What’s New In The Treatment Of Type 2 Diabetes
Doctors and researchers are developing new equipment and treatments to help kids deal with the special problems of growing up with diabetes.
Some kids and teens already use new devices that make blood glucose testing and insulin injections easier and more effective. One of these is the insulin pump, a mechanical device that can be programmed to deliver insulin more like the pancreas does.
Researchers are also testing ways to stop diabetes before it starts. For example, scientists are studying whether diabetes can be prevented in those who may have inherited an increased risk for the disease.
Can Diabetes Cause Hair Loss
Yes, its possible for diabetes to cause hair loss. Uncontrolled diabetes can lead to persistently high blood glucose levels. This, in turn, leads to blood vessel damage and restricted flow, and oxygen and nutrients cant get to the cells that need it including hair follicles. Stress can cause hormone level changes that affect hair growth. If you have Type 1 diabetes, your immune system attacks itself and can also cause a hair loss condition called alopecia areata.
Causes And Types Of Diabetes: Is Diabetes Genetic
Diabetes is a long-term health condition that affects how your body converts food into energy. The majority of the food you eat is converted into sugar which is also known as glucose, and released into your bloodstream. When your blood sugar rises, your pancreas sends a signal to release insulin. Insulin functions as a key, allowing blood sugar to enter cells and be used as energy. If you have diabetes, your body either does not produce enough insulin or does not use the insulin produced as efficiently as it should. Too much blood sugar remains in your bloodstream when there is insufficient insulin or when cells stop responding to insulin. This can lead to serious health issues such as heart disease, vision loss, and kidney disease over time. Although there are many types of diabetes, in this guide, we will discuss the main types and how to cure diabetes by simple lifestyle changes.
Diabetes does not yet have a cure, but losing weight, eating healthy foods, and staying active can all help you to get rid of diabetes. Taking medication as needed, receiving diabetes self-management education and support, and attending health-care appointments can all help to lessen the impact of diabetes on your life.
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Types Of Diabetes: Type 1 Diabetes
Results from the bodys failure to produce insulin, the hormone that unlocks the cells of the body, allowing glucose to enter and fuel them. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes. Most treatment is administered with insulin pumps.
Having type 1 diabetes increases your risk for many serious complications. Some complications of type 1 diabetes include heart disease , blindness , nerve damage , and kidney damage .
What Does It Mean If Test Results Show I Have Protein In My Urine
This means your kidneys are allowing protein to be filtered through and now appear in your urine. This condition is called proteinuria. The continued presence of protein in your urine is a sign of kidney damage.
A note from Cleveland Clinic
Theres much you can do to prevent the development of diabetes . However, if you or your child or adolescent develop symptoms of diabetes, see your healthcare provider. The earlier diabetes is diagnosed, the sooner steps can be taken to treat and control it. The better you are able to control your blood sugar level, the more likely you are to live a long, healthy life.
Last reviewed by a Cleveland Clinic medical professional on 03/28/2021.
References
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Clusters 1 And 2 Had Highest Hba1c Levels
Diabetes is currently classified as type 1 diabetes, type 2 diabetes, and a number of less common diseases such as latent autoimmune diabetes in adults , maturity-onset diabetes in the young , and secondary diabetes.
The classification of diabetes into type 1 and type 2 relies predominantly on the presence or absence, respectively, of autoantibodies against pancreatic beta-cell antigens and younger age. On this basis, 75% to 85% of patients are identified as having type 2 diabetes.
Recent research on glutamate acid decarboxylase antibodies and gene sequencing has demonstrated that type 2 diabetes in particular is highly heterogeneous.
Furthermore, Groop noted, “evidence suggests that early treatment for diabetes is crucial to prevent life-shortening complications.”
“More accurately diagnosing diabetes could give us valuable insights into how it will develop over time, allowing us to predict and treat complications before they develop.”
The researchers therefore set out to establish a more refined diabetes classification that could allow individualized treatment and identify patients at diagnosis who are most at risk of complications.
