Diabetes could be broadly defined as a chronic condition triggered by fluctuating blood glucose levels. This could be either due to the lack of adequate insulin secretion from the pancreas or inability of the available insulin to ensure the uptake of circulating blood glucose by the body. Broadly classified into two variants, Type 1 and Type 2 diabetes mellitus, the former is an auto immune condition while the latter is mostly metabolic in nature. It is caused due to unhealthy diet and lifestyle in most people and is the most prevalent form of diabetes. In India itself it is estimated that at least 101 million people are diagnosed with diabetes and another 136 million are living with either diabetes or pre-diabetes.
Beyond Type 1, Type 2, and gestational diabetes, there are some other forms of diabetes that are often caused due to various factors including genetic or acquired as part of other conditions or physiological stages like pregnancy. Steroid induced diabetes is one such condition which was diagnosed in many people after the initial waves of Covid-19 since steroid-based medications were being given to people diagnosed with diabetes.
Common variants of diabetes
1.Type 1 diabetes
Dr S Satish Kumar, HOD & lead consultant- endocrinology, diabetology & bariatric medicine, Aster hospital, Bengaluru, says, Type 1 diabetes mellitus is a condition developed due to autoimmune destruction of beta cells function of the pancreas that causes insulin deficiency. Generally, type 1 diabetes occurs in children and young adults, but it can also happen in any age.
He adds, those who are diagnosed with 1 diabetes are usually less than 35 years of age, their BMI is usually less than 25, and the symptoms would start over week, or in few months, it usually presents with elevated blood sugar levels. In type 1 diabetes, they need the insulin from day one since the diagnosis of condition.
2. Type 2 diabetes
Dr Sandeep Reddy, senior endocrinologist, Kamineni Hospitals, Hyderabad, says, type 2 diabetes usually occurs in adults and elderly people. The most common reason for this condition is insulin resistance where the pancreas secrete insulin but it is unable to ensure uptake or help various cells to absorb this glucose from your blood for various functions. If not addressed through lifestyle changes and medication in some people, this could lead to destruction of pancreatic beta cells and severely affect insulin secretion in people with chronic type 2 diabetes. Type 2 diabetes mellitus has emerged as a global concern and often comes bundled with other metabolic and vascular comorbidities including obesity, hypertension and high cholesterol. This diabetes variant also increases the risk of cardiovascular complications by manifold.
According to Dr Kumar, unlike Type 1, Type 2 diabetes can often be managed through lifestyle modifications, including a balanced diet, regular physical activity, weight control and insulin.
3. Gestational diabetes
Dr Sharma says, gestational diabetes is a condition where the pregnant women experience high blood sugar during pregnancy, particularly during second, or third trimester of the pregnancy. Gestational diabetes usually subsides post-delivery, however in few people, they continue to have high blood sugar (hyperglycemia) post-delivery as well and usually become diagnosed with type 2 diabetes. Most women with gestational diabetes may have family history of diabetes, being overweight, women above 30 years of age, all are the risk factors for gestational diabetes. Women with gestational diabetes should adopt lifestyle modifications, such as exercise, healthy diet, and weight management, even after post pregnancy to reduce the risk of developing type 2 diabetes.
4. Steroid/Medication- induced diabetes
Dr Sharma says, some people go for steroid therapy for several health conditions, such as rheumatoid arthritis, Covid-related health conditions and diabetes that can increase the blood sugar level temporarily.
Steroid-induced diabetes is an unexpected rise in blood sugar levels due to usage of steroids. Both those with and without a history of diabetes may experience it.
He adds, those who undergo chemotherapy for cancer and immunomodulation therapy can also get steroid-induced diabetes because of the medications used in these treatments. Managing steroid induced diabetes could take a mix of both medication and lifestyle changes depending on instructions from your medical expert.
5. Latent autoimmune diabetes in adults (LADA)
Latent autoimmune diabetes in adults (LADA) is sometimes also referred as type 1.5 diabetes. Lada is diagnosed during adulthood, but unlike type 2 diabetes, it’s an autoimmune disease. Around 10 percent of people with diabetes are diagnosed with LADA. The symptoms of LADA are sort of similar with type 2 diabetes such as frequent thirst, increased urination, and unexplained weight loss.
Dr Reddy says, latent autoimmune diabetes in adults sometimes confused with type 2 diabetes as well, so these people also require insulin later. In LADA, the decline of the beta cell function of the pancreas which secretes insulin is a bit slow compared to type 1 diabetes.
6. Maturity-Onset Diabetes of the Young (MODY)
Maturity-Onset Diabetes of the Young (MODY), is a rare form of monogenic diabetes resulting from mutations or changes in a single gene. Dr Reddy says, MODY usually manifests in adolescence or early adulthood and is often misdiagnosed as type 1 or type 2 diabetes.
The different types of MODY are associated with specific genetic causes. The most common types are HNF1A-MODY (also known as MODY3), accounting for 50 to 70 percent of cases. Early signs and symptoms in these types are caused by hyperglycemia and may include frequent urination (polyuria), excessive thirst (polydipsia), fatigue, blurred vision, weight loss, and recurrent skin infections.
7. Neonatal diabetes
Neonatal diabetes is a rare form of diabetes diagnosed in infants between the first six to 12 months. It is usually diagnosed from high glucose levels in blood or urine of the infant. It is caused due to a mutation in the gene affecting pancreatic beta cell development. There are two main versions of neonatal diabetes, the most common being permanent neonatal diabetes which requires lifelong management. Transient neonatal diabetes, often goes into remission during infancy itself for the infants diagnosed with it. However, these children will have a higher risk of getting diagnosed with other forms of diabetes later on in life.
