HOW MUCH DO YOU KNOW about diabetes? It’s one condition, but there are several distinct types of the disease. Each has its own causes and risk factors. Diabetes is one of the more common diseases in the U.S. – more than 30 million in the country have it as of 2015, according to the 2017 National Diabetes Statistics Report, a publication of the Centers for Disease Control and Prevention. That’s more than 9 percent of the U.S. population.
Millions of people don’t know they have diabetes. More than 7 million people – 24 percent of the total number of people with the disease – weren’t aware or didn’t report having diabetes, according to the report. Meanwhile, the number of people in the U.S. who are overweight or obese – which are risk factors for diabetes – continues to increase. Therefore, the number of people with diabetes is expected to grow, experts say. “Millions of people have diabetes and don’t know it,” says Dr. Garth Graham, a practicing cardiologist and president of the Aetna Foundation in Hartford, Connecticut. “According to the report, nearly a quarter of the total number of people with diabetes either weren’t aware or didn’t report having the disease.”
Diabetes can lead to a raft of health problems, including heart attacks, blindness, strokes and kidney failure. Many diabetics experience peripheral neuropathy. That means poor blood sugar control over time that can lead to pain, tingling or a lack of feeling in your hands and feet. If you don’t have feeling in your feet, you could suffer an injury and not feel it, which in turn can lead to an infection that, if not treated, could require amputation.
Given its prevalence, being educated on diabetes, including how to manage it, is important. Here are the basic differences among prediabetes, Type 1 diabetes, Type 2 diabetes and gestational diabetes:
Types of Diabetes
1. Prediabetes is a precursor to Type 2 diabetes, says Judith Wylie-Rosett, co-director of the New York Regional Center for Diabetes Translational Research at Albert Einstein College of Medicine in New York City. She’s a co-author of “101 Weight Loss Tips for Preventing and Controlling Diabetes” and an associate editor of the journal Diabetes Care. An estimated 34 percent of adults in the U.S. – more than 84 million people – had prediabetes in 2015, according to the 2017 National Diabetes Statistics Report. If not treated, prediabetes often leads to Type 2 diabetes, according to the CDC.
2. Type 1 diabetes occurs when your body doesn’t produce sufficient insulin, a hormone secreted by beta cells in the pancreas. Insulin allows your body to use sugar from carbohydrates for energy. It also helps your body store glucose for future use and keeps your blood sugar level from getting too high or too low, says Dr. Mary Vouyiouklis Kellis, an endocrinologist at the Cleveland Clinic. Type 1 diabetes is often inherited. It’s commonly diagnosed in children and young adults who were born with it, which is why it was once called juvenile diabetes, Kellis says. Doctors can, however, diagnose it in adults.
3. Type 2 diabetes
Is by far the most common kind of diabetes, says Dr. Jay Skyler, deputy director for clinical research and academic programs in the Diabetes Research Institute at the University of Miami in Florida. About 95 percent of people with diabetes have Type 2 diabetes, also known as non-insulin dependent diabetes, Skyler says. Unlike insulin-dependent diabetes, people with non-insulin dependent diabetes are able to produce some of their own insulin, but their bodies are unable to use this insulin to completely control blood sugar levels, he says. This is known as insulin resistance. Unhealthy life choices, like not exercising, eating too many unhealthy goods and carrying too much weight, can contribute to a diagnosis of Type 2 diabetes. It usually develops after age 35, although it can occur in younger people as well, especially if they are overweight and have a sedentary lifestyle, Skyler says. Commonly referred to as “adult onset” diabetes, 80 percent of those with this form of diabetes are overweight and have a family history of Type 2 diabetes. Certain ethnic groups have a higher risk of developing this form of the disease, including African-Americans, Hispanics and American Indians, he says. In addition, women who had diabetes during pregnancy are at greater risk of developing Type 2 diabetes later in life.
4. Gestational diabetes. This kind of diabetes only affects pregnant women. Specifically, pregnant women who have never had diabetes but who have high blood sugar levels during pregnancy are considered to have gestational diabetes, according to the American Diabetes Association. The prevalence of gestational diabetes is as high as 9 percent among all pregnant women, according to a 2014 analysis by the CDC. Gestational diabetes starts when your body can’t make and use all the insulin it needs for pregnancy. Lacking sufficient insulin, glucose can’t leave the blood and be converted to energy, according to the ADA. Therefore, glucose reaches high levels in the blood, causing hyperglycemia. Untreated or poorly controlled gestational diabetes can give your baby high blood glucose levels. This causes the baby’s pancreas to produce extra insulin to get rid of the blood glucose. Babies with excess insulin become children who are risk for obesity or adults who are at risk for Type 2 diabetes.