This week marks the beginning of Diabetes Week. This year the main focus is on, the misconceptions people have in terms of what diabetes is and how it affects individuals. The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014.
There are many myths which surround diabetes, that make it hard for others to believe how deadly diabetes can be. Stereotypes and stigmas have created an inaccurate image of what the condition really is. As a diabetic blogger, I feel the responsibility to spread the correct message to my readers. Let’s start by setting the message straight about the different types of diabetes that can occur.
There are many types of diabetes, the main types include; type 1, type 2, gestational diabetes and MODY (Maturity Onset Diabetes of the Young). Diabetes is a long- standing condition that affects the body’s ability to process glucose (sugars). All these types cause blood glucose levels to increase. Glucose levels are high due to the body’s inability to use the glucose properly.
This occurs because the pancreas either:
- No longer produces insulin
- The amount of insulin being produced is not enough, or
- The insulin that is being produced does not work properly (Insulin resistance)
Therefore glucose is not able to enter into the cells and remains in the blood stream.
Type 1
Type 1 is an autoimmune disorder, which occurs due to the body’s immune system attacking and killing beta cells (insulin cells) in the pancreas, where they are made. The reason why this occurs still hasn’t been discovered, however there are researchers constantly working to find out this very reason. This autoimmune disorder is usually diagnosed in children but can also affect people up to the age of 30, resulting in no insulin being produced. People with this condition learn to use insulin therapy to manage their diabetes.
Type 2
Type 2 diabetes is the most common type of diabetes. It occurs due to insulin resistance, where the pancreas either does not produce enough insulin or the insulin that is being produced does not work properly. Type 2 diabetes for some people can be managed through diet and exercise. Some people also need medication to manage their blood glucose levels/ diabetes.
Gestational diabetes
Gestational diabetes affects women during pregnancy. This usually occurs during the second or third trimester. Women who develop gestational diabetes during their pregnancy usually don’t have diabetes beforehand and for some women gestational diabetes disappears after the birth of the baby. Women who are diagnosed with gestational diabetes in the first trimester, there is a possibility that the condition existed beforehand.
During the second trimester blood tests are done to determine whether or not gestational diabetes is present. If gestational diabetes was present in previous pregnancies, then tests are performed earlier.
Pregnancy hormones can affect the body’s ability to allow insulin to function as it should. This can then cause insulin resistance to occur. Pregnancy already puts a huge strain on the body, so this additional strain on the body can sometimes cause some women to develop gestational diabetes. Woman who are likely at risk include, women who have suffered from gestational diabetes before, overweight or obese women, women who have had very large babies and have had a family history of diabetes. Ethnicity also plays a huge part in the development of gestational diabetes. If you are of, Caribbean, South Asia, African or Middle Eastern decent, then you are at a higher risk of developing gestational diabetes.
MODY diabetes or Type 3 diabetes
What is this type? MODY stands for Maturity Onset Diabetes of the Young. This type of diabetes is quite different from both Type 1, Type 2 and gestational diabetes. It is strongly present in families and is triggered by a mutation in a single gene. If a person carrying this gene has a child with a person who doesn’t carry the gene, then any children they have will have a 50 % chance of inheriting the gene. If a child inherits this gene they will then go onto develop MODY before they reach 25 years old, whatever their weight, lifestyle or ethnicity. These diabetic also don’t necessarily need to take insulin either.
Types of MODY:
- HNF1-alpha– this is the most common type of MODY and can be found in populations with European ancestry. It accounts for about 70% of all cases in Europe. People with this type of MODY don’t need to take insulin, instead they take a mixture of sulphonylureas tablets.
- HNF4-alpha– this type of MODY is very rare and usually affects people whose birth weight was more than 9lbs or suffered a low blood sugar level after birth. People who have this type of MODY are also treated with sulphonylureas tablets.
- HNF1-beta – People with this type of MODY develop several problems which can include; renal cysts, abnormalities in uterine, gout as well as diabetes. With this type of MODY, if diabetes develops insulin treatment becomes essential. A healthy diet and exercise must also be followed to manage diabetes better.
- Glucokinase – This gene once present and functioning allows the body to recognise increase in blood glucose levels. If this gene isn’t working then the body isn’t able to detect high blood glucose levels, allowing the BG level to go higher than it should. The BG level is only slightly higher between ( 5 – 8 mmols/l). There are no noticeable symptoms and it can only be detected through routine tests. No treatment is needed for this type of MODY.
It’s extremely important to know if you have any of these MODY types. If treatment is needed then you can then get it. Also if you have the gene, there is a 50 % chance that you could then pass this gene onto your children. Therefore genetic testing usually is extended to other family members.
I hope that this has helped you to understand the different types of diabetes that can occur. For more information on the prevalence of diabetes and also if you want to help to spread the correct message, then click the links below.
Diabetes Awareness Poster (print and share)
You can also follow me on twitter, instagram and facebook.
Thanks for stopping by friends
Amina xx
I am the mother of 5 kids with GCK-MODY and I can tell you that, in some cases there are symptoms. We have the “I’m thirsty, thirsty, thirsty”, constant trips to the bathroom or incontinence issues, massive mood swings, sweats, headaches/migraines (from going too low), growth, and digestive issues. We don’t really fit the stereotypical GCK-MODY case, but I think the issue is more the actual variant. There are other cases in the literature where this is also the case. Finding this was not incidental, but was due to my oldest daughter’s blanking out at school and starting to shout at friends because she was hyperglycemic. We have seen as high as 15.0 (270) and as low as 3.2 (58). At 3.2, my son was curled up in the fetal position screaming about the pain he was in. A handful of chocolate chips and he was okay 15 minutes later. At 12.5 he is lying on the floor telling me he doesn’t feel well and is so exhausted. I have some that forgo carbs at times because they make them feel poorly. My husband has the GCK variant. When he needs to eat, he needs to eat NOW – not two minutes from now. There is also newer research out that indicates a two fold higher miscarriage rate in GCK-MODY mothers as well as an animal study that indicates there could be autonomic function issues. The reality is that without knowing how GCK acts in the brain and intestines as well as how each variant responds to environmental factors, GCK-MODY should not be seen as benign, but should be treated as a case by case basis. If I just had my more controlled GCK-MODY kids (the 8 year old and 10 year old and even they had issues this past winter), I might agree with the comment of no followup, but the reality is that I have three that do need followup, but it is done at the level of our family doctor and pediatrician because the local endo think it is not necessary. Meanwhile, the 12 year old has missed a lot of school due to issues with vomiting this year and the 16 year old has just gotten back into school after two years of chronic migraine. I now have results that indicated her average glucose level when she was really bad was her typical fasting level when she is healthy meaning she was spending way to much time too low for her body to handle – she didn’t die, but was pretty miserable and who knows the long term ramifications of it. And the 6 year old – he is having numbers that “don’t fit with what are expected from GCK-MODY”.
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