pieces whole grain bread

– 3 pieces turkey bacon

– lettuce and tomato slices (this is a BLT!)

– mustard (unlimited) and/or mayo (2 teaspoons maximum)

– 1 fruit (apple, nectarine)

– 1 cup kefir

Afternoon Snack

– 5 cups of popcorn (no butter/oil)

Dinner

– 4-6 ounces fish of your choice

– 1 cup steamed veggies (pick your favorite)

– 1/2 baked acorn or butternut squash (or sweet potato)

– 2-3 tablespoons Greek yogurt (for the squash/potato) – this is just like sour cream, but healthier!

Night snack/dessert

–1 apple

–1 tablespoon peanut butter or almond butter

This Gestational Diabetes Menu should be complemented with a lot of water. Juices and milks are not the best way to hydrate. The mother should get 8-10 glasses of water a day (at least). If she exercises, she should drink more. Exercise is also a key component of a healthy pregnancy, but women should ask their physician first before starting any new routine.

 

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NOTICE: The material on this site for informational use only and should not be taken as medical advice. This email does not constitute any doctor-patient relationship, or any other type of relationship. The material has been thoroughly researched and believed to be the most up to date information at time of publishing. This material is offered as information only and the reader has the responsibility to verify any medical decisions or actions with his or her health care team.

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