If you’re reading this article, chances are that you or someone close to you has diabetes mellitus, more commonly known simply as diabetes. You have probably learned a great deal about type 1 diabetes or type 2 diabetes—the two most general forms of the disease. How the goals of treatment are achieved depends heavily on the form of diabetes.

Updating the outdated
Over the years, you may have heard the term juvenile diabetes or adult-onset diabetes. You may also have heard of insulin-dependent diabetes or non-insulin-dependent diabetes—referring to whether insulin is needed to control the disease. Today, due to recent medical advances and improved scientific understanding of diabetes, these descriptions are outdated.  

Now, medications are being designed to target the specifics of diabetes, such as the body producing too little insulin and the body being unable to use insulin as it should—insulin resistance. In people with insulin resistance, cells resist the action of the hormone insulin. Insulin helps glucose (sugar) leave the blood and enter body cells, which use the glucose to produce energy.

As a result of these advances, the American Diabetes Association (ADA) has named the forms of diabetes as follows.

• Type 1 diabetes occurs when the body’s immune system destroys cells in the pancreas that produce insulin. Without insulin, glucose cannot enter cells. It then builds up in the blood.  About 5% to 10% of people with diabetes have the type 1 form. Although it more often develops in children and teenagers, type 1 diabetes can develop in adults, too.
• Type 2 diabetes occurs when the pancreas produces some insulin, at least at first, but for reasons not understood the body is not able to use the insulin as it should. Most cases of diabetes are type 2—about 90% to 95%. It often develops with increasing age, in people with a family history of type 2 diabetes, a personal history of diabetes during pregnancy (gestational diabetes), or those who are obese and have an inactive lifestyle. Type 2 diabetes, once considered a disease of adults, is becoming more common in children and teenagers as the incidence of childhood obesity grows.

Other types of diabetes
Many cases of diabetes don’t fit neatly into one group. That is why some experts think it could be more important to identify the cause than to label the type of diabetes.

Gestational diabetes is diabetes that develops during pregnancy and often disappears following the birth. Women who develop the condition are at increased risk of type 2 diabetes later in life.

Pre-diabetes is a condition of impaired fasting glucose, impaired glucose tolerance, or both. Blood glucose levels are higher than normal (impaired) after fasting (not eating for 8 hours). Or levels are higher than normal 2 hours after drinking a glucose solution following a fasting period. Although glucose levels are above normal, they are not high enough to be called diabetes. Because people with pre-diabetes are at increased risk of someday developing diabetes and heart disease, they should be watched closely for high blood pressure, high cholesterol, and weight gain. Some weight loss, regular exercise, and medication have been shown to delay or even prevent the onset of diabetes in people with pre-diabetes.

Other, less common types of diabetes include those caused by defects in genes that affect the ability of the pancreas to produce insulin or the body’s ability to use it. Diabetes also can be a result of various diseases of the pancreas, infection, hormone problems, or other factors.

Finally, some drugs can affect insulin production and the way the body uses glucose. While they may not cause diabetes, they may trigger the condition in some people with insulin resistance.
 
Better treatments,better protection
As diabetes treatments become more targeted toward specific causes, your treatments may change. These changes will better protect people from the complications of diabetes—no matter which type they have.