Diabetes Mellitus – Know Types, Symptoms, 3 steps of Prevention and proven Treatment

Medically reviewed by Dr Itender Pal Singh

Diabetes mellitus, commonly referred to as diabetes, is a chronic condition that affects millions of people worldwide. It occurs when blood glucose levels, also known as blood sugar, are higher than normal. Glucose is the body’s primary source of energy, but excessive levels can lead to various health issues, including fatigue, excessive thirst, and blurred vision. Recent studies estimate that approximately 11% of the U.S. population has some form of diabetes. The good news is that with the right lifestyle changes and medications, diabetes can be effectively managed, helping individuals lead healthier lives and preventing long-term complications.

Types of Diabetes

Diabetes is not a one-size-fits-all condition. There are several types, each with unique characteristics, symptoms, and treatment approaches. Understanding the differences is crucial for effective management.

1. Type 1 Diabetes (T1D)

Type 1 diabetes, which accounts for about 5% to 10% of diabetes cases, is an autoimmune condition. Historically referred to as “juvenile diabetes” or “insulin-dependent diabetes,” T1D typically manifests in childhood or adolescence, although it can develop at any age. In T1D, the immune system mistakenly attacks and destroys insulin-producing cells in the pancreas, leading to a significant reduction in insulin levels. Without sufficient insulin, blood glucose levels rise, resulting in various symptoms and potential complications.

2. Type 2 Diabetes (T2D)

Type 2 diabetes is the most common form, affecting 90% to 95% of people with diabetes. While it often develops in adulthood, it is increasingly being diagnosed in children, particularly those with a family history of the condition or who are overweight. In T2D, the body’s cells become resistant to insulin, causing the pancreas to produce more insulin in an attempt to lower blood glucose levels. Over time, the pancreas may struggle to keep up with this demand, leading to elevated blood sugar levels and the onset of diabetes symptoms.

3. Type 3c Diabetes

A less common type, type 3c diabetes, affects approximately 4% to 5% of people with diabetes. This form is often the result of physical damage to the pancreas, such as from chronic pancreatitis, cystic fibrosis, or pancreatic cancer. Due to the damage, the pancreas loses its ability to produce insulin effectively, leading to high blood glucose levels. Type 3c diabetes is frequently misdiagnosed as type 2 diabetes, which can complicate treatment.

4. Gestational Diabetes

Gestational diabetes occurs during pregnancy due to hormonal changes that affect insulin production. While this type of diabetes typically resolves after childbirth, it increases the mother’s risk of developing type 2 diabetes later in life. Managing gestational diabetes is crucial to prevent complications for both the mother and baby.

Recognizing the Symptoms

Each type of diabetes presents with distinct symptoms, though there are common symptoms across all forms. Recognizing these symptoms early can lead to prompt diagnosis and treatment.

Type 1 Diabetes Symptoms

The symptoms of type 1 diabetes tend to develop rapidly, often within weeks. They can be severe and may include:

• Extreme hunger
• Intense thirst
• Frequent urination
• Fatigue
• Unintentional weight loss
• Blurred vision

In some cases, individuals with type 1 diabetes may experience diabetic ketoacidosis (DKA), a serious complication characterized by vomiting, stomach pain, rapid breathing, and a fruity odor on the breath. DKA requires immediate medical attention.

Type 2 Diabetes Symptoms

Type 2 diabetes symptoms often develop gradually and may be mild or even unnoticed at first. As blood sugar levels rise, symptoms may include:

• Persistent fatigue
• Frequent infections or slow-healing sores
• Dry mouth and increased thirst
• Frequent urination
• Tingling, numbness, or pain in the hands and feet
• Darkened skin patches (acanthosis nigricans)
• Blurred vision
• Mood changes or irritability

Type 3c Diabetes Symptoms

People with type 3c diabetes often experience symptoms similar to those of type 1 and type 2 diabetes. However, they may also have symptoms related to pancreatic damage, such as:

• Fatty stools
• Abdominal pain
• Diarrhea

Gestational Diabetes Symptoms

Gestational diabetes often presents without noticeable symptoms. However, some women may experience increased thirst and more frequent urination during pregnancy.

Causes of Diabetes

Diabetes results from issues with insulin production or function. Insulin is a hormone produced by the pancreas that helps regulate blood glucose levels by signaling cells to absorb glucose for energy. When insulin production or function is impaired, blood sugar levels can rise, leading to diabetes. The underlying causes vary depending on the type of diabetes.

What Causes Type 1 Diabetes?

Type 1 diabetes is caused by an autoimmune response in which the immune system attacks and destroys insulin-producing cells in the pancreas. The exact trigger for this immune response is unknown, but it is believed to involve a combination of genetic and environmental factors.

What Causes Type 2 Diabetes?

Type 2 diabetes develops when the body’s cells become resistant to insulin, a condition known as insulin resistance. The pancreas initially compensates by producing more insulin, but over time, it may not be able to keep up, leading to elevated blood sugar levels. Factors that contribute to insulin resistance include genetics, obesity (especially abdominal fat), and a sedentary lifestyle.

What Causes Type 3c Diabetes?

