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Type 1 or Type 2 Diabetes?

After diabetes is diagnosed, other tests will be required to determine what type of diabetes you have. If you're insulin deficient, you will need insulin replacement therapy with injections (type 1). If you are insulin resistant, adjustments to your diet and lifestyle, or in some cases oral medication may be all that is required (type 2).

Type 1 Diabetes

Although type 1 diabetes (often called juvenile onset diabetes) used to be categorized as a childhood or young adult disease, it can occur at any age. Type 1 diabetes symptoms begin out of nowhere and can develop over just a few days. If the person doesn't have a family history of the disease, the possibility of diabetes may not even be considered. Statistical studies show that the average age for the onset of type 1 diabetes is 14 years.

Type 2 Diabetes

Physical health appears to be the key to this syndrome — eighty percent of type 2 diabetics are overweight and physically inactive. This was once thought to be a middle-aged disease, but since childhood obesity has been on the rise, cases of type 2 diabetes are being diagnosed at every age. However, the majority of type 2 diabetics are still over 55.

Some high-risk groups of people are inclined to develop the syndrome:

people whose parents, brothers or sisters have the syndrome
Americans of African, Alaska Native, American Indian, Asian, Hispanic, or Pacific Islander descent in the U.S.
women who have given birth to a baby weighing more than 9 pounds
women who have had diabetes during pregnancy (gestational diabetes).

Type 2 diabetes is a gradual syndrome with the signs of diabetes developing over years. Although the person may experience excessive urination and thirst, there may be no other apparent diabetic signs. Weight loss and hunger may go unnoticed. For this reason, annual screening for the disease after age 45 is a good idea, especially for anyone who is in a high-risk category.

Type 2 Diabetes and Childhood Obesity

Type 2 diabetes is often called adult onset diabetes because it is most often diagnosed after the age of forty. However, the disease is being diagnosed more frequently in children. Childhood obesity and lack of exercise have been blamed for recent increases in cases of childhood type 2 diabetes.

Eleven percent of American children suffer from childhood obesity, with an even higher percentage considered overweight but not obese. Type 2 diabetes is becoming a serious health risk for many youngsters.

How is the Type of Diabetes Determined?

Basically, type 1 diabetics do not have enough of the blood hormone insulin. In contrast, type 2 diabetics can produce enough insulin, but they are not able to use it properly. One commonly used test evaluates the blood for the presence of a chemical called c-peptide, which is produced in amounts equal to insulin. If insulin production is low or non-existent, the amount of c-peptide in the blood will mirror this. A negative or very low result suggests type 1 diabetes. Those with type 2 diabetes often have c-peptide levels falling into the normal range.

Gestational Diabetes

Between two and five percent of all pregnant women are diagnosed with gestational diabetes, a condition that usually disappears after the birth of the baby. Gestational diabetes occurs when hormones produced by the placenta block the mother's ability to use her body's insulin properly. As the mother's blood sugar level rises, the baby responds by increasing its own insulin production, which causes the baby to gain weight at an abnormal rate.

Risks of Gestational Diabetes: Untreated gestational diabetes poses serious risks for both the mother and her unborn child. Here are some of the possible complications:

The baby may grow too large for a normal vaginal delivery, requiring a C-section.
Premature delivery may occur, caused by the baby's large size.
The baby may be born with Respiratory Distress Syndrome or jaundice.
The mother may develop toxemia and complications caused by high blood pressure.
The risk of infection increases.
After birth, the baby's increased insulin production may cause a sudden drop in the baby's blood sugar, resulting in hypoglycemia.
The mother runs a greater risk of developing type 2 diabetes in later life.

Gestational Diabetes Symptoms

It would make sense if gestational diabetes symptoms resembled the symptoms of type 2 diabetes, but they don't. In fact, gestational diabetes symptoms are rarely noticeable. The only way to tell if a woman has gestational diabetes is to perform a glucose tolerance test.

Resources

Centers for Disease Control and Prevention. (2001). Diabetes public health resource: Frequently asked questions. Retrieved May 15, 2001, from www.cdc.gov/diabetes/faqs.htm.

National Institutes of Diabetes & Digestive & Kidney Diseases. (nd). Your guide to diabetes: Type 1 and type 2. Retrieved August 25, 2003, from diabetes.niddk.nih.gov/dm/pubs/type1and2/index.htm.

National Institute of Child Health & Human Development. (2000, December). Are you at risk for gestational diabetes? [NIH Pub. No. 00-4818].

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