Types of Diabetes
There are a few different types of diabetes. We tailor our approach to care around the specific type of diabetes you have and your unique health needs.
Type 1 Diabetes
Type 1 diabetes is a chronic, autoimmune condition in which the pancreas produces little to no insulin — the hormone that helps your cells use sugar (glucose) as energy. Without insulin, sugar stays in the blood and can cause serious damage to organs. About 5-10% of Americans who are diagnosed with diabetes have Type 1. Typically, Type 1 diabetes is diagnosed in childhood or early adulthood, but it can appear at any age.
Answers to Common Questions About Type 1 Diabetes
The A1C test measures the average blood sugar level for the past two to three months. When glucose (sugar) builds up in the blood, it binds to the hemoglobin in red blood cells. This test measures what percentage of hemoglobin is coated with sugar. An A1C level of 6.5% or higher on two separate tests typically indicates diabetes.
People with diabetes who also have other chronic illnesses, such as hypertension, cystic fibrosis, celiac disease, thyroid problems or polycystic ovary syndrome, benefit from customized treatment plans that take into account how best to manage diabetes when other health problems are present.
Pregnant women and women planning to become pregnant can take advantage of our unique diabetes and pregnancy program in partnership with the University of Chicago Medicine High-Risk Obstetrics Program.
Teens with diabetes receive special care through our transitions program that helps them manage their diabetes as they grow into adulthood. Patients who require surgery can receive expert care through University of Chicago programs in transplantation (heart, lung, liver, kidney and pancreas), cardiac surgery, orthopaedic surgery, vascular surgery and bariatric (weight loss) surgery.
Blood Sugar Monitoring & Insulin Replacement Therapy
Regular blood sugar monitoring is essential for people with Type 1 diabetes. Even if a patient does not feel symptoms, blood sugar may be at unhealthy levels, putting the patient at risk for complications. Consistent monitoring is the only way to ensure that blood sugar level remains within the target range.
Insulin replacement therapy uses medication to simulate the function of a healthy pancreas. Insulin can be delivered to cells through regular injections or through a continuous insulin pump.
Our patients have access to the newest glucose sensor technology and monitoring devices. Patients receive one-on-one education on how to use these important devices. Our insulin pump program offers options to select specific technology that best fits each patient's needs.
Diet & Exercise
Exercise lowers the blood sugar level by moving sugar into cells to be processed for energy. Exercise also increases sensitivity to insulin, which means the body needs less insulin to transport sugar to cells.
Nutrition is one of the most important parts of managing the diabetes puzzle. It’s important for patients to learn how different foods affect blood glucose levels.
Physicals and blood work through the care of a diabetes specialist are important for patients diagnosed with Type 1 diabetes. Diabetic ketoacidosis occurs when the body, unable to metabolize glucose, metabolizes fat instead. This creates a buildup of ketones in the blood and at high levels, ketones are poisonous. Diabetic ketoacidosis can be triggered in Type 1 diabetes patients by infection, injury, a serious illness, surgery or insulin deficiency.
Patients typically also see their doctors for regular blood tests that show average blood glucose levels for the most recent two to three months.
Yes. People with Type 1 diabetes are not making enough insulin from their own bodies. Most people inject insulin at least four times a day. However, the insulin pump, or continuous subcutaneous insulin infusion (CSII), is slowly replacing frequent injections as a preferred delivery system. With the pump, a new catheter is inserted every few days under the skin, and insulin is continuously infused into the body. The pump is not the final word in insulin delivery systems, and there are clinical trials underway testing both a patch and a nasal spray as possible insulin delivery systems.
Feeling fine is no guarantee that your blood sugar levels are in the target range. Remember, symptoms do not appear right away. Without regular blood sugar monitoring, serious damage can happen to your eyes, kidneys, feet – even your brain – without your knowing. If your sugar levels are out of line, consult your doctor.
Yes, but the risk is low. Although Type 1 diabetes is a genetic disease, only about 4% to 5% of children of people with Type 1 diabetes will develop diabetes. The risk varies with age, gender and other factors relating to the parent with diabetes. You can learn more about these odds by having your children undergo certain genetic tests.
Type 2 Diabetes
Most Americans diagnosed with diabetes have Type 2 diabetes. With Type 2 diabetes, the body cannot use its own insulin effectively, a condition known as insulin resistance. Untreated Type 2 diabetes can affect major organs and lead to serious health problems, including heart and blood vessel disease, nerve damage, kidney failure, vision impairment and other issues.
Type 2 diabetes is a genetic condition that isn't cured with treatment. If a Type 2 diabetes patient’s elevated blood sugar levels improve in response to dietary changes, exercise and/or medication, it means the treatment is effective. It doesn’t mean the underlying genetic condition has gone away.
Answers to Common Questions About Type 2 Diabetes
People with diabetes who have other chronic illnesses, such as hypertension, cystic fibrosis, celiac disease, thyroid problems or polycystic ovary syndrome, benefit from customized treatment plans that take into account how best to manage diabetes when other health problems are present.
Pregnant women and women planning to become pregnant can take advantage of our unique diabetes and pregnancy program in partnership with the University of Chicago Medicine High-Risk Obstetrics Program.
Teens with diabetes receive special care through our transitions program that helps them manage their diabetes as they grow into adulthood. Patients who require surgery can receive expert care through University of Chicago programs in transplantation (heart, lung, liver, kidney and pancreas), cardiac surgery, orthopaedic surgery, vascular surgery and bariatric (weight loss) surgery.
