Types of diabetes: risks, characteristics and treatment

There are disorders that generate great concern due to their great impact on the population. A clear example is diabetes mellitus. This set of metabolic alterations have in common that they cause an increase in blood glucose (hyperglycemia).

Diabetes has a high worldwide prevalence. In 2015, approximately 400 million cases worldwide. Alarming data, and even more so if the predictions indicate that this value will rise, especially one of the types of diabetes: type II.

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Diabetes through history

Humanity has suffered from this chronic disease since ancient times. There is data that cases were already recognized by the year 1500 a. C. in Ancient Egypt.

It was not until a few years later that the Ancient Greek physician, Aretheus of Cappadocia, named this disorder, which has persisted to this day.

"Diabetes" means in Greek "runs through", as it refers to one of the most striking symptoms of the condition, low fluid retention.

Types of diabetes

There are different types of diabetes, many of them minor cases, but they all have in common that cause hyperglycemia and the problems that result of it: nervous, cardiovascular and renal complications.

We can mainly divide it into four groups: type I diabetes, type II diabetes, gestational diabetes and other types. In this last group, the MODY syndrome should be highlighted, although there are also diabetes originating from indirectly, such as by an infection in the pancreas or induced by treatment with drugs.

1. Type 1 diabetes mellitus (DM1)

Formerly also called "insulin-dependent diabetes" or "childhood diabetes", it represents about 5% of diagnosed cases.

Type I diabetes is characterized by absence of the hormone insulin, which stimulates the uptake of glucose in the blood by cells. This disappearance is due to the destruction of the β cells of the islets of Langerhans of the pancreas, place of production of the hormone, by the immune system.

This disorder develops normally in children or adolescents, although there are cases of the onset of the disease in adult stages, which are known under the name of LADA (“Latent Autoimmune Disease in the Adult”, that is, “latent autoimmune disease in Adults").

The risk of suffering from DM1 is somewhat complex, since it is a combination of a predisposition genetics along with the interaction of certain environmental factors that trigger the problem (infection or diet). This makes it difficult to prevent the disease.

Symptoms that indicate this alteration Of the metabolism are frequent elimination of urine, unusual thirst, continuous hunger, weight loss, irritability and tiredness. They appear suddenly and their only treatment is the lifetime supply of insulin in the patient, in addition to a rigorous control of the glycemic level, since it is easily prone to coma ketone.

2. Type 2 diabetes mellitus (DM2)

Formerly known as “non-insulin dependent diabetes”, it is the most widespread type of diabetes, being between 85% and 90% of cases that are diagnosed. Hyperglycemia is caused by a body's resistance to insulin or a deficiency in insulin secretion, but never by an autoimmune attack.

Main risk factors are related to lifestyle, such as lack of exercise, being overweight, obesity or the stress. As it is a complex disease, there are other relevant factors such as genetics or alterations in the intestinal flora itself. It is a chronic disease that usually appears in adulthood (over 40 years), although cases begin to be seen in young people.

The symptoms are very similar to type I diabetes but to a lesser extent, since it is a sequential and not sudden process. The biggest problem is that it is diagnosed once it takes a while for the condition to develop.

The initial treatments usually consist of exercise plans and diets, since if it is not well developed it is possible to reverse the effects. In more severe cases, antidiabetic drug therapy is necessary, which lowers blood glucose, despite the fact that in the long run insulin injections are needed.

3. Gestational diabetes mellitus (GDM)

It is a form of prediabetes that can appear during the second or third trimester of pregnancy. It is detected as hyperglycemia in mothers who before pregnancy were not diagnosed with any other type of diabetes.

One of the possible causes of this disorder is that the hormones that are produced during pregnancy interfere with the functionality of insulin. During the first trimester of pregnancy, blood glucose levels can be monitored to rule out GDM.

Some risk factors are having previously suffered GDM in another pregnancy, having suffered several miscarriages, or having a family history of diabetes.

More than the symptoms, the biggest problem is the consequences of this increase in glucose, which, Although they do not reach the established values ​​to diagnose diabetes, they are higher than normal.

Gestational diabetes can trigger labor problems due to macrosomia (excessive growth of the baby) as well as increasing the predisposition of both the child and the mother to suffer from the disease. The usual treatment is a lifestyle control, that is, exercise and diet.

4. MODY syndrome and other types

The last group is a mixed bag where all types of diabetes whose incidence is much lower are grouped, such as type 3.

Despite this, one can be highlighted due to its incidence, between 2% and 5% of diagnoses: it is the MODY syndrome.

Also called monogenic diabetes, the acronym stands for "Maturity Onset Diabetes of the Young" ("Middle-aged diabetes that occurs in young people"), because it looks like DM2 but develops in non-obese adolescents. Unlike the rest, this disorder is monogenic (caused by a single gene) and it is not a complex disease. The greatest risk is having a family history of this type of disorder.

So far, up to 6 different genes have been found that can develop the syndrome. All of them have in common that, when they are mutated, the β cells do not synthesize or release insulin correctly, causing diabetes. It is first treated with antidiabetic drugs oral, despite the fact that in the long run you end up injecting insulin as in DM2.

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