Diabetes

Different types of diabetes

There are different types of diabetes, but the two most common are type 1 and type 2 diabetes.

In type 1 diabetes, your body no longer makes insulin at all. This is because your immune system attacks the cells that make insulin. People with type 1 diabetes must inject insulin every day or wear an insulin pump. They also have to measure their blood sugar regularly and adjust the amount of insulin to what they eat.

Diabetes type 2 is much more common, about 90% of people with diabetes have this form. In type 2, your body still makes insulin, but too little or you don't respond well to it. This is called insulin resistance. Type 2 diabetes often develops in people who are overweight or don't exercise much, but it can also be genetic.

Some forms of diabetes are medically related but still have their own name.

• Diabetes type 1
• Diabetes type 2
• Pregnancy diabetes
• MODY forms
• LADA
• Other types, for example, due to damage to the pancreas.

All types of diabetes listed

Symptoms of diabetes

The symptoms of type 2 diabetes are often difficult to recognize because they also occur with other, less serious symptoms. For example, do you often feel thirsty, need to urinate a lot or feel tired easily? These can be signs of diabetes. Weight loss for no apparent reason, blurred vision and poorly healing wounds can also be signs of type 2 diabetes.

With type 1 diabetes, symptoms often arise more quickly and more intensely. People with type 1 diabetes also often have the same symptoms as type 2, but over a short period of time. They often feel very sick and lose weight quickly.

The symptoms of diabetes 1

The symptoms of diabetes 2

Do you possibly have diabetes?

Do you recognize yourself in some of the symptoms listed above? If so, it is smart to see your family doctor. The family doctor can tell if you have diabetes with a simple test, which involves taking a drop of blood. Don't wait too long, because high blood sugar levels can cause long-term damage to your heart, kidneys, eyes and feet.

You can also test your risk of type 2 diabetes in advance with the Diabetes Risk Test. This test indicates whether you are at higher risk and whether it is wise to get further examinations.

When should you not do the test?

• when you are under 18 years old
• you are being treated for diabetes; this applies to all types of diabetes
• you already have obvious symptoms that may indicate diabetes. If so, always see your doctor.

The Diabetes Risk Test is based on scientific research by VUmc, Wageningen University & Research, UMC Groningen, RIVM and Maastricht UMC.

Take the Type 2 Diabetes Risk Test

Diabetes medications

Oral blood sugar-lowering drugs

Oral blood sugar-lowering drugs are tablets you take if you have type-2 diabetes (adult-onset diabetes). These drugs stimulate your pancreas to make more insulin or make your organs more sensitive to insulin. This lowers your blood sugar.

These drugs are not suitable for people who no longer make insulin at all, as in type-1 diabetes. There are different types:

• Sulfonylurea stimulates your pancreas to make more insulin. Examples include glibenclamide, gliclazide, glimepiride and tolbutamide.
• Biguanides inhibit your body's production of sugar and make your cells more sensitive to insulin. This is especially appropriate if you are overweight. An example is metformin.
• Meglitinide analogues also make your pancreas make more insulin, but they work for a shorter time than sulfonylurea derivatives. Sometimes they are used in conjunction with other drugs, such as repaglinide.
• Pioglitazone improves the absorption of sugar from your blood into cells, lowering your blood sugar.
• Acarbose slows the breakdown of carbohydrates in your intestines, allowing sugar to enter your blood more slowly. This avoids high spikes in your blood sugar.
• DPP-4 inhibitors (such as linagliptin, saxagliptin, sitagliptin and vildagliptin) and incretin-like substances (such as dulaglutide, exenatide, lixisenatide, liraglutide and semaglutide) cause you to have more insulin after a meal and your body to make less sugar.
• Dapagliflozin, empagliflozin and canagliflozin inhibit the SGLT2 protein in your kidneys, causing more sugar to be eliminated through your urine and lowering your blood sugar.

Insulin

Insulin is used as an injection when you have diabetes mellitus. If your body no longer makes its own insulin, you have to make up the shortfall with insulin. This is especially necessary in type-1 diabetes, also called insulin-dependent diabetes.

Sometimes you also need to use insulin in type-2 diabetes. Insulin can be classified as short-acting, intermediate-acting, long-acting or combinations of these. The place where you administer the injection determines how quickly it works: in your abdomen it works quickly, in your upper arm it works normally, and in your thigh or buttock it works more slowly.

Glucagon

Sometimes insulin can work too well, causing your blood sugar to get too low (hypoglycemia). Glucagon causes the sugar stored in your liver to be released into your blood and new sugar to be made from other substances. This causes your blood sugar to rise again.

What can you do about diabetes?

If you have diabetes, it is important to keep your blood sugar levels as balanced as possible. This can be done through a healthy diet, regular exercise and, if necessary, taking medication or insulin. It varies from person to person which treatment works best. That's why it's important to measure your blood sugar regularly and discuss with your healthcare provider what the best approach is for you. Although diabetes cannot be cured, with the right treatment and lifestyle, you can prevent many problems and live a healthy life.