Diabetes Types - Symptoms, Causes, Diagnosis and Treatment

Diabetes (medically, diabetes mellitus) is a metabolic disease, causing high blood glucose (sugar) levels. Diabetes occurs because of the insufficient production of the hormone insulin or inefficient use of insulin by the body.

Insulin directs the glucose in the food to where it is required in the body. Insufficient production or ineffective utilisation of insulin causes the glucose to collect in the bloodstream, leading to hyperglycaemia (high blood sugar levels).

Having high blood sugar consistently can cause health issues like heart disease, nerve damage and eye issues. Diabetes is a chronic condition that can affect individuals of all ages. However, with the implementation of appropriate lifestyle changes and medications, it can be effectively managed, allowing individuals to lead a healthy life without complications.

Types of Diabetes

Here are some types of diabetes along with a brief description of each:

Type 1 Diabetes

Definition and Causes

Type 1 diabetes is an autoimmune disease characterised by the immune system's attack on the insulin-producing beta cells in the pancreas. This results in a progressive decline in insulin production, eventually leading to its complete cessation. The exact causes of type 1 diabetes remain largely unknown. While this condition can affect individuals of any age, it typically manifests in young adults, teenagers and children.

Symptoms and Diagnosis

Some of the common type 1 diabetes symptoms include:

• Frequent urination

• Excessive thirst

• Fatigue

• Unexplained weight loss

• Excessive hunger

• Slow healing of wounds

• Blurred vision

• Vaginal yeast infections

Diagnosing type 1 diabetes is done by:

• Blood Glucose Test: Measures blood sugar levels using a random and/or fasting test.

• A1C (Glycosylated Haemoglobin Test): Measures the average blood sugar levels over 3 months.

• Antibody Test: Tests for antibodies to determine if the person has type 1 or type 2 diabetes.

Treatment and Management Options

Individuals with type 1 diabetes need multiple daily doses of synthetic insulin to maintain healthy blood sugar levels. Managing type 1 diabetes and achieving optimal blood sugar control can be achieved via:

• Regular blood glucose monitoring

• Insulin administration

• Carb counting

Various types of synthetic insulin are available, each working differently in the body. People with type 1 diabetes may need to use multiple types of insulin to effectively manage their condition. The appropriate insulin dosage depends on several factors, such as age, weight, blood sugar levels, diet, physical activity levels, pregnancy, puberty, and concurrent medications.

Insulin can be taken in different ways including:

• Multiple daily injections

• Prefilled insulin pens

• Insulin pump

• Rapid-acting inhaled insulin

Regular visits to the endocrinologist are important to ensure proper dosing of insulin and overall diabetes management.

Type 2 Diabetes

Definition and Causes

Type 2 diabetes, the most common form of diabetes, occurs when the pancreas doesn't produce sufficient insulin and/or when the body does not respond to insulin normally (insulin resistance). Although it predominantly affects adults, type 2 diabetes can also occur in children. If left unaddressed, it can lead to serious problems such as kidney disease, heart disease, stroke and even death. 

Diabetes is mainly caused by:

• Genetic factors or abnormal genes

• Lifestyle factors such as lack of exercise and obesity

Symptoms and Diagnosis

The symptoms of type 2 diabetes include:

• Excessive thirst and hunger

• Fatigue

• Blurred vision

• Frequent urination (especially at night)

• Numbness or tingling in feet or hands

• Slow wound healing

• Unexplained weight loss

Typically, type 2 diabetes is diagnosed by the following tests:

• Random Glucose Test: Can be done anytime without fasting

• Fasting Glucose Test: Measures the blood glucose level after an 8-hour fast

• A1C Test: Measures the average blood sugar levels over 3 month

• Oral Glucose Tolerance Test: Determines how the body manages blood glucose by checking sugar levels before and after consuming a sugary beverage.

Treatment and Management Options

Type 2 diabetes has no cure but the condition can be managed by:

• Monitoring blood sugar and ensuring it is within proper levels by using a glucose meter or Continuous Glucose Monitoring (CGM).

• Adopting a healthy lifestyle like exercising regularly, eating a nutritious diet and avoiding smoking to keep blood pressure under check. Medications like ACE inhibitors and beta-blockers may be prescribed.

• Keeping cholesterol levels under control by following a diet that is low in fat, sugar and salt. Statins may be recommended to reduce cholesterol levels.

Along with following a healthy diet and exercise, the doctor may prescribe medications for type 2 diabetes treatment:

• Oral medicals like metformin to control liver glucose production

• Self-administered injectable insulin shots

• Rapid-acting inhaled insulin

• An insulin pump that delivers insulin continuously via a cannula

Gestational Diabetes

Definition and Causes

Gestational diabetes (GD) develops when hormonal changes during pregnancy impact insulin function, resulting in high blood sugar levels.  GD typically occurs between 24-28 weeks of pregnancy and can increase the risk of developing type 2 diabetes in the future. GD can be caused because of various factors including hormonal fluctuations, being overweight and genetics.

Symptoms and Diagnosis

The symptoms of GD are often not obvious, although some women may experience thirst, nausea, frequent urination and fatigue.

