Mainly there are five types of Diabetes

  • Type I Diabetes
  • Type II Diabetes
  • Fibro calculous Pancreatic diabetes (FCPD). Diabetes due destruction of insulin producing cells of the pancreas
  • Pregnancy Diabetes
  • Diabetes due to other causes such as Endocrine, Drugs ….

Type I diabetes

     It is found in children and young adults. It is also found in adults occasionally. There is completely no insulin in the body. Since all new-born babies are tested for blood sugar diabetes can be detected early enough. It is believed that type I Diabetes is due to autoimmune destruction of insulin producing cells. It happens when your immune system mistakenly attacks and destroys the beta cells in your pancreas that produce insulin. What prompts the attack isn’t clear. The damage is permanent. There may be both genetic and environmental components. Certain infections and medicines are thought to produce Type I Diabetes. Lifestyle factors aren’t thought to play a role. The sad fact is that you cannot live without insulin. Daily injections at different intervals for life are a big challenge. At different stages of life you need support and special care. Adolescents need emotional support and attention. For women pregnancy and child bearing with Type I Diabetes needs specialised medical care. Regular body check-up, blood sugar control, diet control, appropriate exercise along with physician and family support are anchors of Type I Diabetes care. Unlike in Type II Diabetes the symptoms appear suddenly sometimes seriously.

Type II diabetes

     It is the commonest type of Diabetes. In type II Diabetes Insulin resistance initiate the disease process. In a genetically predisposed individual in the presence of acquired factors like obesity and sedentary life insulin resistance develop. This is the starting point of Type II Diabetes. With insulin resistance insulin becomes insufficient and inefficient. Consequently more insulin is produced by insulin producing cells in the pancreas. Gradually these cells get exhausted and there is no more insulin. Diabetes develops.

     Type II Diabetes was previously known as maturity onset Diabetes as this was found only in adults. Due to extremes in life style changes young adults and even school children have Type II diabetes. Type II Diabetes is managed with Food control, Exercise and Medicines. Food control reduces the glucose load. Exercise address insulin resistance and is an alternative way to use up glucose by the body. The benefits of exercise everybody knows today. Medicines used in Diabetes treatment act at different levels of the disease process. Some of them reduce insulin resistance. Some others stimulate pancreas to produces more insulin. Yet another one slows down absorption of glucose from intestine and so forth. Insulin may be required any time in the course of the disease The overall target is to keep blood sugar near normal. Complications and accompanying other morbidities are there with Type II Diabetes.

FibroCalculous Pancreatic Diabetes (FCPD)

     Fibro calculous pancreatic diabetes (FCPD) is an uncommon form of diabetes. This occurs as a result of chronic calcific pancreatitis, in the absence of alcohol abuse. The disease is restricted to tropical regions of the world, and southern India has the highest known prevalence of FCPD. The typical patient with FCPD is a lean adolescent or young adult of either sex, presenting with history of recurrent bouts of abdominal pain and steatorrhea. Demonstration of large, discrete pancreatic calculi by plain radiographs or ultrasonography of the abdomen is diagnostic. While the exact etiology of FCPD is unknown, genetic, nutritional and inflammatory factors have been hypothesized to play a role.

     Diabetes in FCPD is often brittle and difficult to control; most patients require multiple doses of insulin for control of glycaemia. However, in spite of high blood glucose levels, patients rarely develop ketosis. Malabsorption responds to pancreatic enzyme supplementation. Surgical removal or (endoscopic removal) of stones is indicated for symptomatic relief of intractable pain. Development of pancreatic malignancy is the most dreaded complication and should be suspected in any patient who complains of weight loss, back pain or jaundice.

Pregnancy Diabetes

     More pregnant women are becoming Diabetics these days. Their number is increasing and pregnancy related complications are also on the increase. The pregnancy Diabetic mother is likely to become permanent diabetic in the long run unless proper care is taken. The baby of the diabetic mother is also at risk of diabetes. Thus Diabetes begets Diabetes. This however is very serious and we have to be careful.

     A diabetic mother can become pregnant. A pregnant lady can become Diabetic for the first time. In the first case the pregnancy has to be a planned one. In the second case the Diabetes has to be managed with very good sugar control and meticulous follow up during pregnancy. Both for the mother and the baby in the uterus need very good attention and care. Periodic check-up is essential and they need special attention. Best outcome depends on the care during pregnancy and after delivery. Pregnancy Diabetes can become permanent Type II diabetes.

©2017 Dr. Kamalasanan

Navabharath Diabetes Care & Research

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