By Dr Ananya Mandal, MD
There are two major types of diabetes. These are type 1 and type 2 diabetes. The other types are less common and they include gestational diabetes or pregnancy-induced diabetes.
Type 1 diabetes
In type 1 diabetes, the body's immune system destroys the beta cells of the pancreas that produce insulin. This results in a severe lack of the hormone insulin. As no insulin is produced blood glucose levels rise uncontrollably. This can go on to damage the body's organs.
Type 1 diabetes is often known as insulin-dependent diabetes. Since it starts in children and in the young, it is also termed juvenile diabetes or early-onset diabetes. Type 1 diabetes is less common than type 2 diabetes. About 10% of all people with diabetes have type 1 diabetes.
Treatment for type 1 diabetes is insulin injections that are needed for the rest of the person’s lifetime.
Type 2 diabetes
Type 2 diabetes is where the body does not produce enough insulin to meet its own needs. This is known as insulin resistance. It occurs in 75 to 90% of all cases of diabetes in UK.
Type 2 diabetes usually develops gradually over time. Most individuals with the condition may be unaware of their disease especially at early stages as there may be no specific symptoms. Type 2 diabetes is often associated with obesity. Obesity-related diabetes is sometimes referred to as maturity-onset diabetes because it is more common in older people.
In many early cases of type 2 diabetes treatment may be possible by just eating a healthy diet and monitoring blood glucose levels routinely. However, as type 2 diabetes is a progressive condition eventually medications may be needed. There are several groups of oral pills that can be taken to control the blood sugar. In some severe type 2 diabetics insulin injections may be necessary.
Gestational diabetes or diabetes during pregnancy
Some women may develop a high blood sugar during pregnancy. Their bodies fail to produce enough insulin to absorb it all. This is known as gestational diabetes and affects around 4 to 5% of pregnant women.
Pregnant women with gestational diabetes may or may not have pre-existing type 1 or type 2 diabetes. In most cases, gestational diabetes develops during the second trimester of pregnancy (weeks 14-26) and disappears after the baby is born.
Gestational diabetes can increase the risk of health problems developing in an unborn baby. Thus it is important to detect it early and treat it appropriately.
Some women who have gestational diabetes are at increased risk (30%) of developing type 2 diabetes later in life.
Treatment of gestational diabetes is regular insulin injections as oral pills for blood sugar control cannot be used in pregnant women (they can harm the unborn baby).
Around to 1 to 2% of all diabetics may develop secondary diabetes. This could be caused due to a pancreatic disease like cystic fibrosis, chronic pancreatitis, pancreatectomy or pancreas cancer. Endocrine or hormonal disorders like Cushing's syndrome, acromegaly, thyrotoxicosis, phaeochromocytoma, glucagonoma may also raise the risk of secondary diabetes.
Some drugs may raise risk of diabetes. These include thiazide diuretics, corticosteroids, atypical antipsychotics, protease inhibitors used in HIV infection etc.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)