Diabetes: Symptoms, Types, Causes, & Testing

 
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Intro

There are different types of diabetes, and the most common and most-well known type is diabetes mellitus. Diabetes mellitus is a group of conditions when someone has issues with blood sugar, which may happen because of issues with insulin. Insulin is a hormone that is made by the pancreas that is responsible for maintaining healthy blood sugar balance.

To keep things simple, diabetes mellitus will just be called “diabetes” for the rest of this blog post. And, there are different types of diabetes, such as Type 1 and Type 2. There are different reasons why happens the different types happen, and the symptoms (and complications) between the different types of diabetes mellitus can be similar (but there are some slight nuances).

This blog post is a part of a 2-part series on diabetes, and in this blog post, you will learn:

  1. Symptoms & complications of diabetes

  2. Types of diabetes & their causes

  3. Testing for diabetes


Symptoms of diabetes

The classic symptoms of diabetes are:

  • Frequent urination (aka polyuria)

  • Increased thirst (aka polydipsia)

  • Increase hunger (aka polyphagia)

Beyond these classic symptoms, other symptoms of diabetes include:

  • Recurrent infections

  • Pain, tingling, and/or numbness of the feet

  • Vision changes

  • Erectile dysfunction

    & more

Complications of diabetes

Severe weight loss can happen type 1 and type 2 diabetes, but more commonly happens in type 1 diabetes. Those with type 1 also have a higher risk of getting diabetic ketoacidosis compared to those with type 2. Diabetic ketoacidosis is a serious complication of type 1 diabetes that could lead to memory issues, changes to brain function, and death. In addition to this, those with diabetes can also experience slow-healing wounds that can be infected.


Types of diabetes & their causes

There are several different types of diabetes, each happening in different stages of life and each having different causes. The different types of diabetes are:

  • Type 1 diabetes

    Type 1 diabetes is an autoimmune condition usually diagnosed at an early age where the immune system attacks the pancreatic cells responsible for the production of insulin. These pancreatic cells are called beta cells, and when they are attacked and destroyed, it leads to little-to-no production of insulin. And, having little-to-no insulin in the system leads to the significantly high levels of blood sugar seen in diabetes. Interestingly, viral conditions have been connected to type 1 diabetes. Literature reveals that enteroviruses, such as coxsackievirus, has been linked to the development for Type 1 diabetes.

  • Type 2 diabetes

    Type 2 diabetes is the most well-known type of diabetes where people have high levels of blood sugar due to slow onset of insulin resistance. Insulin resistance takes place over time as someone’s blood sugar is consistently elevated. When someone’s blood sugar is consistently elevated, the body attempts to regulate blood sugar levels by sending out insulin. However, as more insulin is sent out, the body becomes less sensitive to the hormone. And, as the body becomes less response to insulin, the body has a harder time regulating blood sugar, leading to the significantly high levels of blood sugar seen in diabetes. Type 2 diabetes is usually diagnosed in adults, but there is a growing number of type 2 causes in younger people.

  • Type 1.5 diabetes

    Type 1.5 diabetes, aka Latent autoimmune diabetes in adults (LADA), is essentially Type 1 diabetes diagnosed later in life. Since this type of diabetes usually comes on later on in life, it can be misdiagnosed as type 2 diabetes.

  • Maturity-onset diabetes of the young (MODY)

    MODY is a genetic condition where there is a mutation in how insulin functions, and MODY is a familial disorder and occurs in those under the age of 25 years.

  • Gestational diabetes

    Gestational diabetes is high blood sugar that occurs in pregnant people. According to John Hopkins Medicine, the cause of gestational diabetes is still unknown. However, there is a theory that hormones made by the placenta during pregnancy might have an anti-insulin effect in the body, leading to the significantly high levels of blood sugar seen in diabetes.

  • Secondary diabetes

    Secondary diabetes is when someone experiences high blood sugar because of a complication of some sort of disease. For example, diabetes can happen after pancreatic disease (such as pancreatitis), hormone issues (such as Cushing disease), or from medications (such as corticosteroids)


Testing for diabetes

In general, a licensed medical provider screens for blood sugar health when a patient comes in for their annual physical/check-up. When screening tests have abnormal results, providers will do further testing to understand what is taking place & what therapeutics to recommend.

