What are the different types of Diabetes?

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There are two main types of diabetes, called type 1 and type 2. Type 1 diabetes was also called insulin-dependent diabetes mellitus (IDDM) or juvenile diabetes mellitus. In type 1 diabetes, the pancreas undergoes an autoimmune attack by the body itself, and rendered incapable of making insulin. Abnormal antibodies were found the majority of patients with type 1 diabetes. Antibodies are proteins in the blood that are part of the body's immune system. type 1 diabetes must rely on insulin medication for survival.


In autoimmune diseases such as type 1 diabetes, the immune system mistakenly produces antibodies and inflammatory cells that against and cause damage to tissues of the patients own body. In people with type 1 diabetes, pancreatic beta cells, which are responsible for producing insulin attacked by misdirected immune system. It believed that the tendency to develop abnormal antibodies in type 1 diabetes is partly hereditary, although the details are not fully understood.

Exposure to certain viral infections (mumps and Coxsackie viruses) or other environmental toxins used to trigger abnormal immune responses that cause damage to cells of the pancreas where insulinmade. Some antibodies seen with type 1 diabetes include anti-islet cells, insulin antibodies and antibodies to glutamic acid decarboxylase. These antibodies be measured in most patients, and can help find people at risk of developing type 1 diabetes.

Currently, the American Diabetes Association does not recommend widespread screening of the population type 1 diabetes, although screening for high-risk people, such as those with first-degree relative (brother or a parent) with type 1 diabetes should encouraged. Type 1 diabetes tends to occur among young people, skinny people, usually before age 30, however, elderly patients does not present with this form of diabetes on the occasion. This subgroup called latent autoimmune diabetes in adults (LADA). LADA is a slow, progressive form of type 1 diabetes. Among all patients with diabetes, only about 10% of patients with type 1 diabetes and 90% have type 2 diabetes.


Type 2 diabetes was also called non-insulin dependent diabetes (NIDDM) or adult onset diabetes mellitus (AODM). In type 2 diabetes, patients can still produce insulin, but do relatively little to the needs of their bodies, especially in the face of insulin resistance as discussed above. In many cases it really means the pancreas produces larger amounts of insulin than normal. A major characteristic of type 2 diabetes is a lack of sensitivity to insulin by cells in the body (particularly fat and muscle cells).

In addition to problems with increased insulin resistance, the release of insulin from the pancreas can also be defective and sub-optimal. In fact, there is a steady decline in the known production of beta cells with insulin in type 2 diabetes that contributes to worsening glycemic control. (This is a major cause for many patients with type 2 diabetes who ultimately require insulin therapy.) Finally, the liver in these patients continues to produce glucose through a process called gluconeogenesis despite high levels of glucose. Control of gluconeogenesis compromised.

Although it said that Type 2 diabetes occurs mainly in people over 30 years and the incidence increases with age, we are seeing a disturbing number of patients with type 2 diabetes who are barely in the adolescence. In fact, for the first time in the history of humans, type 2 diabetes is now more common than type 1 diabetes in childhood. Most of these cases are the direct result of poor eating habits, body weight higher, and lack of exercise.

Although there is a strong genetic component to the development this form of diabetes, there are other risk factors - most important of which is obesity. There is a direct relationship between the degree of obesity and risk of type 2 diabetes, and this is true in children and adults. It estimated that the chances of developing diabetes doubles for every increase of 20% of desirable body weight.

Regarding age, the data show that for each decade after age 40 regardless of weight there is an increased incidence of diabetes. The prevalence diabetes in people 65 to 74 years of age is almost 20%. Type 2 diabetes is more common in certain ethnic groups. Compared to a prevalence 6% in Caucasians, the prevalence among African-Americans and Asian Americans estimated at 10%, 15% among Hispanics, and Native American communities in some 20% to 50% . Finally, diabetes occurs much more often in women with a history of diabetes that occurs during pregnancy (gestational diabetes - see below).

Diabetes can occur temporarily during pregnancy. Significant hormonal changes during pregnancy can lead to a rise in blood glucose levels in genetically predisposed people. The elevation blood sugar during pregnancy called gestational diabetes. Gestational diabetes usually disappears when the baby is born. However, 25% -50% of women with gestational diabetes eventually develop type 2 diabetes later in life, especially in those requiring insulin during pregnancy and those who stay overweight after delivery. Patients with gestational diabetes are usually asked to tested for oral glucose tolerance of about six weeks after delivery to decide if their diabetes has persisted beyond the pregnancy, or if no evidence (such as tolerance glucose) is present that may write future risk for the patient to develop diabetes.

"Secondary" diabetes refers to high levels of sugar in the blood of another medical condition. Secondary diabetes may develop when the tissue of the pancreas responsible for producing insulin destroyed by disease, such as chronic pancreatitis (inflammation of the pancreas by toxins like alcohol too), trauma or surgical removal of pancreas.

Diabetes can also cause other hormonal disturbances, such as excessive production of growth hormone (acromegaly) and Cushing's syndrome. In acromegaly, a tumor of the pituitary gland at the base of the brain causes the excessive production of growth hormone, leading to hyperglycemia. In Cushing's syndrome, the adrenal glands produce too much cortisol, which promotes the elevation blood sugar.

In addition, some medications may worsen diabetes control, or "unmask" latent diabetes. This seen most commonly when steroid medications (like prednisone) taken and with the drugs used in the treatment HIV infection (AIDS).