Diabetes mellitus is a metabolic disease that causes high blood sugar. Your body either doesn’t make enough insulin or can’t effectively use the insulin it makes.
The hormone insulin moves sugar from the blood into your cells to be stored or used for energy. If this malfunctions, you may have diabetes.
Untreated high blood sugar from diabetes can damage your nerves, eyes, kidneys, and other organs. But educating yourself about diabetes and taking steps to prevent or manage it can help you protect your health.
There are a few different types of diabetes:
- Type 1: Type 1 diabetes is an autoimmune disease. The immune system attacks and destroys cells in the pancreas, where insulin is made. It’s unclear what causes this attack, but in the past decade researchers have developed a 3-stage classification for the onset of this autoimmune condition, leading from pre-clinical lab diagnostic testing to when you may notice symptoms and begin treating T1D.
- Type 2: Type 2 diabetes occurs when your body becomes resistant to insulin, and sugar builds up in your blood. It’s the most common type—about
90% to 95% of people living with diabetes have type 2. - Type 1.5: More commonly known as latent autoimmune diabetes in adults (LADA), this type occurs during adulthood and sets in gradually like type 2 diabetes. LADA is an autoimmune disease that is similar to T1D in nature and cannot be treated by eating or lifestyle changes, but can have a gradual onset like T2D.
- Gestational: Gestational diabetes is high blood sugar during pregnancy. Insulin-blocking hormones produced by the placenta cause this type of diabetes.
A rare condition called diabetes insipidus is not related to diabetes mellitus, although it has a similar name. It’s a different condition in which your kidneys remove too much fluid from your body.
Each type of diabetes has unique symptoms, causes, and treatments.
Prediabetes is the term that’s used when your blood sugar is higher than expected, but it’s not high enough for a diagnosis of type 2 diabetes. It occurs when the cells in your body don’t respond to insulin the way they should. This can lead to type 2 diabetes down the road.
Experts suggest that more than
Diabetes symptoms are caused by rising blood sugar.
General symptoms
The symptoms of type 1, type 2, and LADA are the same, but T1D symptoms develop in a shorter period than LADA and T2D. The other types often develop more gradually.
In T2D, the onset tends to be slower, and tingling nerves and slow-healing sores are more common.
The general symptoms of diabetes include:
- increased hunger
- increased thirst
- weight loss
- frequent urination
- blurry vision
- extreme fatigue
- sores that don’t heal
Left untreated, T1D can lead to diabetic ketoacidosis. This is a medical emergency when there is a dangerous level of ketones in the body. It’s less common in other types of diabetes, but still possible.
Stages of T1D
Since 2015, researchers and the diabetes medical community have divided T1D’s onset into three stages:
- Stage 1: Pre-clinical. You may test positive for 2 or more diabetes-related autoantibodies. The immune system has already begun attacking the insulin-producing beta cells, although there are no symptoms and blood sugar remains normal.
- Stage 2: Pre-clinical. Like Stage 1, in this stage you may test positive for 2 more diabetes-related autoantibodies. Blood sugar levels are higher due to the gradual loss of beta cell function, but there are no other symptoms.
- Stage 3: Symptoms develop. This is where people may notice symptoms and a clinical diagnosis may take place. Insulin-producing beta cells has led to symptoms that can become life threatening quickly.
Different causes are associated with each type of diabetes.
| Type 1 | Type 2 | LADA | Gestinational | |
|---|---|---|---|---|
| Causes | Not fully understood. Genetics and environmental factors are likely involved | Combination of genetics and lifestyle factors | Not fully understood. Genetics and environmental factors are likely involved | Hormonal changes during pregnancy cause cells to become less sensitive to insulin |
| Risk factors | Family history, obesity, and weight gain before or during pregnancy | Race, ethnicity, family history, obesity, physical activity habits, age, prediabetes | Family history of T1D, genetics, possible environmental causes such as illness | 25 or older, family history, obesity, and weight gain before or during pregnancy |
| Common long-term complications | Nerve damage, eye disease, kidney damage | Nerve damage, eye disease, kidney damage | same as T1D | hypertension, pre-term labor, preclampsia, birth and baby complications |
| Treatments | insulin required | lifestyle changes, pills, non-insulin injections, possible insulin therapy | insulin required, but may not be as immediate as T1D | Lifestyle changes, insulin therapy |
The short answer: You can develop any type of diabetes at any age.
