Back to basics: types of diabetes |
Diabetes Forecast, April, 2005 by Shauna S. Roberts |
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| This month we are focusing on the two main types of diabetes: type 1 and type 2. |
| Diabetes is not one disease, but many. All share an important feature: Glucose, a kind of sugar, builds up in the blood. It then can damage organs, raise the risk of infection, and just plain make you feel bad. |
| Sometimes people get diabetes because they have a gene that makes them more likely to develop problems with insulin-producing beta cells. Other people have a defect in the insulin-detecting sensors on cells. |
| Injuries to the pancreas and diseases that damage it sometimes cause diabetes. Abnormal amounts of certain hormones and some drugs can cause high blood glucose levels that lead to diabetes. Pregnancy can bring on a temporary form of diabetes called gestational diabetes. |
| No matter what kind of diabetes a person has, high blood glucose levels are harmful. So treatment includes bringing blood glucose levels down. For this reason, people with other kinds of diabetes generally follow a type 1-like or type 2-like treatment program, depending on which form of diabetes theirs resembles. |
| Although there are many kinds of diabetes, most likely you have type 1 or type 2, the most common ones. In both cases, good blood glucose control can help people live long, productive, and healthy lives. |
| * Type 1 diabetes affects 5 to 10 percent of people with diabetes. People with type 1 must take insulin to survive. (Insulin is a hormone that helps the body's cells take glucose, their energy source, from the blood.) |
| * Type 2 diabetes affects 90 to 95 percent of people with diabetes. People with type 2 diabetes have what is called insulin resistance. Their bodies are less "sensitive" to insulin and do not use it properly. Treatment varies from person to person. |
| Type 1 Diabetes |
| Type 1 diabetes occurs when beta cells in the pancreas are destroyed. Beta cells are essential because they make insulin. Without insulin, cells do not take in glucose. Glucose then builds up in the blood. |
| The most common cause of type 1 diabetes is "autoimmunity." Autoimmunity occurs when the body's immune system, which guards against bacteria, fungi, viruses, and other harmful organisms, also attacks its own cells. In autoimmune type 1 diabetes, the immune system attacks the beta cells and destroys them. |
| Type 1 diabetes often starts in childhood or the teen years. Treatment of type 1 diabetes has several parts. All aim to keep blood glucose levels as close to normal as possible. |
| * First, people must take insulin shots. Insulin helps cells take in glucose, reducing glucose levels in the blood. |
| * Second, people should follow a meal plan that they create with a dietitian. Because foods containing carbohydrates raise blood glucose levels, the meal plan specifies how much carbohydrate to eat. If people take the same amount of insulin each day, then they should also eat meals of the same size and same carbohydrate content at the same times each day. Because diabetes greatly raises the risk of heart disease, the diet should be heart-healthy. That is, it should be low in cholesterol and saturated fats (both of which come mostly from animal foods) and low in salt, and it should contain a variety of whole grains, fruits, and vegetables. |
| * Third, regular exercise can bring down blood glucose levels. But it's vital that people discuss any exercise program with their doctors before starting. Your doctor can help you decide which exercises are safest for you and which time of day to exercise. He or she can tell you when to check your blood glucose levels. Your doctor can also teach you how to adjust your insulin doses to account for your meals and exercise patterns. |
| Type 2 Diabetes |
| Type 2 diabetes has several causes. Being overweight or having excess fat on the abdomen increases the risk of type 2 diabetes, in part because both conditions can cause insulin resistance. Getting older and not being physically active also increase the risk of diabetes. A tendency to get type 2 diabetes can be inherited. |
| Until recently, type 2 diabetes was a disease of middle-aged and older people. But Americans are getting heavier. As a result, type 2 diabetes is occurring earlier, sometimes even in childhood. |
| Type 2 diabetes has no cure. But blood glucose levels sometimes return to normal in people who take excess weight off and keep it off. |
| Treatment of type 2 diabetes varies. The goals of treatment are to lower blood glucose levels and to reduce insulin resistance. Several actions can help with one or both goals: |
| * People who are overweight or have excess abdominal fat should lose weight. |
| * Exercise is a good idea for almost everyone with type 2 diabetes. For safety reasons, you should plan your exercise program with the help of your doctor. |
| * People with type 2 diabetes should follow a heart-healthy eating plan (described earlier). Most people with type 2 diabetes are overweight, so their plan should be a reduced-calorie one. |
| People who take insulin need to coordinate insulin doses with food intake and time of meals. A dietitian can help you create a meal plan that fits your needs and preferences. |
| * Some people need one or more drugs. There are several different kinds of diabetes pills that work in different ways. Many people with type 2 eventually require insulin injections to maintain healthy blood glucose levels. |
| COPYRIGHT 2005 American Diabetes Association |
| COPYRIGHT 2005 Gale Group |
