There are more than just two types of Diabetes, but types 1 and 2 are the most common. 90% of people with diabetes have type 2, and around 8% have type 1.
The rarer forms of diabetes make up the remaining 2% and are listed below. You can read about them more in detail here. Whilst there is no cure for the condition, most people with diabetes can expect to lead an active, fulfilling life with the correct management and treatment plan.
- Type 3
- Neonatal diabetes
- Double diabetes
- MODY diabetes
- Gestational diabetes
- LADA diabetes
- Diabetes Insipidus
- Brittle diabetes
- Drug induced diabetes, e.g steroids
Type 1 Diabetes is an autoimmune condition caused by a fault with the body’s immune response. The immune system mistakenly attacks and kills beta cells within the pancreas which are the cells responsible for insulin production, and as they deplete over time , the body stops being able to produce insulin which is when the symptoms of diabetes begin to appear. Currently, our understanding of type 1 is that it is caused by several different variants including genes and environmental factors such as low levels of vitamin D and viral infections which may trigger the disease.
A person with type 1 diabetes will need to take insulin for the rest of their life. This type is not preventable through diet and is predetermined by the above variants leading to the body being unable to naturally produce the hormone insulin. This is one of the key differences between the two types – Type 2 diabetes is largely preventable by leading an active lifestyle and avoiding a sugar rich diet, but if you have type 1 diabetes, your immune system has already decided on a different route of avoiding insulin production by mistakenly attacking the cells in your pancreas. Another key difference here is that the triggers for developing type 1 are beyond your control – there is no amount of sugar you could consume that would lead you to develop type 1 diabetes, whereas the same cannot be said for type 2. Remaining active, not smoking and eating a well balanced diet will give you the best chances of preventing type 2 diabetes.
Have you heard of honeymooning?
The honeymoon period isn’t exclusive to a budding new romance – it also exists after some people first receive their type 1 diagnosis, and it can be quite the misnomer.
When someone first starts insulin treatment after receiving a type 1 diagnosis, their blood sugar can revert back to normal and their symptoms may disappear or wane, giving the impression that their diabetes has gone into remission, or ceased altogether. Doctors call this the honeymoon phase.
It happens when some of the insulin producing beta cells still function, and whilst they continue to do their job, the need for synthetic or additional insulin may not be as necessary. The honeymoon period can vary from weeks to years; as well as be intermittent for a period of time. In time, the remaining insulin cells will stop working.
During the honeymoon phase, diabetes still needs to be taken seriously, even though all of the symptoms may not be presenting. Managing insulin and blood glucose (sugar) levels isn’t entirely straightforward – it can consume a lot of time and comes with its own challenges, which have recently been met with a “bio hacking” response by the type 1 community who have turned to algorithms and continuous glucose monitors (CGM’s) to create a fascinating device known as the artificial pancreas. The potentially life altering technology has revolutionised the way blood glucose levels are controlled in type 1 diabetics, and has been hailed as more effective than any current technology. You can read more about the artificial pancreas system here.
This type of diabetes is largely preventable, and is influenced mostly by diet and levels of physical activity, with a smaller genetic component. It happens when the body becomes resistant to insulin, or can’t make enough of it, and is not classed as an autoimmune condition. The number of people with type 2 diabetes has been increasing consistently and has reached roughly 500 million globally.
With type 2, your body can still break down carbohydrates and turn that into glucose, but without enough being absorbed into your cells. Since the process doesn’t run smoothly, glucose stays in the bloodstream rather than being properly absorbed, which then leads to diabetes symptoms.
The good news is that research into type 2 diabetes is proving that not only is it possible to prevent type 2 diabetes, reversal is also possible too.
10 years ago, Prof. Roy Taylor put forward the “twin cycle” hypothesis, which he and his team of researchers at Newcastle University are working to put into action in their ongoing Diabetes Remission Clinical Trial (DiRECT).
The “twin cycle” hypothesis argues that type 2 diabetes is a result of long term excess calories causing a build up of fat in both the liver and pancreas. The fatty liver responds poorly to insulin and produces too much glucose; meanwhile the beta cells within the fatty pancreas begin to fail in their insulin production. Both of these mechanisms lead to a raised blood glucose level as seen in type 2 diabetes. You can read the specifics of these findings here, but the conclusion of the study appears to be that type 2 diabetes reversal is possible with short term calorie restriction followed by longer term dietary changes and patient perseverance.