Type 1, type 2 and more

What diabetes means

Diabetes means there is too much glucose (sugar) in your blood. This happens when the body cannot make enough insulin, or cannot use it properly. Insulin is the hormone that lets glucose move out of your blood and into your cells, where it is used for energy. The different types of diabetes are really different reasons for the same end result – and that is why they are treated differently.

Type 1 diabetes

Type 1 is an autoimmune condition. The body's own immune system attacks the cells in the pancreas that make insulin, so it makes very little or none at all. It is not caused by lifestyle or weight, and nothing you did brought it on.

• Who gets it. It can start at any age, but often appears in childhood or early adulthood.
• How it is treated. Because the body makes no insulin, type 1 is always treated with insulin – by injections or an insulin pump – for life.
• How it starts. The symptoms often come on quickly, over a few weeks.

Type 2 diabetes

Type 2 is the most common type in the UK. Here the body either does not make enough insulin, or the body's cells stop responding to it properly – this is called insulin resistance. It usually develops slowly.

• What raises the risk. The chance of type 2 rises with age, with being overweight, and with a family history of diabetes. It is also higher in people of South Asian, Black African and African Caribbean backgrounds.
• How it is managed. Type 2 is managed with changes to food and activity, often with tablets, and sometimes with insulin as well.
• Remission. According to Diabetes UK, some people can put type 2 into remission – blood sugar back in the normal range without medication – particularly through weight loss.

Gestational diabetes

Gestational diabetes is high blood sugar that develops during pregnancy and usually goes away after the baby is born. It does raise the chance of developing type 2 later in life, so it is worth staying aware of afterwards. The targets in pregnancy are tighter than at other times – see the guide to diabetes in pregnancy.

Prediabetes

Prediabetes – also called non-diabetic hyperglycaemia, or being at high risk of type 2 – means your blood sugar is higher than normal, but not high enough to be type 2 diabetes. The NHS defines it as an HbA1c of 42 to 47 mmol/mol (6.0 to 6.4%). It is best thought of as a warning sign, and it can often be turned around with changes to food, activity and weight.

Rarer types

A few less common types exist too. LADA (latent autoimmune diabetes in adults) is a slow-onset form of type 1 that appears in adulthood, and MODY is an inherited type caused by a single gene change. These are uncommon and are diagnosed by a specialist, often after the usual type 1 or type 2 picture does not quite fit.

Spotting undiagnosed diabetes

Whatever the type, the common symptoms of diabetes that has not yet been diagnosed are similar:

• Feeling very thirsty
• Peeing more than usual, especially at night
• Feeling tired
• Losing weight without trying
• Blurred vision

With type 1 these often come on quickly, over a few weeks. With type 2 they can be gradual, or there may be no symptoms at all – which is why type 2 is sometimes found during a routine check. If you notice these symptoms, see your GP.

Whatever your type, logging helps

Knowing your type tells you what to aim for; logging shows whether you are getting there. You can start logging your readings free and watch the pattern build up over the days and weeks.