While T1D was once viewed as “juvenile diabetes” in children, the modern understanding is that this autoimmune condition can develop at any age. That is largely what’s led to the
Type 2 can
The same goes for gestational diabetes, which is most often diagnosed in those 25 and older but can also be seen in pregnant people who are younger than their mid-20s.
High blood sugar damages organs and tissues throughout your body. The higher your blood sugar is and the longer you live with it, the greater your risk for complications.
Possible long-term complications of any type of diabetes diabetes can include:
- heart disease, heart attack, and stroke
- neuropathy
- nephropathy
- retinopathy and vision loss
- hearing loss
- foot damage, such as infections and sores that don’t heal
- skin conditions, such as bacterial and fungal infections
- depression
- dementia
Gestational diabetes
Unmanaged gestational diabetes can lead to problems that affect both the mother and baby. Complications affecting the baby can include:
- premature birth
- higher-than-typical weight at birth
- increased risk for type 2 diabetes later in life
- low blood sugar
- jaundice
- stillbirth
A pregnant person with gestational diabetes can develop complications such as high blood pressure (preeclampsia) or type 2 diabetes. You may also require cesarean delivery, commonly referred to as a C-section.
There is also a
Treating diabetes depends largely on the type.
For those with T1D and LADA, you must take insulin. This may be through injections, prefilled insulin pens, an insulin pump device, or inhaled insulin.
LADA can be challenging to treat because it may be misdiagnosed as T2D, and your need for insulin may be masked at the time of diagnosis. This means your doctor may not immediately prescribe insulin if you’re being or have been diagnosed already with T2D.
But as other treatments don’t work as effectively, that may eventually lead to a correct LADA diagnosis and insulin use.
For T2D, you may not need insulin to treat the condition. Depending on many factors, your doctor may prescribe eating or exercise changes to manage the condition. They may also prescribe pills or other medications that are not insulin.
But many people with T2D effectively manage their condition with insulin, and this is not a signal that you’ve done anything wrong or that you are to blame for needing insulin. Your healthcare team should not discourage insulin if you have T2D if other treatment options have not allowed you to manage the condition effectively.
If you receive a diagnosis of gestational diabetes, you’ll need to monitor your blood sugar level several times per day during pregnancy. If it’s high, dietary changes and exercise may be enough to bring it down.
Research has found that about
What is insulin?
Insulin is a hormone that helps regulate blood sugar levels. However, for people with diabetes, the body doesn’t produce or use this hormone effectively, and you need to supplement that natural process.
Various types of insulin exist. They come in different brands and work differently, from how quickly they start to work to how long their effects last.
- Rapid-acting insulin: starts to work within 15 minutes and its effects last for 2 to 4 hours
- Short-acting insulin: starts to work within 30 minutes and lasts 3 to 6 hours
- Intermediate-acting insulin: starts to work within 2 to 4 hours and lasts 12 to 18 hours
- Long-acting insulin: starts to work 2 hours after injection and lasts up to 24 hours
- Ultra-long acting insulin: starts to work 6 hours after injection and lasts 36 hours or more
- Premixed insulin: starts working within 15 to 30 minutes (depending on whether a rapid-acting or short-acting insulin is part of the mix) and lasts 10 to 16 hours
Healthy eating is an essential part of diabetes management.
Your blood sugar level rises or falls based on what you eat and drink. Starchy or sugary foods and beverages make blood sugar levels rise rapidly. Protein and fat cause more gradual increases.
Counting carbohydrates is an important part of eating for those with diabetes who take insulin and manage their blood sugar levels. A dietitian or nutritionist can help you figure out how many grams of carbs to eat at each meal.
