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How Many Types of Diabetes is There?

Type 1 Mellitus Diabetes:

Over 300 thousand Canadians have Type 1 diabetes, which used to be called Juvenile diabetes. In the earlier year, they would see this in younger children, usually starting at two years old. They now refer to it as type 1 as they started seeing cases in the early 20,

30, and even 60's years of age. Type 1, also known as IDDM (Insulin-dependent diabetes Mellitus), is when your immune system mistakes the beta cells in your pancreas as a foreign invaders and kills off your betta cells. Your betta cells (Insulin) are like the briefcase of your energy system attaching to glucose and delivering it around the body to provide you with energy; without this briefcase, your body cannot absorb energy. A client with Type 1 diabetes is referred to as insulin-dependent, which


means they must give insulin externally through injection (needle or pump therapy (artificial pancreas) to absorb energy from carbohydrates. If they do not, glucose will accumulate in the bloodstream. In addition, the body will start utilizing fat for fuel. When the body uses fats for fuel, they produce a by-product called ketones; when someone has ketones, it smells like fruity juice or bubble gum. Too much ketone can make your blood acidotic this is too much bicarbonate in the bloodstream or (Co2), and high blood sugar can make you incredibly sick, and even cause death.

Over the years, scientists thought this was due to hereditary markers, so it is passe


d from generation to generation. However, they have started seeing this happen with children and adults with no family history, and now they have stated they believe it has to do with genetics. A client with type 1 can do everything a non-diabetic can do; they just need a little extra planning than most. The use of a CGM (Continuous glucose monitor, a machine that checks glucose levels every 5 minutes) and Pump therapy (artificial pancreas) has made things like exercise much easier for people living with diabetes and reduced their risks of nighttime lows. Low blood sugars can happen especially after exercise; lows or hypoglycemic symptoms are dizziness, confusion, sweating, hungry, thirsty, seizures, and even death. There is no cure for type 1 diabetes, and the actual cause of diabetes is unknown

Type 2 Diabetes Mellitus:

Type 2 is more common than type 1; over 425 million people are living with type 2 worldwide. Type 2 is when the body is unable to use insulin in the body properly, we call this insulin resistant. As I stated above, insulin is the briefcase that distributes insulin into our cells; with type two, the body will overproduce insulin, but the body will not be able to use it, the glucose will accumulate in the blood, which as we know high glucose can be extremely dangerous.

Type 2 can be managed through oral medication, but some are insulin-dependent. Type 2 can be managed through supervised activity and diet by a qualified personal trainer and their team. Type 2 diabetics should still be monitored with exercise the same as a person with type 1 diabetes. They can still have the risk of hyperglycemia (high blood glucose) or hypoglycemia (low glucose), especially if they are on any other medication. This can still affect the way they exercise.

Prediabetes:

This is the stage we start to see higher-than-normal blood glucose levels. It is normal to see glucose levels in a nondiabetic in 5.0mmol – 10mmol. Anything over the 10mmol level is considered high glucose levels, and prediabetes. The doctor would see elevated glucose levels through a fasted glucose test, but they wouldn't be high enough for a diagnosis of type 2 diabetes. There are over 6 million Canadians that are prediabetic. If the client does not manage their glucose level, this can develop into a type 2 diagnosis.


There are 14 different other kinds of diabetes, and it is very common when you have a diabetes diagnosis, especially type 1, that you can get a second autoimmune disease, such as celiac disease.


So, what are the other types of Diabetes?

I. Type 1 Mellitus: Autoimmune disease, insulin-dependent, no cure

a. Also, it is prevalent for someone who has an autoimmune disease to get a second such as Celica, autoimmune gastritis, pernicious anemia, and vitiligo. You see this a lot with a T1D diagnosis. Evan is checked yearly by his endocrinologist for antibodies.

II. Type 2 Mellitus: Insulin resistant, oral medication, and insulin-dependant

III. Diabetes Insipidus: This is due to the imbalance of fluid in the body. This can make you thirsty, you would produce large amounts of urine. You could produce upwards of 19 litres of urine a day, the average adult output is 1-2 litres a day.

IV. Gestational Diabetes: The body doesn't produce enough insulin to regulate glucose levels during pregnancy. Glucose level usually goes back to normal level soon after delivery. There have only been a few cases where it does not return.

V. Brittle Diabetes: This form is very difficult to control. They also call it “Labile Diabetes.” People living with brittle diabetes experience frequent and extreme swings in glucose levels. It’s more common in women than in males. A CGM is highly recommended to monitor highs and lows before they are at a dangerous level.

VI. MODY (maturity-onset diabetes of the young): This form is rare and usually hereditary. This is caused by a mutation of a gene in the body; usually, a parent has this gene and passes it onto the child, and there is usually a 50% chance that the child can inherit this mutation.

VII. Neonatal Diabetes: Babies born or diagnosed under six months are a different kind of diabetes than type 1 diagnosis. This is more common than type 1, and this happens when a gene affects the way insulin is produced. Other complications can arise with this diagnosis, such as delayed learning seizures when you have a neonatal diagnosis. These children don't use insulin for treatment; they are given oral medication to treat.

VIII. Wolfram Syndrome: This is a rare genetic disorder also known as (DIDMOAD syndrome, Diabetes insipidus, diabetes mellitus, optic atrophy, and deafness)

IX. Alstrom Syndrome: rare genetic and inherited, this comes with many complications from vision issues, hearing loss, cardiomyopathy, obesity, T2D, kidney failure, and orthopedic problem. They are prescribed an oral medication.

X. LADA (Latent autoimmune diabetes in adults): This is a mixture of type 1 and types 2 diabetes together; they don't have a classification for this condition. It is often mistaken at first for type 2 at diagnosis, as you can see this in your 50s and 60s.

XI. Type 3 Diabetes: A person with type 2 that develops Alzheimer's.

XII. Type 3c Diabetes: This happens when there is damage to the pancreas, such as acute pancreatitis, pancreatic cancer, cystic fibrosis, or hemochromatosis

XIII. Steroid-induced or drug-induced diabetes: Patients who take steroids for conditions that can develop into a steroid induces diabetes. A condition such as Crohn's disease can develop into diabetes.

XIV. Schmidt Syndrome (Type 1 & Addison’s Disease): This is sometimes used interchangeably with autoimmune polyglandular syndrome type II. Only 1% of the population is at risk of being diagnosed, but the risk for type 1 is significantly higher. Addison’s disease is an adrenal gland insufficiency that happens when the adrenal glands do not produce enough of the hormones cortisol & aldosterone.

XV. Cystic fibrosis diabetes: CF is a condition children are born with. Patients with CF get a build-up of mucus in their lungs and organs. This can cause issues with the pancreas and other organs and can damage the production cells, leading to high glucose levels.

XVI. Pancreatic Cancer: This starts in the cells of the pancreas. Doctors usually find a tumour or cells in the pancreas. Surgery or treatment is usually done, which can make the pancreas no longer viable. Again, the client would be insulin-dependent, among many other issues that may arise from their cancer diagnosis.



References:

Beyond Type 1 Diabetes – Diabetes Education, Support, Resourcesdiao


Diabetes UK – Types of Diabetes


Stollery Children's Hospital – Pediatric Diabetes Education Clinic

- Diabetes Training, Pump Therapy Training, Diabetes Dietitian training


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