They gathered data from five cohorts: Swedish All New Diabetics in Scania , Scania Diabetes Registry , All New Diabetics in Uppsala , Diabetes Registry Vaasa , and Malmö Diet and Cancer Cardiovascular Arm .
What They Have In Common
All types of diabetes are characterized by changes in the function of insulin, a hormone produced by the pancreas that helps to move glucose from the blood into cells, where it’s used for fuel.
Depending on the type of diabetes, either the pancreas does not produce insulin or the body is unable to use it as it should. Either way, without ample insulin or a healthy response to it, the sugar circulating in the blood cannot get into cells.
Early symptoms of diabetes, whatever the type, include fatigue, extreme thirst, and frequent urination.
If the disease progresses, a number of complications are possible, including vision changes or loss , diabetic neuropathy , increased risk of heart disease, kidney damage, and more.
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Does Eating Sugary Foods Cause Diabetes
Sugar itself doesn’t directly cause diabetes. Eating foods high in sugar content can lead to weight gain, which is a risk factor for developing diabetes. Eating more sugar than recommended American Heart Association recommends no more than six teaspoons a day for women and nine teaspoons for men leads to all kinds of health harms in addition to weight gain.
These health harms are all risk factors for the development of diabetes or can worsen complications. Weight gain can:
- Raise blood pressure, cholesterol and trigelyceride levels.
- Increase your risk of cardiovascular disease.
- Cause fat buildup in your liver.
- Cause tooth decay.
A Step Toward Precision Medicine
When the researchers assessed the treatment received by adults in each of the five clusters, they noticed that some were being treated inappropriately.
As an example, the team points out that just 42 percent of patients in cluster 1 and 29 percent of patients in cluster 2 received insulin therapy from the point of disease onset.
They say that this indicates that the current classifications of diabetes fail to target the underlying features of the disease.
As such, Prof. Groop and colleagues propose that diabetes should be categorized into five distinct types.
While further research is required to refine these five clusters by using biomarkers and genetic risk scores, for example the team believes that this study is a great stride toward tailored treatments for diabetes.
Existing treatment guidelines, concludes Prof. Groop, are limited by the fact they respond to poor metabolic control when it has developed, but do not have the means to predict which patients will need intensified treatment.
This study moves us towards a more clinically useful diagnosis, and represents an important step towards precision medicine in diabetes.
Prof. Leif Groop
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Conditions Linked With Type 1 Diabetes
Type 1 diabetes is an autoimmune disease, meaning that the bodys immune system mistakes its own cells for invading pathogens that need to be destroyed.
People with type 1 diabetes tend to have a higher risk of having other autoimmune diseases than the rest of the population.
Other autoimmune diseases include:
- Autoimmune thyroid disease
What Are The Symptoms Of Diabetes
Symptoms of diabetes include:
- In women: Dry and itchy skin, and frequent yeast infections or urinary tract infections.
- In men: Decreased sex drive, erectile dysfunction, decreased muscle strength.
Type 1 diabetes symptoms: Symptoms can develop quickly over a few weeks or months. Symptoms begin when youre young as a child, teen or young adult. Additional symptoms include nausea, vomiting or stomach pains and yeast infections or urinary tract infections.
Type 2 diabetes and prediabetes symptoms: You may not have any symptoms at all or may not notice them since they develop slowly over several years. Symptoms usually begin to develop when youre an adult, but prediabetes and Type 2 diabetes is on the rise in all age groups.
Gestational diabetes: You typically will not notice symptoms. Your obstetrician will test you for gestational diabetes between 24 and 28 weeks of your pregnancy.
