Tag: Insulin resistance

What are the different types of diabetes?

diabetes-week2016-11

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 Facts and stats 

Diabetes Awareness Poster (print and share)

You can also follow me on twitter, instagram and facebook.

Thanks for stopping by friends

Amina xx

Type 1 diabetic on Metformin

metformin extraType 1 diabetic? CHECK

Insulin dependent? CHECK 

Taking Metformin?  ERR CHECK

Yup your vision isn’t failing you. I’m a type 1 diabetic on Metformin. I started to take metformin over 4 years ago alongside my insulin pump therapy. I began to notice that my insulin basal doses seemed to be increasing steadily on a monthly basis. In fact my basal doses had more than doubled over a course of 4 months.

So what is Metformin?

Metformin – is a drug, which is usually used to treat type 2 diabetics.  It is commonly given to type 2 patients who are overweight, obese and with normal kidney function. It is also used to treat gestational diabetes and polycystic ovaries.

“So why do I take it?”Metformin1

I wasn’t overweight or obese and I maintained a good healthy weight for several years. So why did I need it all of a sudden?  It just made no sense at all. Being the scientist that I am, I started to look for different research papers which might be related to metformin and type 1 diabetes.  A lot of the papers I came across only made mention of type 2 diabetics taking this drug due to insulin resistance.

Wikipedia states that, Insulin resistance (IR) is a physiological condition in which cells fail to respond to the normal actions of the hormone insulin. The body produces insulin, but the cells in the body become resistant to insulin (through changes in their surface receptors) and are unable to use it as effectively. Beta cells in the pancreas increase their production of insulin, further contributing to hyperglycaemia. This often remains undetected and can contribute to a diagnosis of Type 2 Diabetes.

Could it be that I’d developed some sort of insulin resistance specific to type 1 diabetes? HMMMM!! As I delved deeper, I came across a paper which talked about insulin resistance occurring in type 1 diabetics.  Just like type 2 diabetics, type 1 diabetics are also known to suffer from insulin resistance. Metformin had been mentioned as a drug which was able to lower the amount of insulin required, by helping the body move and use the insulin more efficiently.

So maybe in my case the insulin from my insulin pump wasn’t being used and moved around my body efficiently!

I decided to make an appointment to see both my diabetic doctor and nurse to see what they thought, without telling them the extensive research I’d done. After a lengthy conversation they also came to the conclusion I might be Insulin resistant and suggested that I try Metformin. They explained all the past and recent research done, the success people with both type 1 and 2 diabetes have experienced with this drug.

So I thought,” why not, what’s the worst that can happen?”

Initially, I started to take (500mg metformin, prolonged release tablets), once a day with my evening meal. Almost instantly I noticed that the amount of insulin I had needed prior to metformin began to reduce. I was then advised to increase my dose to (500mg prolonged release twice a day) with my evening meal.

I started to experience different side effects. Some of the good side effects were, my HbA1c dropped from 7.9% to 7.0%. I dropped a few pounds and my insulin requirement continued to decrease drastically. Some of the unpleasant side effects were, severe abdominal pain followed by gas and severe upset stomach, which would then settle after 24 – 48 hours. Later I realised that this was down to sometimes forgetting to take my tablet. So if you make the decision to take metformin, remember not to skip your dose.

I began to think this drug really was amazing! It was reducing my insulin intake, my HbA1c was fantastic and I was in even greater shape than I was before. This all became extremely important because my husband and I had made the decision to try to conceive. When I finally conceived, I continued to take metformin for the first 4 months of my pregnancy. I then stopped taking it completely until nearly a year after my pregnancy. I’ll go further into this when I do my post on diabetes and pregnancy.

As a type 1 diabetic, if you’re considering metformin, I’d definitely recommend talking to your doctor first. “Do your own research, prepare questions to ask your doctor. Be prepared!” After all it is your body. You must remember that, we all react to medication in different ways and you may or may not have the same results that I did. However, I strongly feel that the metformin played a great part in reducing my HbA1c and also more than halving my insulin basal dose. Perhaps the metformin combined with other factors such as eating a low carb diet, exercising and eating healthily, which I was doing prior to taking metformin helped to achieve good results with the drug.