Your medical team may recommend that you limit the amount of carbohydrates you eat each day. You’ll also need to balance your carb intake with your insulin doses. Counting carbs helps to balance the carb intake with the insulin doses.
In some cases, changing your eating habits may be enough to manage the disease.
Your physical activity levels also play a big role in diabetes management, no matter the type.
Staying active helps your cells react to insulin more effectively and lowers your blood sugar levels. Exercising regularly can also help you:
- reach and maintain a healthy weight
- reduce your risk of diabetes-related health complications
- boost mood
- get better sleep
- improve memory
If you have type 1 or type 2 diabetes, general guidance is to aim for at least 150 minutes of moderate-intensity exercise each week.
There are currently no separate exercise guidelines for people who have gestational diabetes. But if you’re pregnant, start out slowly and gradually increase your activity level over time to avoid overdoing it.
Talk with your doctor about safe ways to incorporate activity into your diabetes management plan. You may need to take special precautions, like checking your blood sugar before and after working out and staying hydrated.
Here are the types of doctors and healthcare professionals you may need as part of your diabetes care team.
If you don’t already have a primary care specialist, you can browse doctors in your area through the Healthline FindCare tool.
Anyone who has symptoms of diabetes or is at risk for the condition should be tested. People are routinely tested for gestational diabetes during their second trimester or third trimester of pregnancy.
Doctors use these blood tests to diagnose prediabetes and diabetes:
- The fasting plasma glucose (FPG) test measures your blood sugar after you’ve fasted for 8 hours.
- The A1C test provides a snapshot of your blood sugar levels over the previous 3 months.
- A 75-gram oral glucose tolerance test is also used. This checks the BG 2 hours after ingesting a sugary drink containing 75 grams of carbs.
How to diagnose gestational diabetes
To diagnose gestational diabetes, your doctor will test your blood sugar levels between the 24th week and 28th week of pregnancy. There are two types of tests:
- Glucose challenge test: During a glucose challenge test, your blood sugar is checked an hour after you drink a sugary liquid. If your results are standard, no more testing is done. If blood sugar levels are high, you’ll need to undergo a glucose tolerance test.
- Glucose tolerance test: During a glucose tolerance test, your blood sugar is checked after you fast overnight. Then, you’re given a sugary drink, and your blood sugar is re-tested after 1 hour and again after 2 hours. Gestational diabetes is diagnosed if any of these three readings indicate high blood sugar.
The earlier you are diagnosed with diabetes, the sooner you can start treatment. Find out whether you should get tested, and get more information on tests your doctor might perform.
Neither T1D or LADA are preventable, because they are autoimmune conditions.
People who’ve never had diabetes can also suddenly develop gestational diabetes during pregnancy. Hormones produced by the placenta can make your body more resistant to the effects of insulin.
You can lower your risk of developing T2D, though it isn’t guaranteed that you can always prevent it because there are genetic and age-related links between how and why it develops in certain people.
However, some T2D risk factors are manageable.
Most diabetes prevention strategies involve making simple adjustments to your eating habits and fitness routine.
If you’ve received a diagnosis of prediabetes, here are a few things you can do to delay or prevent T2D:
- Get at least 150 minutes per week of aerobic exercises like walking or cycling.
- Cut saturated and trans fats, along with refined carbohydrates, out of your diet.
- Eat more fruits, vegetables, and whole grains.
- Eat smaller portions.
- Try to lose
5% to 7% of your body weight if you are overweight or live with obesity.
There are a few main types of diabetes, and while they differ, they involve blood sugar regulation in your body. Type 1 and adult-diagnosed LADA require insulin, while those with both T2D and gestational diabetes during pregnancy may be able to manage the condition without insulin.
The main components of managing diabetes are blood sugar monitoring, eating habits, physical activity levels, and mental health considerations.
Discuss potential diabetes risks with your doctor. If you’re at risk, have your blood sugar tested and follow your doctor’s advice for managing your blood sugar.