Diagnosis for GD is by testing blood sugar during pregnancy:

• Glucose Challenge Test: This involves testing for blood glucose after consuming a sweet drink and waiting an hour.

• Glucose Tolerance Test: Done if the glucose challenge test results are high. The test involves fasting for 8 hours and checking blood sugar levels after drinking a sweet liquid at various intervals.

Treatment and Management Options

If diagnosed with GD, the person must undergo more frequent blood sugar monitoring and check-ups. The condition can typically be managed with modification in diet and exercise, but some women may need insulin for effective diabetes control.

Other Types of Diabetes

LADA

Sometimes known as type 1.5 diabetes, Latent Autoimmune Diabetes in Adults (LADA) is an autoimmune form of diabetes like type 1 diabetes that develops very slowly. Usually, LADA occurs in people 30 years or older.

MODY

Also known as monogenic diabetes, Maturity-onset Diabetes of the Young (MODY) is caused as a result of an inherited genetic abnormality that modifies the way the body produces and utilises insulin. With more than 10 known types, MODY impacts around 5% of individuals with diabetes and often runs in families.

Secondary Diabetes

Secondary diabetes often occurs as a result of another medical condition such as chronic pancreatitis, cystic fibrosis, hemochromatosis, PCOS (polycystic ovary syndrome), Cushing’s syndrome, glucagonoma or pancreatic cancer. It may also be drug-induced by taking medications including beta-blockers, corticosteroids and thiazide diuretics.

Complications of Diabetes

Diabetes can cause both short-term and long-term complications including:

Short-Term Complications

• Hypoglycaemia (low blood sugar): Occurs in people taking insulin. It may cause blurred vision, disorientation, clumsiness and seizures and may need immediate administration of glucagon and/or medical treatment.

• Hyperosmolar Hyperglycaemic Syndrome (HHS): Mainly affecting people with type 2 diabetes, HHS causes confusion and severe dehydration and needs immediate medical intervention.

• Diabetes-related Ketoacidosis (DKA): DKA occurs due to prolonged insulin deficiency, resulting in the breakdown of fat. This process releases ketones into the blood, leading to increased acidity. Symptoms of DKA include vomiting, difficulty breathing, dehydration, loss of consciousness and even coma. Immediate medical attention is necessary in such situations. 

Long-Term Complications

High sugar levels damage the blood vessels and in turn, impact the various tissues and organs in the body. Some long-term diabetes complications include:

• Cardiovascular problems (heart attack, coronary artery disease, stroke and atherosclerosis)

• Kidney disease

• Nerve damage

• Foot problems

• Retinopathy

• Sexual dysfunction

• Loss or hearing

• Gastroparesis

• Oral health issues

• Mental health issues

Diabetes Treatment and Management

Since diabetes is a complex condition, managing it needs varied approaches and must be personalized as per the individual’s needs. Broadly, diabetes treatment and management aspects include:

Lifestyle Changes

A healthy diet is essential for blood sugar control and diabetes management. Counting carbs is crucial for insulin users. Regular exercise can help to manage diabetes by improving insulin sensitivity and reducing insulin resistance.

Medications

Oral diabetes medications like metformin can help to manage blood glucose levels for people with GD, type 2 diabetes and prediabetes. People with type 1 diabetes and sometimes those with type 2 diabetes require insulin, which can be injected or administered via pumps, pens or inhalers.

Blood Sugar Monitoring

Regular blood sugar monitoring is essential to determine if the diabetes treatment is working. Blood sugar monitoring can be done with a finger stick and glucose meter or CGM. These methods provide valuable information that facilitates effective diabetes management.

Conclusion

Understanding the different types of diabetes and their symptoms is vital for effective management. With diabetes treatments including insulin therapy, medications and lifestyle changes individuals can take control of their health for better outcomes.

Frequently Asked Questions

1. How is Diabetes Diagnosed?

Diabetes is diagnosed using a variety of tests including A1C, fasting plasma glucose test, glucose challenge test and oral glucose tolerance test

2. What are The Symptoms of High and Low Blood Sugar Levels?

Symptoms of high blood sugar include nausea, drowsiness, frequent urination, extreme thirst/ hunger and blurry vision. Low sugar includes sweating, fast heartbeat, anxiety, shaking, extreme hunger, dizziness, tiredness, weakness and irritability.

3. Can Diabetes be Cured?

No, there is no cure for diabetes. However, with proper management strategies like medications and lifestyle changes, the condition can be controlled.

4. What are the Treatment Options for Diabetes?

Treatment options for diabetes encompass oral medications such as metformin, injectables and various forms of insulin, which can be administered through syringes, pens, pumps, inhalers, jet injectors and artificial pancreas. Additionally, alternative diabetes treatment options may involve weight-loss surgery and pancreatic islet transplantation.

5. What Lifestyle Changes Can Help Manage Diabetes?

Lifestyle changes including consuming a low-fat and low-calorie diet and following a moderate-intensity workout routine for about 150 minutes per week can help in managing diabetes.

6. How Can Diabetes be Prevented?

Diabetes can be prevented by consuming a healthy Diabetic diet, exercising often, keeping weight in check and avoiding smoking.