There are at least two different types of diabetes. Making an accurate diagnosis, especially later in life, is sometimes difficult. We will explain the different types below. To make an accurate diagnosis, please use this information to have a conversation with your doctor. No web page is equipped to make a medical diagnosis!
In This Section
The Types of Diabetes
Historically there are two forms of diabetes, type 1 diabetes (formerly known as juvenile diabetes) and type 2 diabetes (formerly known as adult-onset diabetes). Now a days there are more types as scientists realize that there are multiple causes, including MODY, LADA, Bronze Diabetes, and Steroid Induced Diabetes. Still most doctors will place the forms under a type 1 or type 2 heading.
The cause of the disease is the determining factor on which type you have. Treatment is important, but both types (many of the types) share the same treatment so the discriminating factor is the cause. Online, you often see abbreviations like T1, T2, and T1.5. This simply means ‘type 1 diabetes’, ‘types 2 diabetes’, and ‘type 1.5 diabetes’.
Type 1 diabetes is an autoimmune disease. This means that your body’s defenses have taken to attacking the insulin-producing beta cells in the pancreas. As a consequence, you can no longer produce insulin and have to take exogenous (an outside source) insulin in order to survive. The GADA (glutamic acid decarboxylase autoantibody) test is a common test which screens for auto antibodies, or antibodies which recognize you instead of a foreign body. This is the hallmark of an autoimmune disease so have autoantibodies means you have an autoimmune disease.
The c-peptide test measures the c-peptide produced during insulin creation. There is a 1:1 ratio of c-peptide to insulin molecules so by measuring c-peptide doctors can get a pretty good idea of exactly how much insulin is floating around. A low c-peptide level therefore corresponds with a low insulin level and can indicate type 1. Upon diagnosis type 1 diabetics more often experience DKA (diabetic ketoacidosis) weight loss, and rapid onset of symptoms. It’s important to remember that this is not a requirement for a T1 diagnosis neither is is restricted to T1s. T2s and other forms of diabetes can, although much more rarely experience weight loss and DKA.
Type 1.5 Diabetes
Type 1.5, also known as LADA and slow onset type 1 is identical to type 1 diabetes except that it has a much slower onset of action. The destruction of beta cells is not usually nearly as quick as it is in young children and as a result these adults can experience long honeymoon periods and even survive on oral medications or very low doses of insulin for years. Diagnosis is more difficult and is ‘’’often mis-diagnosed as type 2’’’ as it doesn’t fit the “typical” type 1 profile. GADA tests turn up positive often in type 1.5 individuals, so this test may be a good discriminating factor. There are also other antibody tests not routinely run, but which do come up positive more often in type 1.5 individuals than younger type 1 individuals. The C-peptide test may or may not be reliable due to ongoing insulin production.
Type 2 diabetes is historically caused by Insulin Resistance (IR) while the cause of IR can range from any number of genetic deficiencies to environmental causes. Undoubtedly a combination of both causes the disease so it’s important to look at both when considering a type 2 diagnosis. Type 2 diabetics can experience the typical symptoms of any other type of diabetic, but the very slow onset of the disease often allows nearly all the symptoms to be masked or ignored until complications occur. Random blood sugar screenings at doctor checkups are a good way to notify you of type 2 and of course any symptoms should be checked out by a doctor ASAP.
Double Diabetes is the unofficial term for someone with type 1 diabetes (autoimmune disease) who gains insulin resistance (type 2 diabetes). It can also go the other way around but that is much more uncommon. Since double diabetes is a combination of both types it isn’t a common initial diagnosis but occurs after the initial diagnosis has already occurred.
Diabetes Due to Pancreatitis
This is an interesting cause of diabetes as the infection in the pancreas kills off the beta cells (along with other necessary cells), thereby reducing the insulin available to the body. Some medications can stimulate the pancreas to spit out more insulin for a while, but usually in a year or two, a boost in the form of long-acting basal insulin such as Lantus and Levemir is needed to help the pancreas produce enough insulin. There are digestive hormones created in the pancreas as well as insulin, and someone who’s survived pancreatitis typically needs to also take these hormones in the form of pills.
Get an Accurate Diagnosis!
What sometimes happens is that doctors do not run the necessary tests to see which kind of diabetes you have, but make the assumption, often faulty, that because you are overweight you must be Type 2, or contrary wise, because you are thin you can’t be type 2.
This is simply not the case!
The biggest clue that you may not be type 2, even though diagnosed as one, is if the oral medications you have been given simply do not work. Get back to your doctor if that happens, but you do need to know that some of the oral medications take a number of weeks to take full effect. Type 2 medicines make you more sensitive to insulin, increase the amount of insulin your pancreas produces, slow down your digestive process, or limit the amount of glucose your liver releases.
If you are type 1, and therefore make no insulin, none of the above things will help you. If that is the case, you need to take insulin. However, just because you do not immediately need insulin, this does not mean you don’t have type 1. People have a honeymoon phase that lasts for years where their insulin needs are very low.
Identifying what type of diabetes you have is the first step towards a long and healthy life. Make sure you understand how diabetes works and trust your doctor’s diagnosis.