Diet & Exercise
Complications from Type 2 diabetes can be greatly improved by lifestyle changes beginning with eating a healthy diet, being physically active and losing extra weight. If these lifestyle changes alone cannot control blood sugar, patients may also need medication or insulin replacement therapy.
Blood Sugar Monitoring & Insulin Replacement Therapy
Regular blood sugar monitoring is essential because even if a patient does not feel symptoms, their blood sugar may be at unhealthy levels, putting the patient at risk for complications. Physicians typically provide the patient with a glucometer — a device that uses blood to determine blood glucose levels. Patients often see their doctors for regular blood tests that show average blood glucose levels for the most recent two to three months.
Medication may be used to decrease insulin resistance, slow the digestion of food or increase insulin levels in the bloodstream and essentially decrease blood glucose levels after eating. Insulin therapy can be used to increase insulin circulating in the bloodstream.
Our patients have access to the newest glucose sensor technology and monitoring devices. Patients receive one-on-one education on how to use these important devices. Our insulin pump program offers options to select specific technology that best fits each patient's needs.
Controllable risk factors for Type 2 diabetes include:
- Obesity — about 80% of people with Type 2 diabetes are overweight
- Physical inactivity
Uncontrollable risk factors for Type 2 diabetes include:
- Age — risk increases with age
- Family history of diabetes
- History of gestational diabetes
- Ethnic background — African Americans, Native Americans, Latinos and Asian Americans are at higher risk
Type 2 diabetes is a genetic condition or predisposition that doesn’t change with treatment. If you have Type 2 diabetes and your blood sugar is controlled during treatment (diet, exercise and medications), it means that the treatment plan is working. Your blood sugar levels have improved because of the treatment – not because your diabetes predisposition has gone away. You will need to continue your treatment; otherwise your blood sugar will go back up.
When your blood sugar is normal with no treatment, then the diabetes is considered to have gone away. However, even when blood sugar is controlled, because Type 2 diabetes is a genetic condition, the predisposition for diabetes always exists. High blood sugar can come back.
Maybe. However there are many new drugs available that may delay or prevent the need for insulin therapy. It is expected that fewer and fewer individuals will need insulin replacement to control their blood sugar.
You may feel fine, but that is no guarantee that your blood sugar levels are in the target range. Remember, diabetic complications do not appear right away. And complications may develop even when the blood sugar is only slightly elevated. Regular blood sugar monitoring can help you keep your blood sugar in control and prevent serious damage to your eyes, kidneys and nerves. If your sugar levels are out of line, consult your doctor.
Yes. Type 2 diabetes is a genetic disease. The risk is highest when multiple family members have diabetes, and if the children also are overweight, sedentary and have the other risk factors for Type 2 diabetes. Your child has a 10-15% chance of developing Type 2 diabetes when you have Type 2 diabetes. And if one identical twin has Type 2 diabetes, there is a 75% likelihood of the other twin developing Type 2 diabetes also.
Our focus goes beyond managing diabetes. We’re working to prevent diabetes in people who are most at risk. Our diabetes prevention programs target ethnic groups that have a higher-than-average prevalence of diabetes, including African Americans and Non-White Hispanic Americans.
The University of Chicago has served as a clinical study site in the ongoing, multi-center diabetes prevention program (DPP), funded by the National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Disorders (NIH/NIDDK). It has focused primarily on African Americans at high risk of diabetes.
To date, the study has shown that diet and exercise can prevent or delay the onset of Type 2 diabetes in certain people at risk (those with impaired glucose tolerance). Results have also shown that the oral drug metformin helped to prevent or delay Type 2 diabetes, although not as effectively as diet and exercise.
The Diabetes Prevention Program is a 27-center, randomized clinical trial designed to evaluate the safety and efficacy of interventions that may delay or prevent development of diabetes in people at increased risk for Type 2 diabetes. The University of Chicago was selected to participate as a research site. The area near the University of Chicago is comprised primarily of African Americans, a target population identified by the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) as a group at high risk for diabetes.
At the University of Chicago, research focused in part on individuals with impaired glucose tolerance (IGT), a prediabetic condition that is associated with insulin resistance and increased risk of cardiovascular disease. The University of Chicago’s results supported those of the larger DPP study group, which substantiated that appropriate interventions can help prevent Type 2 diabetes from developing in individuals with IGT.
Monogenic Diabetes
The overwhelming majority of those diagnosed with diabetes have either Type 1 or Type 2 diabetes. However, in a small number of people, a rare gene abnormality can cause monogenic diabetes. Monogenic diabetes presents characteristics of both Type 1 and Type 2, and is often misdiagnosed as one of those more common types.
There are two main forms of monogenic diabetes:
- Neonatal diabetes is usually diagnosed in infants from birth to 6 months, though diagnosis may occur later in some cases.
- Maturity onset diabetes of the young (MODY) is more common and usually diagnosed in late childhood to adulthood
Learn more about monogenic diabetes
Gestational Diabetes
Gestational diabetes is a type of diabetes brought on by pregnancy. Roughly 6% to 9% of people who are pregnant will develop gestational diabetes. With this condition, the pancreas does not produce enough insulin to control sugar levels in the blood.
Diabetes Care at UChicago Medicine
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