Sky-high insulin costs have put diabetes in the news lately. When1 in 10 Americans have it, that’s concerning enough. And yet, around 20 percent of people with diabetes don’t know that they have it.
There’s a false notion that every person with diabetes made unhealthy food and lifestyle choices. But everything from family history to endocrine conditions can contribute to a diagnosis.
All types of diabetes have to do with your body’s ability to produce or process insulin. When you eat, your digestive system converts food into glucose to fuel your body. Think of your bloodstream as a river; the hormone insulin acts as a fisherman, cleaning up any extra glucose to keep the ecosystem thriving and balanced.
If your body cannot generate or utilize the right amount of insulin to manage your blood sugar levels, you develop diabetes. The disease can affect every part of your body and can lead to serious health issues such as kidney disease, nerve disease, blindness, stroke or heart disease.
Each type of diabetes has significant features. We break it down.
Type 1 diabetes
Around 5 to 10 percent of people with diabetes have type 1 diabetes. Experts think type 1 diabetes stems from an autoimmune reaction, in which antibodies in your body attack cells in your pancreas that produce insulin. Many people have no idea the attack is occurring until it’s too late and they are showing symptoms.
Since insulin is necessary for survival, people with type 1 diabetes rely on insulin injections for the rest of their lives. Your genetics, as well as certain environmental triggers, including some viruses, can increase your chances of developing type 1 diabetes. Unlike type 2 diabetes, diet and other factors don’t affect your chances of developing type 1 diabetes.
Most people who get a type 1 diagnosis do so around age 13 or 14, but babies and even people above 40 can receive diagnoses.
Prediabetes
Prediabetes is always a precursor to type 2 diabetes — it can’t lead to type 1. Your doctor may diagnose prediabetes if your blood sugar levels are consistently higher than they should be but aren’t quite at type 2 levels. The Centers for Disease Control and Prevention estimates that more than 1 in 3 American adults is prediabetic — and more than 80 percent don’t know it.
Eating too much sugar itself doesn’t lead to prediabetes, but being overweight can put you at a higher risk of prediabetes and diabetes. Other risk factors include an immediate family member with type 2 diabetes, a history of gestational diabetes, polycystic ovary syndrome (PCOS) or a sedentary lifestyle.
While prediabetes is not as serious as type 1 and type 2, it can still carry significant health risks and greatly increases your chances of developing type 2 diabetes.
Type 2 diabetes
The vast majority of people with diabetes have type 2 diabetes, when your body can’t make enough insulin and/or use it effectively, resulting in high blood sugar levels.
This type often goes hand in hand with other health conditions, such as high blood pressure or high cholesterol. While experts don’t know exactly what causes type 2 diabetes, research shows that you’re at a higher risk of developing it if you are overweight, have a close family member that has diabetes, live a sedentary lifestyle or have had gestational diabetes.
Type 2 diabetes cannot be completely cured or reversed. However, people can achieve remission — the ability to maintain their blood sugar levels below the diabetic range without needing medication — through careful diet and lifestyle changes.
“The most important factor is weight loss,” says Dr. William Cefalu, director with the National Institute of Diabetes and Digestive and Kidney Diseases. “Obesity contributes to increased blood glucose levels.”
Gestational diabetes
Sometimes pregnant people without a prior history of diabetes cannot produce enough insulin to regulate their blood sugar levels. Most pregnant people should be tested for gestational diabetes.
Your ob-gyn may screen for gestational diabetes by administering a glucose challenge test, which measures your blood sugar levels after you drink a certain quantity of sugary liquid to see how well your body processes glucose.
This condition is treatable and relatively easy to diagnose. Many patients bounce back to their prediabetic levels of insulin balance after giving birth. Still, gestational diabetes can increase risks to you and your baby during pregnancy, as well as increasing future risk of type 2 diabetes.
If you are overweight, physically inactive, have high blood pressure or PCOS, have a history of heart disease or had gestational diabetes during a previous pregnancy, you have a higher risk of developing gestational diabetes.
Common symptoms
Diabetes can hide behind many different symptoms. Some common indicators of type 1 and type 2 include increased thirst and urination, feelings of hunger and fatigue, unexpected weight loss, feeling tingly or numb in your hands and feet, blurred vision or unexplained dark rashes around your neck and armpits.
Many women and pregnant people may not experience any symptoms of gestational diabetes, while others may notice that they’re drinking more water or going to the bathroom more often than usual.
Overall, it’s important to distinguish between different types of diabetes so you’re aware of how you and your doctor can prevent it in the future. Read our story on preventing diabetes and what happens if you do end up with a diabetes diagnosis.