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Testing For Type 2 Diabetes And Prediabetes In Children And Adolescents
In the last decade, the incidence and prevalence of type 2 diabetes in adolescents has increased dramatically, especially in ethnic populations . Recent studies question the validity of A1C in the pediatric population, especially among certain ethnicities, and suggest OGTT or FPG as more suitable diagnostic tests . However, many of these studies do not recognize that diabetes diagnostic criteria are based on long-term health outcomes, and validations are not currently available in the pediatric population . The ADA acknowledges the limited data supporting A1C for diagnosing diabetes in children and adolescents. However, aside from rare instances, such as cystic fibrosis and hemoglobinopathies, the ADA continues to recommend A1C in this cohort . The modified recommendations of the ADA consensus report Type 2 Diabetes in Children and Adolescents are summarized in .
Common Symptoms Of Diabetes
The symptoms of diabetes are caused by the surplus of glucose in your bloodstream. Glucose is a sugar that comes from food and is used for energy. However, too much glucose in the blood can lead to complications down the road if left unmanaged. Some common symptoms include fatigue, being extremely thirsty or hungry all the time, frequent urination, blurry vision, cuts or bruises that are slow to heal, tingling or numbness of the hands and feet, and unexpected weight loss.
In summary, diabetes is a metabolic disorder that involves the bodys inability to produce or respond adequately to insulin. Tens of millions of Americans live with diabetes. The four types of diabetes are gestational diabetes, prediabetes, Type 2 diabetes, and Type 1 diabetes. If you have any form of diabetes, you may experience symptoms like fatigue, being extremely hungry or thirsty all the time, blurred vision, and frequent urination.
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Conditions Which Can Lead To Diabetes
Some conditions, including genetic syndromes and surgery, can lead to high blood glucose levels and therefore diabetes.
Such types of diabetes account for around 1 to 2% of all diagnosed cases of diabetes.
Examples of such conditions include:
- Glucagonoma a condition in which the body produces too much of the hormone glucagon
- Chronic pancreatitis a condition which causes inflammation of the pancreas
- Cystic fibrosis a genetic condition that causes mucus to build up in the lungs and digestive system
- Pancreatectomy surgical removal of the pancreas
Cluster Research Points To Four Different Variations Of Type 2 Diabetes Each With Different Causes And Best Practice Treatments Is Your Treatment Wrong
Things just got a lot more complicated than type 2 diabetes vs type 1. But changes in how these diseases are defined are likely to help those who suffer from them
Have you ever heard of type 5 diabetes? How about types 3 or 4?
If youre like most people, even those who happen to suffer from diabetes, youve likely only ever heard of type 1 and type 2. But a new study out of Scandinavia aims to rewrite everything we know about these two diseases.
Namely, that there are actually five of them.
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Why Was This Classification Developed
Dr. Groop and his team analyzed data from a number of diabetes patient registries to do their research. The number of patients involved in the analysis was more than 13,000. For all of the patients, the researchers isolated measurements of a number of variables, including insulin resistance, insulin secretion, blood sugar levels, age and onset of illness.
The results of their data analysis suggested that there should be five classifications of diabetes two mild types and three severe types.
What Insulin Medications Are Approved To Treat Diabetes
There are many types of insulins for diabetes. If you need insulin, you healthcare team will discuss the different types and if they are to be combined with oral medications. To follow is a brief review of insulin types.
- Rapid-acting insulins: These insulins are taken 15 minutes before meals, they peak at one hour and work for another two to four hours. Examples include insulin glulisine , insulin lispro and insulin aspart .
- Short-acting insulins: These insulins take about 30 minutes to reach your bloodstream, reach their peak effects in two to three hours and last for three to six hours. An example is insulin regular .
- Intermediate-acting insulins: These insulins reach your bloodstream in two to four hours, peak in four to 12 hours and work for up to 18 hours. An example in NPH.
- Long-acting insulins: These insulins work to keep your blood sugar stable all day. Usually, these insulins last for about 18 hours. Examples include insulin glargine , insulin detemir and insulin degludec .
There are insulins that are a combination of different insulins. There are also insulins that are combined with a GLP-1 receptor agonist medication .
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What Does This Mean For The Future Management Of Diabetes
While one study regardless of its large size isnt about to change how healthcare professionals treat diabetes, it may provide some insights into how diabetes should be managed. Depending on the type and cause of diabetes a person has, the management of their disease may differ accordingly. This might mean a much more individualized approach to future diabetes management by tailoring and targeting early treatment to patients who would benefit most.
