Don’t be fooled by stereotypes—both main types of diabetes (1 and 2) can occur at any weight or age.
Type 2 Diabetes
Type 2 diabetes is far more common, diagnosed in 90 percent of people with diabetes, frequently among older people and those with excess weight. If you have been diagnosed but have never had diabetic ketoacidosis (DKA) from high blood sugars, and are responding well to a treatment without insulin, then you likely have type 2 diabetes.
Treatments include eating fewer carbohydrates, increasing activity levels, and taking non-insulin medications, especially one that contains metformin. Many people with type 2 diabetes also take insulin if their body cannot produce enough to manage their sugar levels. Going on insulin does not mean you have developed type 1 diabetes.
Pre-Diabetes or Gestational Diabetes
Type 2 diabetes [develops] along a continuum as the body loses its ability over time to manage blood sugars. When this process begins, before it reaches the clinical definition of type 2 diabetes, we call it pre-diabetes.
When the process starts during pregnancy, it is called gestational diabetes. Without action, pre-diabetes and gestational diabetes almost always lead to type 2. If you have been diagnosed with one of these conditions, think of it as your chance to halt the progression into type 2 diabetes.
Many people are only diagnosed with type 2 when they experience a complication such as nerve damage in their fingers, toes, or eyes. Early knowledge gives you a chance to slow, halt, or even reverse the effects of diabetes.
Type 1 Diabetes If you have had an episode of DKA and take insulin, you likely have type 1 diabetes.This is more common in children and young adults. If in doubt, ask your doctor to confirm the diagnosis with two tests.
The first is aGAD antibodies test. When positive, it indicates that your body is creating antibodies to attack the cells that we know are damaged in people with type 1 diabetes. The second is C-Peptide test, which determines how much insulin your body is producing. The test requires a simple blood draw, and should be done when your sugars are above 100 mg/dL.
The C-Peptide test is not widely available, and should be done by a diabetes specialist or someone who is familiar with ordering the test and interpreting the results. It is not a perfect tool for diagnosis, as most people with type 1 diabetes continue to produce some insulin, especially in the first couple of years. If you have type 1 diabetes, the result will be below the normal range and possibly zero.
If you find yourself quickly moving from a pill to insulin injections, especially if you are in your 20s or 30s, you may have a variation of type 1 diabetes called LADA, for “latentautoimmune diabetes of adulthood.” The treatment is the same as for type 1 diabetes.
Understanding Points vs. Trends
A single number on its own has very little meaning. It’s like looking at a single frame from a movie and thinking that you understand the story.
Diabetes is not about managing individual blood sugars, but about managing how they rise and fall. This distinction is extremely important. For example, your blood sugar is 100 mg/dL and you are getting ready to drive, what do you do? If your blood sugar has been stable at 100 mg/dL for the last hour, probably nothing.
But what if it was 300 mg/dL an hour ago and you treated it with an extra insulin injection? You may be heading towards a severe low blood sugar—and possibly a car accident if you don’t take action to treat the oncoming low by consuming carbohydrates.
Work with your body and learn to manage your diabetes for a healthy and happy life.
Thriving with Diabetes empowers you to take charge of your diabetes, so you don’t just deal with your symptoms, but change the way you think to improve your health, happiness, and quality of life. Through a simple four-step process, people with diabetes learn how to intuitively understand their blood sugars and what causes both good and bad numbers. This proactive approach results in the ability to manage diabetes personally, not just by a set of notes from the doctor.
Written by Dr. Paul Rosman and David Edelman, co-founder of Diabetes Daily,Thriving with Diabetes is not just about eating joyful, satisfying, and diabetes-friendly meals (although that’s certainly part of it!), but also about managing the daily challenges of physical activity, stress, pain, sleep patterns, and other life events that have a major, but underappreciated, impact on blood sugar trends. You’ll also pinpoint your favorite meals and activities and use them as multipliers of success–focusing on the positive rather than the negative. The result is immediate and satisfying improvements to total health, both physically and mentally!