Screening tests that might be done with a licensed medical provider are:

  • Fasting blood sugar: Fasting blood sugar is just a snapshot in time of a person’s blood sugar. Providers usually want the patient to be fasting so that they can understand a patient’s baseline blood sugar at that moment in time. High fasting blood sugar will raise red flags and can prompt your doctor to do further labs.

  • Hemoglobin A1c: Hemoglobin A1c is a measure to help providers understand how your blood sugar levels have been for the past few months. This lab data is combined with fasting blood sugar to get a better understanding of a patient’s overall blood sugar health. If hemoglobin A1c is high, it can prompt your doctor to do further labs.

  • Urinalysis: Urinalysis is a screening test that might be ordered by some providers to check for kidney and urinary tract health. Those with diabetes may show sugar and/or protein in urine. And, if urine does show sugar and/or protein, it can prompt your doctor to do follow-up labs.

Further labs for diabetes:

  • Fasting insulin

  • C-peptide

  • Antibodies

  • Salivary genetic testing

  • Oral glucose tolerance test

    & more

According to the American Diabetes Association, diabetes is diagnosed when labs show a fasting blood glucose level of 126 mmol/dL, an A1c level of 6.5% or more, and more (click here to read more from the American Diabetes Association). Sometimes, people will need a second test for actual diagnosis, but if a doctor sees that blood sugar is very high or if someone has the classic symptoms of diabetes with at least 1 positive test, a second test might not be needed. After a diagnosis is made, a licensed provider may do further testing to understand what type of diabetes someone is experiencing for proper diagnosis. Remember, this blog post is meant to be educational only, and is not meant to diagnose, treat, or prevent disease. If you are concerned that you have diabetes, speak to your doctor about the information that you read in this blog post.


In most cases, diabetes and blood sugar imbalance occurs with cardiovascular disease and other metabolic conditions. And, a licensed provider may include other screening labs with blood sugar screening to check for other metabolic issues.


Summary & Takeaways

Diabetes is a condition when someone has high blood sugar levels due to changes in insulin function or production. In this blog post you learned what the symptoms and complications of diabetes are, what the different types of diabetes are & what causes them, and what testing a provider may do for diabetes.

Here are 3 takeaways from this week’s blog post:

  1. There are 6 different types of diabetes:

    1. Type 1 (due to autoimmunity & usually diagnosed in children)

    2. Type 2 (due to insulin resistance & usually diagnosed in adults)

    3. Type 1.5 (due to autoimmunity & usually diagnosed in adults)

    4. MODY (due to genetic changes to insulin function & usually diagnosed in children)

    5. Gestational diabetes (theoretically due to anti-insulin hormones made during pregnancy & only diagnosed in pregnant people)

    6. Secondary diabetes (due to complications from a condition or medication)

  2. Testing for diabetes first involves screening measures, and if there are abnormal screening test results, a licensed provider can order more in-depth testing.

  3. A licensed provider can diagnose diabetes if someone has high levels of fasting blood sugar and/or high A1c. However, there are many other tests that can be completed for diagnosis of diabetes.

Next week’s blog post will focus on integrative management of Type 2 diabetes. To stay up-to-date about future blog posts, click here sure to sign up for my email newsletter. And, if you want to set up an appointment with me, click here.

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DISCLAIMER: THESE STATEMENTS HAVE NOT BEEN EVALUATED BY THE FOOD AND DRUG ADMINISTRATION. DR. BRYANT ESQUEJO, ND HAS NO FINANCIAL TIES TO ANY SUPPLEMENT COMPANIES, PHARMACEUTICAL COMPANIES, OR TO ANY OF THE PRODUCTS MENTIONED IN THIS POST. THIS POST IS NOT MEANT TO TREAT, CURE, PREVENT, OR DIAGNOSE CONDITIONS OR DISEASES AND IS MEANT FOR EDUCATIONAL PURPOSES. AS ALWAYS, PLEASE CONSULT YOUR DOCTOR BEFORE TRYING ANY NEW TREATMENTS OR SUPPLEMENTS.

 
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