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The Other Diabetes


By Eduardo Gonzales, MD

Q: Is it true there are two types of diabetes? How do they differ? —

A: Yes, there are two types of diabetes mellitus, types 1 and 2. Both are characterized by a persistently high blood sugar (glucose) level that is caused by either the failure of the pancreas to produce enough insulin, the hormone that enables the cells of the body to utilize sugar as energy source, or the inability of the cells of the body to effectively use insulin. Diabetes type 1, which usually arises in childhood, accounts for only five to 10 percent of diabetes cases. It occurs when the cells of the pancreas that produce insulin are destroyed by illness or by the body’s own immune system. Diabetes type 2, on the other hand, is what we usually refer to when we say diabetes because it accounts for 90 to 95 percent of diabetes cases. It generally arises in adulthood from the interplay of genetic, environmental, and lifestyle factors, mainly overweight or obesity and physical inactivity.

With the ongoing concern about type 2 diabetes, which has become a global epidemic because of the explosive increase in the number of obese or overweight people all over the world and the sedentary lifestyle that characterize modern society, it is easy to forget that there is another form of diabetes (i.e., diabetes type 1), which, although far less common than its type 2 counterpart, can be a much more serious disease that can afflict unsuspecting young people, often arising out of nowhere and for no apparent reason.


What brings about type 1 diabetes?
The exact cause of type 1 diabetes, which was once called juvenile diabetes because most cases are diagnosed in children and teenagers, is unknown. Usually it occurs when the immune system, which normally fights harmful bacteria and viruses, mistakenly destroys the insulin-producing cells in the pancreas called beta cells. Sometimes the beta cells are wiped out by something else, like a disease, an injury, stress, or other environmental factors.

The known risk factors for type 1 diabetes include family history (anyone with a parent or sibling with type 1 diabetes has increased risk for the condition), genetics, geography (the incidence of the disease increases as one travels away from the equator), and age. Although type 1 diabetes can appear at any age, it appears at two noticeable peaks. The first peak occurs in children between four and seven years old, and the second is in children between 10 and 14 years old.


When adequately managed, type 1 diabetes patients can enjoy a productive and active life, and a normal lifespan.


Type 1 diabetes often appears suddenly
Unlike type 2 diabetes, which has a gradual onset, type 1 diabetes often develops rather quickly. Its symptoms, albeit similar to those of type 2 diabetes, appear suddenly and include increased thirst, frequent urination, bed-wetting, extreme hunger, weight loss, irritability, fatigue, weakness, and blurred vision.

Complications of type 1 diabetes
If untreated, type 1 diabetes invariably results in serious complications that are similar to those of type 2 diabetes, which include poor healing of wounds, stroke, heart failure and heart attack, kidney failure, blindness, susceptibility to infection, and nerve damage that results in muscle weakness and reduced sensation.

Another serious complication is ketoacidosis. Without enough insulin, sugar is unavailable as energy source for the cells, hence the body begins to break down fat to serve as fuel. This process produces a buildup of acids in the bloodstream called ketones.The combination of extra glucose, dehydration, and acid buildup is known as ketoacidosis, a condition that can be life-threatening.

Treatment and outlook for type 1 diabetes
Type 1 diabetes has no cure. Treatment focuses on managing blood sugar levels with insulin, diet, and lifestyle to prevent complications. Most patients must be treated with insulin for their entire lives.When adequately managed, type 1 diabetes patients can enjoy a productive and active life, and a normal lifespan. Take it from Gary Valenciano and Halle Berry, two celebrities who are living with the condition.

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