Type 3c diabetes is caused by physical damage to the pancreas, which impairs its ability to produce insulin. This damage can result from conditions like chronic pancreatitis, cystic fibrosis, or pancreatic cancer.

Diagnosis of Diabetes

If you suspect you have diabetes, it is essential to seek medical attention for a proper diagnosis. Your healthcare provider will review your medical history, assess your symptoms, and perform a physical examination. They may also order one or more of the following diagnostic tests:

1. Fasting Glucose Test

This test measures blood glucose levels after you have fasted for at least eight hours. A fasting glucose level of 126 milligrams per deciliter (mg/dL) or higher indicates diabetes, while a level between 100 and 125 mg/dL suggests prediabetes.

2. Hemoglobin A1C Test

The A1C test provides an average of your blood glucose levels over the past three months. An A1C level of 6.5% or higher indicates diabetes, while a level between 5.7% and 6.4% suggests prediabetes.

3. Random Plasma Glucose Test

This test measures blood glucose levels at any time of day, regardless of when you last ate. It is less reliable for diagnosing diabetes but may be used in certain situations.

4. Glucose Challenge Test

Commonly used to diagnose gestational diabetes, this test measures blood glucose levels after consuming a sugary drink.

For suspected type 1 diabetes, additional tests may be performed to detect antibodies against insulin-producing cells, which are present in type 1 diabetes but not in type 2 diabetes.

Treatment Options for Diabetes

While there is no cure for diabetes, various treatments can help manage the condition and maintain normal blood sugar levels. Treatment plans typically include a combination of lifestyle changes and medications.

Lifestyle Changes

Making healthy changes to your diet and increasing physical activity can significantly improve insulin sensitivity and blood sugar control. For some individuals with type 2 diabetes, lifestyle changes alone may be sufficient to manage the condition without medication.

Non-Insulin Medications

If lifestyle changes are not enough to control blood sugar levels, your healthcare provider may prescribe non-insulin medications. The most commonly prescribed drug is Gluformin (metformin), which is effective, low-cost, and promotes weight loss. Other oral medications include:

• Diabetrol (glyburide)
• Avandia (rosiglitazone)
• Invokana (canagliflozin)
• Januvia (sitagliptin)

In some cases, injectable medications like Ozempic (semaglutide) may be recommended.

Insulin Treatments

Insulin therapy is the primary treatment for type 1 diabetes and may also be necessary for individuals with type 2 diabetes whose condition progresses. Insulin can be administered via a needle and syringe, an insulin pen, or a pump. Regular monitoring of blood sugar levels is essential for those on insulin therapy.

Preventing Diabetes

While type 1 diabetes cannot be prevented, there are steps you can take to reduce your risk of developing type 2 diabetes. Key prevention strategies include:

• Physical Activity: Engaging in regular physical exercise, such as walking, strength training, or aerobic activities, can improve insulin sensitivity and reduce the risk of type 2 diabetes.
• Healthy Diet: Eating a diet rich in whole grains, high-fiber foods, and lean proteins while reducing the intake of sugary foods and beverages can help prevent the onset of diabetes.
• Weight Management: Maintaining a healthy weight, particularly around the waist, can lower the risk of developing insulin resistance and type 2 diabetes.

Research has shown that losing just 2.2 pounds (1 kilogram) can reduce the risk of diabetes by 16%.

Complications of Diabetes

Diabetes, if not managed properly, can lead to several serious complications. These include:

• Diabetic Ketoacidosis (DKA): A life-threatening complication more common in type 1 diabetes, DKA occurs when the body breaks down fat for energy, leading to a buildup of ketones. This condition requires immediate medical attention to prevent diabetic coma or death.
• Hypoglycemia: Low blood sugar, or hypoglycemia, can occur if too much insulin is taken or after excessive alcohol consumption. Severe hypoglycemia can lead to seizures and requires prompt treatment.
• Organ Damage: Long-term elevated blood sugar levels can cause damage to various organs, including the kidneys, heart, and eyes. It is essential to monitor and manage blood sugar levels to prevent these complications.

Living with diabetes requires careful management, but it is possible to lead a healthy life with the right strategies. By understanding the different types of diabetes, recognizing symptoms, making lifestyle changes, and following a treatment plan, individuals can effectively manage their condition and reduce the risk of complications. Always consult with your healthcare provider for personalized advice and treatment options.

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Sources–

Harrison manual of internal medicine.

Johns Hopkins Medicine: “Prediabetes.”

Autoimmunity: From Bench to Bedside [Internet]: “Autoimmune diabetes mellitus (Type 1A).”

National Institute of Diabetes and Digestive and Kidney Diseases: “Type 1 Diabetes,” “The A1C Test & Diabetes,” “Type 2 Diabetes,” “Definition & Facts of Gestational Diabetes,” “Tests & Diagnosis for Gestational Diabetes,” “What Is Diabetes?” “Monogenic Diabetes (Neonatal Diabetes Mellitus & MODY),” “Symptoms & Causes of Gestational Diabetes.”

Merck Manual Consumer Version: “Diabetes Mellitus (DM).”

CDC: “About Diabetes,”  “Diabetes Basics,” “Prediabetes: Your Chance to Prevent Type 2 Diabetes.”

World Journal of Diabetes: “Type 2 diabetes mellitus in children and adolescents.”