Know your type

Officially, there are four types of diabetes:

  • Type 1: An autoimmune disease in which the immune system attacks the insulin-producing cells, resulting in the body not being able to produce enough insulin. It is considered a “genetic” disease and is believed to be caused by an illness, perhaps as simple as a head-cold, “triggering” the the disease. Most but not all cases begin during childhood or adolescence. Insulin treatment is always necessary to live with T1D, though lifestyle and other medications can support its management. There is no cure for type 1 diabetes.
  • Type 2: A metabolic disease in which the body has increased insulin resistance, meaning it does not use insulin efficiently. A genetic component is necessary—a fact that diabetes-shamers ignore—and the most common triggers are related to inactive lifestyle, poor diet, excess weight, and aging. Treatments include lifestyle and diet changes, oral medications, insulin treatment, and some combination thereof. Contrary to common claims, there are no “cures” for type 2 diabetes; if your new diet or exercise routine returns your blood sugar to normal, you are successfully managing your diabetes.
  • Pre-diabetes: Believed to be a precursor stage before type 2 diabetes. Increasing insulin resistance leads to fasting blood sugar results between 100 and 125 mg/dl. Treatment usually involves lifestyle and diet changes, but may also include oral medications.
  • Gestational: When insulin resistance abnormally increases blood sugar levels during pregnancy. It is related to pre-diabetes and type-2 diabetes, but it usually disappears after the pregnancy is over. Treatment usually involves lifestyle and diet changes, but may also include oral medications or insulin treatment.

However, many medical and healthcare professionals recognize that diabetes is more complicated than 4 categories. A simple and common example if this is when a type 1 diabetic develops increased insulin resistance. There are also theories of other distinct “types” of diabetes, including:

  • 1.5/LADA: Adults who are diagnosed with type 1 diabetes often develop the disease more slowly than do children and adolescents, and they often have increased insulin resistance. In fact, many of these people are first diagnosed with type 2 before later being diagnosed with type 1. This possible “type” is autoimmune, just like type 1. 1.5/LADA is not currently a medical diagnosis, but many diabetics and physicians think of it as a distinct “type.” There have been cases where treatment begins with oral medications, but this depends on how much insulin is still being created by the body. Insulin treatment will become necessary, just as it is for someone with type 1. (As a side note: my endocrinologist and I both suspect that I may actually have late-stage 1.5!)
  • Type 3: One of many theories as to the cause of Alzheimer’s disease is insulin resistance of the brain. Proponents of this theory have proposed “type 3 diabetes” as a new term for the disease.
  • Type 3c/Pancreatogenic: A proposed distinct “type” still being researched, with the theory that chronic pancreatitis may cause diabetes.