Medical: Which types of diabetes exist?

Children usually have diabetes Type 1 or Type 2, but there are also other types of diabetes:
  • Diabetes type 1
  • Diabetes type 2
  • Monogenetic diabetes
    • MODY, ‘Maturity Onset Diabetes of the Young’
    • Neonatal diabetes
    • Syndromal associated diabetes
  • MIDD, ‘Maternally Inherited Diabetes and Deafness’. This type of diabetes is hereditary and comes from your mother's side of the family. With this type of diabetes, you also lose your hearing.

Diabetes Type 1

If you have diabetes Type 1, your beta cells can't make insulin. This means that the glucose you get from food can't be absorbed into your body's cells, and your blood sugar level rises. If your blood sugar level is too high, you need to pee a lot and you are always thirsty. At the same time, when your body’s cells are not getting glucose (which they use as fuel), they don't get enough energy. This causes your body to look for fuel from other sources in your body. When your body does this, it can result in the waste material around that fuel also being released. This can lead to symptoms like losing weight, being very tired and drowsy, and, in extreme conditions, a diabetic-induced coma. This form of diabetes can occur at any age but usually starts at a young age. Diabetes Type 1 is an auto-immune disease.

Diabetes Type 2

You get diabetes Type 2 when your body is no longer reacts properly to insulin and your beta cells produce less insulin than you need. The glucose in your blood is not as easily absorbed into your body's cells and your blood sugar level rises. This makes you pee a lot and you are often thirsty, just like diabetes Type 1. But in diabetes Type 2, glucose does get into the body's cells, even though it is harder to absorb. Because the glucose gets into the cells, they get enough energy and your body does not look for other sources of fuel, so the weight loss, tiredness, and diabetic comas rarely happen.

Diabetes Type 2 can also occur at any age, but more often it happens to elderly people and overweight people who don't exercise enough. Because a growing number of children are overweight, this type of diabetes is now more common at a younger age.

Monogenetic diabetes

Monogenetic diabetes is caused by a defect in one single gene (a piece of hereditary material in a chromosome) in your body. This contrasts with diabetes Type 1 and 2, where multiple genes play a role in causing the disease. The following types of diabetes are monogenetic types:

MODY (Maturity Onset Diabetes of the Young) is a hereditary type of diabetes. One of your parents or grandparents will likely also have this. At the moment, there are seven known types of MODY, and each is caused by a different gene. With MODY, the beta cells in the pancreas don't make enough insulin. The symptoms are often mild, sometimes you will only have a higher blood sugar level. Therefore, doctors may think a patient has diabetes Type 2 instead of MODY. However, after some time the symptoms can worsen if the pancreas becomes less effective (especially with MODY Type 1 and 3). The type of MODY determines which treatment is needed: dietary advice, taking tablets or injecting insulin. Usually, only a small dose of medication is needed because MODY patients tend to react well to treatment. The long-term negative effects of MODY Type 1 and 3 are like those of diabetes Type 1 and 2.

Neonatal diabetes is a hereditary type of diabetes among newborn babies, often found in the first three months. Two types exist, a transient one and a permanent one. The type depends on the genes that are affected. The transient type is called ‘transient neonatal diabetes’ and is caused by beta cells making less insulin than they should. The other type is permanent, ‘permanent neonatal diabetes’. This type may also be caused by beta cells making less insulin than they should, but also because there may not be enough beta cells, which would also cause too little insulin to be made. This is the case with, for example, patients with Wolcott-Rallison syndrome.

Syndromal associated diabetes occurs in children with a genetic difference that leads to diabetes and other problems, like a non-functioning pancreas, deafness, blindness, or developmental delays.

MIDD (Maternally Inherited Diabetes and Deafness) is a hereditary type of syndrome diabetes and is usually found in adulthood. In MIDD, the beta cell does not respond properly to an increase in blood sugar levels, resulting in less insulin being released. This type of diabetes also leads to hearing loss (mostly the high tones), which often happens years before the diabetes is diagnosed. In the beginning, you usually only need to take insulin tablets. It may be necessary to inject insulin in later stages of MIDD.

Overview of types of diabetes occurring in children and young people

TypeYour insulin productionReaction of your body to insulin Age at which you can get it (onset)TreatmentParents with diabetes
Type 1You are not producing insulin.Good.From 6 months to young adult.You need insulin daily, either by injection or a pump.2-4 %
Type 2You don’t produce enough insulin.Low, insensitive.Usually at older age, but also possible during puberty.Advice on nutrition and exercise. Usually a need for tablets, sometimes injections.80%
MODYYou don’t produce enough insulin.Good.Late puberty.Depending on the type of MODY; advice on nutrition, need for tablets, rarely injections.90%
Neonatal diabetesYou don’t produce enough insulin.Good.Babies younger than three to six months.Inject insulin, sometimes take tablets.90%
MIDDYou don’t produce enough insulin.Good.Adulthood. Need for tablets (no metformin) or injections.-

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