types Diabetes
Diabetes or Diabetes Mellitus is a chronic condition that is characterized by one’s body’s inability to convert the glucose (sugar) in food into energy and effects about 537 million adults from the ages of 20-70 around the world, and 1.2 million children ages 0-19 are affected by Diabetes Type I around the world. It is projected to rise to 643 million by 2030 (International Diabetes Federation, 2021). There are four common types of diabetes.
Prediabetes
Prediabetes is caused by one’s body not responding to insulin production and resulting in higher levels of blood sugar. A person with prediabetes has an A1C range between 5.7-6.4%, when normally it is less than 5.7%. (A1C is a test that assesses for the percentage of blood that has sugar-coated hemoglobin.) Individuals with Prediabetes commonly exhibit the following risk factors:
- Overweight
- +/= 45 years old
- Immediate familial history of Type II Diabetes (see below)
- Physical activity less than 3 times per week
- Polycystic Ovary Syndrome (PCOS)
- Giving birth to a baby who is more than 9 pounds
- Gestational Diabetes (see below)
Having Prediabetes can lead to Type II Diabetes (see below) if not managed (CDC).
Gestational Diabetes
Gestational diabetes is characterized by a pregnant person’s body being affected by insulin production. This can also impact the person’s pregnancy and their baby’s health. Individuals with Gestational Diabetes have a higher risk of developing Type II Diabetes (see below) as well. There aren’t as many symptoms an individual with Gestational Diabetes may experience other than the possibly having increased thirst or more frequent need to urinate. Possible risk factors a pregnant person may be:
- Overweight or obesity
- Little to no physical activity
- Diagnosis of Prediabetes
- History of gestational diabetes in previous pregnancies
- PCOS
- Family history of diabetes
- History of delivering a baby more than 9 pounds in previous pregnancies
Gestational Diabetes can cause complications in both the pregnant person and the baby. The pregnant person may experience the following complications:
- High blood pressure
- Preeclampsia
- Deliver via C-section
- Developing Type II Diabetes in the future
The baby of a person with Gestational Diabetes can have the following complications as well:
- High birth weight leading to complications in delivery
- Preterm birth
- Respiratory Distress Syndrome (RDS) which is characterized by experiencing severe breathing difficulties
- Hypoglycemia (low blood sugar)
- Developing Type II Diabetes or Obesity in the future
- Stillbirth
Type I DIABETES
Type I Diabetes used to be known as Juvenile Diabetes because it was predominantly diagnosed in children, however it can be diagnosed in adulthood. It is chronic condition that is characterized by a one’s pancreas inability to produce enough insulin. While the causes for Type I Diabetes is still being researched, it is believed that genetics, viral exposure, or environmental factors can cause Type I Diabetes. Treatment is primarily concerned with managing insulin levels, diet, and lifestyle. Common symptoms of Type I Diabetes may be:
- Increased thirst
- Frequent urination
- Unhistorical bed-wetting in children
- Increase hunger
- Accidental weight loss
- Irritability, mood changes
- Fatigue
- Feeling physically weak
- Blurred vision
Individuals with Type I Diabetes can develop further complications throughout their body in the future if blood sugar isn’t managed well:
- Development of cardiovascular diseases
- Neuropathy (nerve damage)
- Nephropathy (kidney damage)
- Diabetic retinopathy (eye damage)
- Foot problems
- Oral complications
- Dermatological complications
- Pregnancy complications
Type II DIABETES
Type II Diabetes is also a chronic condition that is characterized by irregulation of sugar transformation into fuel, resulting in too much sugar in the bloodstream. Type II Diabetes is caused by the pancreas inability to make enough insulin and the body’s cells become resistant to that insulin. While there is no cure for Type II Diabetes, patients can manage the disease with weight loss, proper diet, physical activity, combined with medication. People with Type II Diabetes tend to experience the following symptoms:
- More thirst
- Increased urination frequency
- More hunger
- Accidental weight loss
- Fatigue
- Blurred vision
- Sores can take awhile to heal
- Having more infections
- Numbness or tingling in extremities (hands and feet)
- Parts of skin are darker than the rest of the skin (often seen on the neck or in the armpits)
Individuals are at higher risk for developing Type II Diabetes if they experience any of these factors:
- Overweight or obesity
- Fat distribution is mainly in the abdomen (mens’ waist of 40″+; women’s waist of 35″+)
- If a person doesn’t use up the sugar through physical activity
- Other family members have Type II Diabetes
- High levels of the “bad” cholesterol (triglycerides) and low levels of “good” cholesterol (High-Density Lipoprotein, HDL)
- The risk of developing Type II Diabetes increases as one ages
- Prediabetes
- Gestational Diabetes or giving birth to a baby weighing 9 pounds or more
- PCOS
Much like Type I Diabetes, Type II Diabetes can lead to complications throughout the body:
- Cardiovascular diseases, such as atherosclerosis (high blood pressure and narrow blood vessels)
- Neuropathy in extremities and other areas of the body
- Nephropathy
- Retinopathy
- Dermatological complications
- Slow healing; when left untreated, sometimes the cure requires amputation
- Hearing problems
- Sleep apnea
- Dementia
Diabetes in the Asian American Community
In the Asian American community, 1 in 3 people are diagnosed with a type of diabetes (CDC, 2022) and is the fifth leading cause of death in AAPI (Joslin Diabetes). At the U.S. Department of Health and Human Services Office of Minority Health published the statistical differences of Asian Americans and their other nationality counterparts. They found that they are 40% more likely to have diabetes than non-Hispanic Whites. From 2017-2018 South-Asian Americans were 70% more likely to develop diabetes in comparison to their non-Hispanic white counterparts (OMH, March 2021). Due to the distribution of fat, primarily the visceral fat (fat distributed around organs), Asians can appear to be at a healthy weight and often under diagnosed with diabetes. As a result, it is recommended than Asian Americans have their A1C checked if their BMI is 23 or greater (CDC, April 2022). As the Asian population is quite diverse, it is difficult to identify the specifics of each subgroup and more research is needed (NIH News Releases, 2015).
Diabetes Impact on Mental Health in Asian Americans
The Mind-Body Connection impacts the individual with diabetes. People with diabetes are two to three times more likely to suffer from depression for various reasons and not many of these individuals are diagnosed and treated. Anxiety and stress can also impact diabetes prognosis (CDC, 2021) due to the manner in which the body burns energy. As diabetes is impacted by diet, individuals can develop Eating Disorders(MHA) and perhaps even Body Dysmorphia due to the weight fluctuations one can endure throughout the disease process. Furthermore the difference in BMI standards to adjust to Asian body types may impact the individual’s view of themselves. Research has noted that the implementation of conjoint intervention of medicine and lifestyle changes (i.e. diet, physical activity, and therapy) can greatly improve the lives of individuals with diabetes.
Resouces
Diabetes Care– ADA’s Standards of Medical Care in Diabetes clinical practice recommendations
Drag ‘n Cook– a resource for Asian food recipes with nutritional information
International Diabetes Federation (IDF)
International Diabetes Federation Diabetes Atlas 10 ed. (2021)
Mayo Clinic The Essential Diabetes Book, 3rd ed., Maria Regina Castro, M.D. (2022)
National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States
Prediabetes– CDC
Prediabetes– Mayo Clinic
Menke A, Casagrande S, Geiss L, Cowie CC. Prevalence of and Trends in Diabetes Among Adults in the United States, 1988-2012. JAMA. 2015;314(10):1021–1029. doi:10.1001/jama.2015.10029
This month’s article was written by our chronic illness specialist, Aarti S. Felder, MA, LCPC, BCN.