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.

For more information

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12 Responses to How Many Types of Diabetes Are There?

  1. n tavascia says:

    i’d like to learn more about hyperglycimia.

  2. Scott Doerner says:

    there is also a type of diabetes that is similar to type 1 but is not auto immune. I know of 2 people that have it. It is brought on by an accident, that does damage to the pancreas. my one friend was an electrician and had a major electrical shock, was hospitalized, then was insulin dependent, He was a good weight and very healthy.

  3. Kathleen Hatt says:

    People with cystic fibrosis often become insulin-dependent diabetics. What is diabetes in people with cystic fibrosis called?

  4. Dorothy L. Rodriguez says:

    How interesting! I’ve learned a lot about diabetes since my daughter was diagnosed almost 8 years ago when she was not quite 5, but I had never heard of LADA, MODY or NDM. Neither did I know that Type 2 diabetes is NOT autoimmune. Thanks!

  5. jan sullivan says:

    was diagnosed 4 yrs ago (at age 60) with type 2 diabetes. ended up in ICU for 3 days, dehydrated, electroloytes gone crazy. never passed out/went into coma, but b.s was very high.
    have had dehydration 4 times, and acute kidney failure last fall (determined to be from taking small amount of tylenol for pain–they also gave me tylenol in hospital, until a friend reminded me i had severe reactions to all nSAIDS. i stopped the tylenol, ama, and immediately began to get better! kidney numbers almost back to normal.
    no family history of diabetes.
    no warning before diagnosis, hospitalization.
    have to take insulin when on prednisone or antibiotics
    spiking occurs and it seems random.
    not overweight.
    count carbs meticulously. NEVER over 150/dau
    have knee injury which currently prevents me from getting the amount of exercise i need–
    so what kind of diabetes do i have?
    thanks for any tips!!!! would really like to have more control over this disease!
    what kind of diabetes do i have??

  6. Diabetes can also be a symptom of Cushing’s syndrome, an endocrine disorder in which the body is exposed to excess levels of the steroid hormone cortisol for an extended period of time. To learn more about Cushing’s, visit the Cushing’s Support and Research Foundation, http://www.csrf.net.

  7. Pingback: Diabetes Symptoms and also Treatment: What There is To Do |

  8. Pingback: What is Diabetes? The Difference Between Type 1 and Type 2 | Joslin Diabetes Center Blog

  9. Franksr says:

    I’ve just been diagnosed with Diabetes as my A1C was 12.4 and my Blood Sugar was 389. However my Auto immune diabetes was Negative. Going in today for a abdominal pelvic CT Scan to check pancreas and liver. Then tomorrow I start on Metformin. Any thoughts on all of this? I have no idea what is going on but I feel fine.

  10. Phil Short says:

    I have Sarcoidosis – an autoimmune condition. Since diagnosis with that I also developed diabetes. At first I was diagnosed and put onto insulin, and they couldn’t decide if I was type I or II. In the end they diagnosed type II. Or maybe steroid induced. I got my BS under control withing a couple of months and came off insulin and onto metformin, which worked for 18 months or so, then my BS started to go awol again. I was prescribed Gliclazide to “squeeze” my pancreas, but it had absolutely no effect whatsoever. I am now back on insulin, Levemir basal and 3 Novorapid daily.

    I’m not sure what I am – type I, 1.5, II or steroid induced. I doesn’t really matter, I’m diabetic, but it would be nice to know.

  11. Natalie ._c- says:

    And then there’s my type of diabetes, which hasn’t even been described. I started to show mild hyperglycemia at age 43, and full-blown diabetes at 45. Tried the sulfonylureas (which were all that was available) for 5 months and they didn’t touch my blood sugars. So I went on insulin, which worked like magic. I was overweight but not obese. I did not have gestational diabetes. At this point, age 65, I’m still on insulin, and it’s still working at a very reasonable dose (avg. 33u a day total). But at this point, I’m antibody negative, but still do have below-normal C-peptide detectable on ordinary assays. And I unfortunately proved that I will die without insulin by omitting and going into a coma. So I’m not classic T2, not classic T1, not a LADA, not MODY (because neither parent had diabetes). I just don’t fit into the boxes, but call myself T1 because it’s closer than anything else, and I don’t want to die because some doc won’t give me insulin in the hospital. Which they already tried to do when I was recovering from the coma. So I guess you need an etc. category!

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