Forums » Smalltalk » World Diabetes Day

Hi everyone! It's World Diabetes Day today, which is a good opportunity to discuss the disease. As a diabetic myself, I run into a lot of questions, myths and suggestions regularly, and maybe I can give some insights on it from my personal experience and research. So I invite everyone to ask questions unashamedly and share their experiences, whether it's personal or through relatives and friends.

This topic will not provide a medical diagnosis. Please always consult your doctor if you want to be tested for diabetes. Do not change your diabetes treatment without consulting your doctor first.

With that out of the way, I want to give a quick overview of what the disease is.

What is diabetes?
Diabetes is a condition of the body where it can't effectively use the glucose in the blood stream anymore, leading to high levels of blood glucose. High blood glucose levels over an extended period of time can lead to a very high risk of serious complications, such as:

• Cardiovascular disease
• Nerve damage (neuropathy)
• Kidney damage (nephropathy)
• Eye damage (retinopathy)
• Foot damage
• Skin conditions
• Hearing impairment
• Alzheimher's disease

This is why it's important to find a treatment that works for you where you can manage your condition effectively.

When should I see a doctor about diabetes?
It's a good idea to get regular blood glucose readings at your clinic. I also know that in the US, large chains like Walmart sometimes have diabetes booths where you can get free checkups on your values. I recommend dropping by sometimes and just getting tested. Early discovery of the condition gives you the best chances after all!

In all other cases, watch for these symptoms and go see a doctor immediately if you are experiencing any or several of them:

• Urinating often
• Feeling very thirsty
• Feeling very hungry - even though you are eating
• Extreme fatigue
• Blurry vision
• Cuts/bruises that are slow to heal
• Weight loss - even though you are eating more (type 1)
• Tingling, pain, or numbness in the hands/feet (type 2)

What types of diabetes are there?
Most people are only familiar with type 1 and type 2. Both have had their names changed frequently over the years as we learn more about the disease. Currently, we know of the following:

Type 1 - This is where the body's immune system attacks the body. We don't know what triggers this condition quite yet, but genetics appear to play a key in whether or not someone can get it. In this case, the beta-cells in the pancreas, which produce insulin, are destroyed. Most people get this type of diabetes in their childhood up into their late teens. Insulin production usually crashes from 100% to almost nothing over the course of days, weeks or just a few months. From that point on the person has to give themselves daily insulin injections adjusted to the food they eat in order to manage their glucose levels.

Type 2 - This is where the body becomes less sensitive to insulin, or the pancreas has been worn out and is no longer producing enough insulin. This condition is not caused by eating too much sugar, but is the result of a combination of factors, such as weight, lifestyle choices and genetic factors. However, skinny people can get type 2 diabetes as well. The most effective treatment of type 2 is a healthy diet and healthy exercise regime. Limiting carbohydrates is a good first step.

Gestational - This develops during pregnancy, and in most cases reverses after the pregnancy has ended. This can happen to women who were not diabetic before their pregnancy. Women with gestational diabetes may succeed with only diet and exercise, but in many cases they are on temporary insulin injections until the end of the pregnancy. This varies per individual. We don't know exactly what causes it, but hormone disruptions from the placenta appear to play a large role in it. In some cases, women develop diabetes permanently from gestational diabetes.

Neonatal - This develops during the first 6 months of a baby's life, and sometimes have a special genetic form of neonatal diabetes. This requires a different treatment than type 1 diabetes. This genetic form is officially named Kir-6.2 and causes a deformation in the pancreas that leads to reduced/unregulated insulin secretion.

MODY - This is a form of diabetes that occurs in children. It's short for Maturity-Onset Diabetes of the Young. There are different forms of MODY, but with all of them something went wrong with the pancreas development in utero. This leads to exhaustion of the pancreas early on in life and a reduction of insulin output. It is, essentially, a form of type 2 diabetes in young children. This form is also much more linked to genetics than other forms of diabetes and you can be tested for MODY if you're planning on having children. Children with MODY require a different treatment than children with type 1, however, most doctors don't test for MODY, which often leads to a lifetime of slightly irregular glucose control. Many children with MODY can live without a lot of treatment if they have a 'good' form of it. Other children could live on tablets/pills for up to 10 years before having to use insulin.

LADA - This is a form of type 1 diabetes that occurs in adults, up to their late 50's. It's short for Latent Autoimmune Diabetes in Adults. The difference between type 1 and LADA is that LADA occurs very gradually. It has initial symptoms of type 2 diabetes (weight, easily managed with oral medication etc.) and is often misdiagnosed as such. However, most people with LADA don't fit the type 2 category (also due to weight, age and oral medication becoming less effective with time). Because it is an autoimmune condition, it cannot be controlled with diet and exercise and will eventually lead to insulin dependency no matter what your treatment is. Doctors are divided on the course of treatment. Some suggest people with LADA can go for 2-10 years without insulin and using oral medication instead, others insist on starting insulin injections immediately. It's important to be tested for LADA if you're 'too young' for type 2 (20-50 years old), not overweight, or finding your oral medication is ineffective.

MIDD - This is an inherited and very rare form of diabetes. It's short for Maternally Inherited Diabetes and Deafness. This form is inherited from the mother, which means the pancreas doesn't respond to rising blood sugar levels and doesn't secrete enough insulin. It's usually discovered between 30 and 50 years old, when most patients have been fighting with loss of hearing for years. It can usually be treated with oral medication for a while.

Type 3 of Alzheimer - This is a form of diabetes unlike most others. The brain is capable of secreting insulin as well. When the brain loses this functionality, it's presumed to be one of the leading causes for Alzheimer's disease. Scientists are not entirely certain on this yet, however. There's a lot of conflicting and lack of information on the subject, so I don't have a whole lot to share, but I thought it worth sharing. Do note that there are many other forms of dementia caused by damage to blood vessels and the nervous system due to diabetes complications.

Diabetes myths
Here is a very interesting article on diabetes myths. It's worth reading through if you want to learn more about it!


I will not make this topic any bigger, as I'm sure it's a lot of information to digest. All of my info here has been taken from official Diabetes websites (both Dutch, English and American) but we're discovering new things about diabetes all the time, so I recommend not holding on too strongly to the definitions given here. As we learn, we adapt our definitions and labels to accommodate the knowledge.

If you are diabetic yourself, I would absolutely LOVE to hear your story!

I'm a type LADA myself, but I have researched diabetes in general extensively and have spoken to many people suffering from other types as well. If you have any questions I'd be more than happy to give you my personal/anecdotal input!