Educate Educate Educate

June 28th, 2011 by Amy Gonsalves Leave a reply »

There is a lot of education required to live well with any diabetes diagnosis, from pre-diabetes to type one diabetes. 

I tried to explain what life is like to a group of nursing students yesterday in an hour and a half.  You can imagine how little I was able to explain! 

Beyond our own diabetes, we need to educate others about our disease.  I think it helps cut down on misunderstandings, eradicate myths, and hopefully increase support.

Yet, in a quick conversation about diabetes I rarely get beyond explaining there are two types with different pathology and management.

So when Joslin blogged today about the SEVERAL known types of diabetes that exist today I thought I would share the information.  I think it’s useful for a lot of us to know, in light of news articles about cures and treatments that surface nearly every day and our friends and family send our way. 

If you don’t have time to read the entire article, I’ll give you the six broad types they include:

–          Gestational

–          Type 1 (autoimmune)

–          Type 2 (not autoimmune)

–          LADA (latent autoimmune diabetes in adults)

–          MODY (maturity onset diabetes of the young)

–          NDM (neonatal diabetes mellitus)

I find this information fascinating; like I said, I’m not going to explain it to someone in an elevator as we travel together for a few moments, but it helps me figure out some of the wacky information I’ve seen and heard through the years.

Maybe you’ll find it useful too.

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HOW MANY TYPES OF DIABETES ARE THERE?

This is a question that we get asked regularly.

If we asked this question to the general population twenty years ago, a majority probably wouldn’t have any idea.  But today, unfortunately, so many people have diabetes that everyone seems to at least have heard of  type 1 and type 2.

And—due to the rising rate of obesity in pregnant women—the public is becoming much more familiar with gestational diabetes.

However, when you get to the details of this complex disease, things get less and less clear cut—not only how many types of diabetes there are, but also how they’re characterized.

For example, type 1 is an autoimmune disease, and people require insulin at diagnosis. Usually the diagnosis is in childhood, adolescence or early adulthood, but not always (people can be diagnosed with type 1 at any age).

Type 2 isn’t autoimmune,  and it may take years before a person requires insulin, if at all—and patients are usually older and often overweight, but again this is a generality, particularly as the number of people who are obese grows and gets younger.

Gestational diabetes occurs during pregnancy and blood glucose returns to normal after delivery, but often it doesn’t.

In addition, researchers have discovered another category of diabetes called latent autoimmune diabetes in adults (LADA). Think of LADA as a slowly progressing version of type 1 with some of the characteristics of type 2.  In fact, some people call it type 1.5.

People with LADA have antibodies to the disease like those with type 1 but they don’t need insulin right away.  Their blood glucose can be controlled on lifestyle or oral agents for months or sometimes years.

There’s more.  Type 1, 2, gestational diabetes and LADA are polygenic—this means that it takes the involvement of many genes to cause the disease.  But there are other, much rarer forms of diabetes that are monogenic, meaning a change in only one gene is responsible for the condition. There are two types of conditions in this category: Maturity Onset Diabetes of the Young  (MODY) and Neonatal Diabetes Mellitus (NDM).

MODY

Between 1 and 5% of people diagnosed with diabetes are thought to have MODY.

MODY usually presents in childhood or adolescence but because its symptoms are often mild, many are not diagnosed until much later.  Unlike those with type 2, people with MODY are usually of normal weight and don’t have high blood pressure or high cholesterol levels.

Physicians may start to consider a diagnosis of MODY and do genetic testing if there is a history of diabetes in successive generations in the family—grandparent, parent and child.  Most often people with MODY can be treated with lifestyle or oral agents.

NDM

Type 1 diabetes is diagnosed after 6 months of age.  But there is a rare condition called neonatal diabetes mellitus that can occur from birth to 6 months.  Unlike other forms of diabetes, about half of the cases of NDM are temporary.  This type of diabetes will disappear in infancy, although it may come back in adulthood.  The other half of the cases will continue to have diabetes throughout their lives.

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