I wasn’t surprised when I was diagnosed with Type 2 diabetes 20 years ago. Everyone I knew on my father’s side of the family had the disease, and I certainly met the physical criteria: middle age and slightly overweight.
What sent me to the doctor initially was a yeast infection that wouldn’t go away, and when my fasting blood glucose level came back at 280, my doctor immediately put me on two types of medications to lower my glucose levels.
What are the different types of diabetes?
“When people refer to diabetes, they are commonly referring to diabetes mellitus,” says Rajnish Jaiswal, MD, the associate chief of emergency medicine at Metropolitan Hospital Center in New York City. “Insulin-dependent diabetes mellitus (IDDM), or Type 1 diabetes, is when the body doesn’t produce any insulin at all. And non-insulin dependent diabetes mellitus (NIDDM), or Type 2 diabetes—which is the most common type accounting for 85% to 90% of all cases—is characterized by insulin resistance rather than insulin deficiency.”
Prediabetes is having blood sugar levels higher than average but not high enough for a diabetes mellitus diagnosis, according to the American Diabetes Association.
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While lesser-known, gestational diabetes occurs during pregnancy. While the patient’s blood glucose levels will often return to normal after giving birth, it is important to know that women with gestational diabetes are at higher risk for developing Type 2 diabetes later in life.
According to the Centers for Disease Control and Prevention (CDC), diabetes complications can include heart disease, heart attack, kidney disease, nerve damage, damage to the feet, oral health problems, hearing loss, vision loss, and mental health problems. Fortunately, many of these are preventable with the right lifestyle changes (such as healthy eating and regular physical activity to maintain a healthy weight) as well as diabetes medication like insulin therapy.
My diabetes diagnosis
I can only assume that my initial diagnosis was based on my age, family history, and physical characteristics. I was uninsured at the time, and the local health department performed a blood glucose test, then transferred me to a local doctor. My sister has Type 1 diabetes and struggles to keep her blood glucose levels stable. I knew I didn’t want that diagnosis. I was relieved when I left the office labeled with Type 2 diabetes.
“If a person is fairly thin and seemingly healthy, but displaying very severe signs at diagnosis (dehydration, urinary frequency, severe weight loss) the patient will often go through extensive diagnostic testing initially,” according to Stephanie Redmond, Pharm.D., a co-founder of diabetesdoctor.com.
“However, if a patient is overweight and an adult,” continues Dr. Redmond, “one might just assume Type 2 and first try them on Metformin or other oral medications to see if they respond. If they don’t, then they may be asked to complete further testing. If a patient is older than 45 with a high BMI, we usually assume Type 2 and start treatment promptly.” That’s the route my healthcare provider went.
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Treating my diabetes
“Those with Type 2 diabetes still produce insulin, so they are prescribed pills, and sometimes insulin to lower sugar levels. Diet and exercise often play a large part in their treatment,” Dr. Jaiswal says.
Since the doctors told me I had Type 2 diabetes, my initial treatment regimen reflected that. I was prescribed an oral medication for managing blood sugar, but it never worked well enough to get my numbers where they needed to be. I also used a combination of basal/bolus (long-acting) insulin and meal-time (quick-acting) insulin.
Diet has always been the most challenging part to manage in my journey with diabetes mellitus. I’m more into potatoes than salads. But, over time, I have learned that moderation is the key to my food choices. I don’t make a regular habit of eating sweets, but I occasionally enjoy a scoop of ice cream. Luckily, I enjoy walking and do so every day.
Eventually, I resisted taking the pills. I had tried several types, and they weren’t controlling my condition. Not to mention, they caused unpleasant side effects like weight gain and stomach issues.
Last year, I received a C-peptide test that measures insulin in the pancreas. My test came back negative, and I found out that I’ve had Type 1 diabetes all along. “People with Type 1 diabetes need regular insulin shots,” says Dr. Jaiswal. It explained why I generally felt better when taking just insulin.
Honestly, though I dreaded this diagnosis, I am happy to be on the right track with treatment. The stress of trying out new medicines wasn’t good for me, and I always gained five to seven pounds when I switched medications.
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Living with diabetes
“One thing that sometimes gets missed is that diabetes, though a medical disease, can have psychological consequences as well,” explains Dr. Jaiswal. “It can be an overwhelming illness and can cause a lot of stress, depression, anxiety. Sharing these feelings with your doctors is helpful and speaking to counselors, social workers, and family is also an integral part of the treatment plan.” In other words, don’t try to go it alone. Seek support from your healthcare team, friends, and even support groups. This condition is likely to be with you for a lifetime, and they can help you when times are tough.
No one knows your body better than you do. If you’re not comfortable with your current diabetes care, have an honest conversation with your healthcare provider. And, take a tip from my story: Make sure you know for sure what type of diabetes mellitus you have for the best long-term diabetes management.