Further studies in other populations and countries are definitely needed to confirm and validate the results of this study.
The Five Clusters Of Diabetes
The researchers came to their proposal by analyzing the data of four study cohorts. These included a total of 14,775 adults from Sweden and Finland, all of whom had been newly diagnosed with diabetes.
As part of the analysis, the scientists looked at six measures in each subject that each represent different features of diabetes.
These measures were: body mass index age at diabetes diagnosis hemoglobin A1C , a measure of long-term blood sugar control beta cell functioning insulin resistance and the presence of diabetes-related autoantibodies.
As well as conducting genetic analyses of the participants, the researchers also compared their disease progression, complications, and treatment.
The study revealed five distinct forms of diabetes, three of which were severe and two that were mild. The team categorized these as follows:
The researchers note that each of these five types were also genetically distinct, meaning that there were no genetic mutations that were shared across all five clusters.
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Why Diabetes Type 2 Vs Type 1 Isnt Good Enough
While it may seem like an unnecessary distinction, breaking diabetes into five separate diseases could have a profound impact on the prognosis for every diabetic.
Today, we know that type 1 diabetes must be treated with multiple daily injections of insulin or an insulin pump. This treatment is very specific to the cause of the disease.
The majority of type 2 diabetics receive a treatment that consists of oral medications to reduce insulin resistance and lower blood sugars. They are also told to follow a certain diet and exercise more. But what if that treatment plan only actually works for some causes of type 2 diabetes?
According to the five cluster theory, there are four different causes of what is typically thought of as type 2 diabetes . Rates of secondary complications seen in each cluster already tell us that this typical treatment isnt right for every cause. Clusters 2 and 3 both suffer complications at a higher rate than cluster 1 and clusters 4 and 5, which would appear better suited to treatment by current means.
If youve ever felt like you do everything youre told but still struggle to get your blood sugar under control, this theory might explain why. And also why youre not alone in feeling that way.
How Is Type 2 Diabetes Diagnosed
Doctors can determine if a person has type 2 diabetes by testing blood samples for glucose. Even if a child or teen doesn’t have any symptoms of type 2 diabetes, doctors might test blood sugar in kids who are more likely to get it like those who are overweight.
Sometimes doctors may do another blood test, called the glycosylated hemoglobin test, to check for diabetes in children at higher risk for getting type 2 diabetes. This test shows how blood sugar levels have been running over the past few months.
If diabetes is suspected or confirmed, the doctor may refer you to a pediatric endocrinologist, a doctor who specializes in the diagnosis and treatment of diseases of the endocrine system in kids.
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How Do These Data Relate To Type 3c Diabetes
The current results follow those of a study published in late 2017, which showed that patients with diabetes resulting from pancreatic dysfunction type 3c diabetes are often misdiagnosed as having type 2 diabetes.
As reported by Medscape Medical News, that analysis of more than 30 000 incident diabetes cases showed that type 3c diabetes, also known as diabetes of the exocrine pancreas, is almost as common as type 1 diabetes and misdiagnosed in over 87% of patients.
The misdiagnosis results in an increased risk of poor glycemic control compared with patients with type 2 diabetes and a far greater reliance on insulin.
Sladek said the current study is not directly related to type 3c diabetes, as this latter, rarer form of the disease is considered a ‘secondary diabetes.’ “In other words, it occurs as a result of a well-recognized disease process that does not alter insulin secretion directly and independently,” he said.
Noting that the patients with type 3c diabetes had some form of exocrine pancreatic disease that affected endocrine function, Sladek said “this could occur for many reasons that share the common feature that the exocrine pancreas damage precedes the development of diabetes.”
“In contrast, patients with type 1 or 2 diabetes have normal exocrine pancreatic function.”
Lancet Diabetes Endocrinol. Published online March 1, 2018. Abstract
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