Most people with prediabetes will develop diabetes within ten years. Although people with prediabetes don’t usually develop small blood vessel complications of diabetes like blindness, kidney failure, and nerve damage, they’re more prone to large vessel disease like heart attacks and strokes, so you want to get that level of glucose down.
Type 1 diabetes: This used to be called juvenile diabetes or insulin dependent diabetes. It mostly begins in childhood and results from the
body’s self-destruction of its own pancreas. The pancreas is an organ of the body that sits behind the stomach and makes insulin, the chemical or “hormone” that gets glucose into cells where it can be used. You can’t live without insulin, so people with type 1 diabetes must take insulin shots. Of the 24 million Americans with diabetes, about 10 percent have type 1.
Type 2 diabetes: Once called adult-onset diabetes, type 2 used to begin around the age of 40, but it is occurring more often in children, many of whom are getting heavier and heavier and exercising less and less. The problem in type 2 diabetes is not a total lack of insulin, as occurs in type 1, but a resistance to the insulin, so that the glucose still doesn’t get into cells but remains in the blood.
Gestational diabetes: This type of diabetes is like type 2 diabetes but occurs in women during pregnancy, when a lot of chemicals in the mother’s blood oppose the action of insulin. About 4 percent of all pregnancies are complicated by gestational diabetes. If the mother isn’t treated to lower the blood glucose, the glucose gets into the baby’s bloodstream. The baby produces plenty of insulin and begins to store the excess glucose as fat in all the wrong places. If this happens, the baby may be larger than usual and therefore may be hard to deliver. When the baby is born, he is cut off from the large sugar supply but is still making lots of insulin, so his blood glucose can drop severely after birth. The mother is at risk of gestational diabetes in later pregnancies and of type 2 diabetes as she gets older.
Other types: A small group of people with diabetes suffer from one of these much less common varieties of diabetes:
• Latent autoimmune diabetes on adults (LADA), which has characteristics of both type 1 and type 2 diabetes
• Genetic defects of the beta cell, which makes insulin
• Medications that affect insulin action like cortisol or prednisone
• Diseases or conditions that damage the pancreas like pancreatitis or cystic fibrosis
• Genetic defects in insulin action