The main types of diabetes are type 1, type 2, and gestational diabetes. Adults may also be diagnosed with latent autoimmune diabetes. Each type varies, but they all require management plans.
There are three main types of diabetes, all of which involve how your body uses or makes a hormone known as insulin to regulate your blood sugar levels.
These can develop for different reasons. Treatment and management can vary, but they overlap in certain ways.
There are different causes tied to the different diabetes types.
While genetics is a key part of diabetes development, other risk factors play a role in diabetes, depending on the type.
Type 1 diabetes
Type 1 diabetes (T1D) is an autoimmune condition, which means your immune system mistakenly attacks and destroys the beta cells in your pancreas that produce insulin. This cannot be reversed.
What prompts the attacks is not clear. There may be both genetic and environmental reasons. Lifestyle factors are not believed to play a role.
Adult-diagnosed type 1 diabetes, or type 1.5
Many adults may receive a T1D diagnosis, or what is known as latent autoimmune diabetes in adults (LADA). This is also referred to as type 1.5.
LADA may not develop as suddenly as T1D, and that delayed onset, coupled with adult age can lead to a misdiagnosis of type 2 diabetes (T2D).
Make sure to discuss your symptoms with your healthcare and diabetes team, including any treatments you have that may not work as well as you’d expect them to.
Type 2 diabetes
Type 2 diabetes (T2D) starts out as insulin resistance.
This means your body cannot use insulin efficiently, which causes your pancreas to produce more insulin until it cannot keep up with demand. Insulin production then decreases, which causes high blood sugar.
The exact cause of T2D is unknown. Contributing factors may include:
- genetics
- a more sedentary lifestyle
- higher weight or obesity
There may also be other health factors and environmental reasons.
Gestational diabetes
Gestational diabetes is caused by insulin-blocking hormones produced during pregnancy.
This type of diabetes only happens during pregnancy. It is often seen in people with preexisting prediabetes and a family history of diabetes.
General symptoms of unmanaged diabetes include:
- excessive thirst and hunger
- frequent urination
- drowsiness or fatigue
- dry, itchy skin
- blurry vision
- slow-healing wounds
T2D can cause discolored patches in the folds of skin in your armpits and neck. Since T2D usually takes longer to diagnose, you may feel more symptoms at the time of diagnosis, like pain or numbness in your feet.
T1D often develops more quickly and can cause symptoms like weight loss or diabetic ketoacidosis (DKA), which can occur when you have very high blood sugar but little or no insulin in your body.
Symptoms of both types of diabetes can appear at any age, but type 1 usually appears in children and young adults.
Type 2 has historically been diagnosed in older adults. But younger people are increasingly receiving T2D diagnoses due to sedentary lifestyles and an increase in weight.
About
Beyond those with diabetes,
Prediabetes develops when your blood glucose is higher than it should be but not high enough to be diabetes.
You’re more likely to develop diabetes if you have a family history of the disease.
Other T2D risk factors include:
- having a sedentary lifestyle
- living with extra weight or obesity
- history of gestational diabetes or prediabetes
Complications of diabetes generally develop over time. Having poorly managed blood sugar levels increases the risk of serious complications that can become life threatening.
Chronic complications include:
- vessel disease, which can lead to heart attack or stroke
- eye problems (retinopathy)
- infection or skin conditions
- nerve damage (neuropathy)
- kidney damage (nephropathy)
- amputations due to neuropathy or vessel disease
T2D may increase the risk of developing Alzheimer’s disease, especially if your blood sugar is not well managed.
Possible concerns during pregnancy
High blood sugar levels during pregnancy can increase the risk of:
- high blood pressure
- preeclampsia
- miscarriage or stillbirth
- birth defects
No matter what type of diabetes you have, you’ll need to work closely with your doctor to manage it.
The main goal is to keep blood glucose levels within your target range. Your doctor will let you know what your target range should be. Targets vary with the type of diabetes, age, and presence of complications.
If you have gestational diabetes, your blood sugar targets will be lower than those of people with other types of diabetes.
Physical activity is an important part of diabetes management. Ask your doctor how many minutes you should devote to aerobic exercise per week. Diet is also important.
You’ll also need to monitor your blood pressure and cholesterol.
Treating type 1
All people with T1D must take insulin to live since damage to the pancreas is permanent. Different types of insulin are available with different onset, peak, and duration times.
Insulin is injected just under the skin. Your doctor will show you how to properly inject and rotate injection sites. You can also use an insulin pump, which is a device worn outside your body that can be programmed to release a specific dose.
Continuous blood glucose monitors (CGMs) can also check your blood sugar 24 hours a day and night.
You’ll need to monitor your blood sugar levels throughout the day. If necessary, you may also need to take medication to manage cholesterol, high blood pressure, or other complications.
Treating type 2
T2D can be managed and sometimes even reversed with diet and exercise. It can also be treated with a variety of medications to help manage blood sugar.
The first-line medication is usually metformin (Glumetza, Glucophage, Fortamet, Riomet). This medication works by reducing glucose production in the liver. If metformin does not work, your doctor can prescribe another medication.
You’ll need to continuously monitor your blood sugar levels. You may also need medications to help manage blood pressure and cholesterol.
There’s no cure for T1D. It requires lifelong disease management. But with consistent monitoring and adherence to treatment, you may be able to avoid more serious complications of the disease.
If you work closely with your doctor and make healthy lifestyle choices, T2D can often be successfully managed or even reversed.
If you have gestational diabetes, it will likely resolve after the baby is born. However, you do have a higher risk of developing T2D later in life.
