Type 1 & Type 2 Diabetes - What Are the Stages & Symptoms?
Diabetes is an often silent and incurable
disease that affects one in eleven people in the world. Estimates from
2018 show that over 10% of the US population suffers from this
condition, over 7 million of whom are not aware that they have it. How
come this severe disease is often unnoticed for years? And when one gets
diagnosed with diabetes, what physiological changes in the body should
they watch out for with time?
Although the progression of the disease is
individual and not everyone reaches the advanced stages, both type 1
diabetes and type 2 exhibit specific patterns that are important for
patients and caretakers to recognize.
The Many Faces of Diabetes
Diabetes isn’t a single condition. It’s a collection of three separate
diseases - type 1 diabetes, type 2 diabetes, and gestational diabetes -
all of which have a distinct cause and progression. What unites these
three conditions under the umbrella term ‘diabetes’ is high glucose
(blood sugar).
Glucose is the main source of fuel for the body, but in order to enter
the cells, it requires insulin - a hormone produced in the pancreas.
When the levels of insulin fall, or when the body doesn’t respond to
insulin as it should, too much glucose is left in the bloodstream. This
has a destructive effect on the body.
Type 1 diabetes is an autoimmune
condition where the immune system attacks and destroys the cells in the
pancreas responsible for producing insulin called beta cells. Due to the
scarcity of insulin in the body, glucose builds up in the blood. Type 1
diabetes has a hereditary component. Only slightly more than 5% of
diabetics are diagnosed with type 1 diabetes, but researchers believe
that this number is likely higher by another 5-15% since many people
initially diagnosed with type 2 diabetes actually have type 1 diabetes
according to Diabetes Daily.
Type 2 diabetes is the most widespread form of diabetes. It accounts
for over 91% of diabetes diagnoses in the US. In type 2 diabetes, the
cells become increasingly resistant to insulin, so the sugar can’t get
into the cells and builds up in the blood instead. The exact causes of
this condition are unknown, but both environmental factors and weight
gain seem to play a role.
Gestational diabetes is usually a temporary form of diabetes that
appears in 6-9% of pregnancies. Pregnancy hormones have the side effect
of making cells more resistant to insulin, which is usually balanced out
by increased production of insulin in the pancreas. When the pancreas
isn’t able to meet that increased demand for insulin, gestational
diabetes develops.
In the past years, the American Diabetes Association (ADA) and the
American Association of Clinical Endocrinologists (AACE) have developed a
type 1 and type 2 diabetes development model divided into various
stages.
The Stages of Type 1 Diabetes
Type 1 diabetes is formally divided into 3
separate stages that reflect how the immune system gradually damages the
beta cells in the pancreas and how this is reflected in the development
of diabetes symptoms.
Stage 1
The earliest stage of type 1 diabetes is asymptomatic. It is most often
diagnosed in children whose parents suffer from diabetes during a
screening antibody blood test. This blood test finds the immune system
antibodies that attack the pancreas. When someone has one or more kinds
of such autoantibodies, but their blood sugar levels are normal, they
are diagnosed with Stage 1 type 1 diabetes.
Research suggests that nearly 100% of children diagnosed with this
asymptomatic form of diabetes have developed diabetes symptoms in their
lifetime, with 44% of children experiencing symptoms in 5 years after
testing and 70% in 10 years.
Stage 2
At Stage 2, a person’s glucose levels start to rise as well, but they
may still not experience any overt symptoms of the disease. It can take
from months to years before a person experiences the first symptoms of
diabetes, which is why so many people suffering from type 1 diabetes
actually get misdiagnosed with type 2 diabetes.
The Stages of Type 2 Diabetes
Four recognized stages of type 2 diabetes exist. This framework was
developed based on dysglycemia, which refers to any abnormality in blood
glucose levels, and it was designed to promote early diagnosis and type
2 diabetes prevention.
Stage 1
The first stage of type 2 diabetes is called insulin resistance. At this
early stage of the disease, the cells in the body are only starting to
become resistant to insulin. However, patients will not experience any
symptoms because the pancreas is still able to make up for this by
making more insulin. For this reason, blood glucose levels are within
normal at the insulin resistance stage.
Stage 2
Stage 2 of type 2 diabetes is called prediabetes. The resistance of
cells to insulin continues to rise, so much so that blood sugar levels
begin spiking up, but not enough to be classified as diabetes. It is
recommended that you get tested for prediabetes if you are 45 years old
or older, especially if you are also overweight. Prediabetes is VERY common - about 1 in 3 Americans have this condition.
It’s important to note, though, that many people with prediabetes never
actually get a formal diabetes diagnosis and sometimes manage to delay
the onset by decades. According to the CDC, “You can prevent or delay
prediabetes from developing into type 2 diabetes with simple, proven
lifestyle changes.” Such lifestyle changes include a healthy diet, a
physically active lifestyle, and stress management.
Stage 3
Stage 3 diabetes is the point at which a patient gets a formal diabetes
diagnosis. At this stage, the patient’s blood glucose levels are
consistently high, so they require medical treatment to lower glucose
levels and prevent damage to the organs and the body.
Stage 4
One of the most dangerous effects of diabetes on the body is the ability
of high blood sugar to damage the blood vessels. This increases one’s
risk of both heart attack and stroke, which is, unfortunately, why more
than half of diabetes patients pass away from one of those two
conditions.
Apart from direct cardiovascular problems, the condition also weakens
the blood supply to the kidneys, eyes, extremities, and other parts of
the body. Over time, this can lead to advanced complications like kidney
disease, nerve damage, vision and hearing loss, dementia, and severe
damage to the feet.
These adverse changes don’t necessarily occur in all diabetics, and when
they do, it’s usually after decades of living with diabetes. Both type 1
and type 2 diabetes have similar complications. Research points out
that a combination of medical treatment and following a healthy diet and
exercise routine can help patients dramatically reduce the risk of
complications.