The Many Faces of Diabetes: Yes, There Are More Than Just 1 and 2!

Knowing you’re in early-stage T1D (pre-type 1 diabetes) gives you time to learn about the condition and explore medications like Tzield that can delay its onset.

Quick Facts:

• Risk factors: Family history, genetic predisposition
• Symptoms: No symptoms in stage 1 or 2
• Treatments: Glucose monitoring, optional clinical trials, Tzield

2. Type 1, Type 1.5 & Latent Autoimmune Diabetes in Adults (LADA)

Type 1 diabetes happens when your immune system goes haywire and mistakenly destroys insulin-producing beta cells in your pancreas. We don’t know why this happens, but researchers are working hard to figure it out. T1D can be diagnosed at any age; in fact, more than half of new cases occur in adults.

Which brings us to LADA and 1.5.

LADA (Latent Autoimmune Diabetes in Adults) – also sometimes called type 1.5 – is simply type 1 diagnosed in adulthood. Because beta cell destruction can be slower in adults, it’s often misdiagnosed as T2D. Our vote (if anyone’s asking) is to ditch both of these terms because it’s all T1D, and the different names of these types of diabetes are confusing.

Quick Facts:

• Risk factors: Family history, genetic predisposition
• Symptoms: Full-blown T1D symptoms include frequent urination, excessive thirst, weight loss, and blurred vision, but in LADA they are more subtle, which contributes to a delay in diagnosis 
• Treatment: Insulin therapy

3. Antibody Negative Type 1 Diabetes

Some people have every classic type 1 diabetes symptom, but they test negative for the autoantibodies. Up to 15% of people with T1D fall into this category.

Quick Facts:

• Risk factors: Not well understood, happens in both children and adults
• Symptoms: Same as type 1 (thirst, urination, weight loss, fatigue, etc.)
• Treatment: managed the same way as antibody-positive type 1

4. Prediabetes

Prediabetes is type 2 diabetes in the very early stages. Blood sugars are higher than normal, but not in diabetes territory just yet. The good news? Progression to type 2 is not inevitable. Prediabetes can often be reversed with lifestyle changes or taking a GLP-1 medication like Wegovy or Zepbound.

Quick Facts:

• Risk factors: Family history, central obesity, high triglycerides, low LDL
• Symptoms: Usually no symptoms – often only found with screening tests
• Common treatments: Lifestyle changes (weight management, diet, physical activity), sometimes metformin or a GLP-1 medication

5. Type 2 Diabetes

Type 2 diabetes is the most common type of diabetes, affecting over 30 million people in the U.S. alone. Your body still makes insulin, but it either doesn’t make enough of it, or your cells don’t respond to it properly because of insulin resistance. Many people with type 2 also have metabolic syndrome, which is a group of conditions that include abnormal cholesterol levels, high blood pressure, and central obesity.  

Quick Facts:

• Risk factors: Overweight/obesity, family history, older age, ethnicity
• Symptoms: Often gradual; increased thirst, frequent urination, fatigue, slow-healing wounds
• Common treatments: Lifestyle changes, oral and/or injectable medications, insulin if needed

6. Gestational Diabetes

Gestational diabetes is a type of diabetes that normally occurs in women. 😉

Pregnancy hormones can make your body more insulin-resistant, which can lead to diabetes. Gestational diabetes usually goes away after the baby is delivered, but during pregnancy it needs to be watched closely to keep mom and baby healthy. If left untreated, it can lead to complications like a larger baby or delivery issues.

Quick Facts:

• Risk factors: Family history, previous gestational diabetes, older maternal age, ethnicity, overweight
• Gestational Diabetes Symptoms: Often no obvious symptoms, usually found through screening tests
• Common treatments: Diet and exercise, glucose monitoring, insulin or oral medication if needed

7. Ketosis-Prone Type 2 Diabetes  

Ketosis-prone diabetes (called “Flatbush diabetes” at first, as it was identified in the Flatbush neighborhood of Brooklyn) is a less common form of diabetes that blurs the lines between type 1 and type 2. 

People are often diagnosed in DKA, which is typical for type 1 diabetes. However, they can often come off insulin and switch to oral meds once their blood sugars return to normal, which is more typical for type 2 diabetes.

Quick Facts:

• Risk factors: Ethnicity (more common in African American, Hispanic, and Asian populations), overweight, family history of type 2
• Symptoms: Extreme thirst, frequent urination, fatigue, DKA symptoms
• Common treatments: Insulin at first, then oral medications

8. MODY

MODY (Maturity Onset Diabetes of the Young) is a type of diabetes caused by a single gene mutation (also called monogenic) passed down from a family member. There are at least 13 different subtypes, and it typically shows up before age 25. 

People with MODY usually produce some insulin, just not enough. MODY can go undiagnosed for years, but a simple genetic test can confirm it.

Quick Facts:

• Risk factors: Strong family history; autosomal dominant inheritance
• Symptoms: Often mild high blood sugar noticed in youth or young adults
• Common treatments: Some require insulin, others respond to oral medication, and some need no treatment at all

9. Type 3c Diabetes

Type 3c diabetes (also called pancreatogenic diabetes) is a type of diabetes that can show up when something damages the pancreas and keeps it from making enough insulin. People with type 3c often have both diabetes symptoms and signs of pancreatic exocrine insufficiency, such as difficulty digesting food.

Quick Facts:

• Risk factors: Pancreatic disease, chronic pancreatitis, cystic fibrosis, hemochromatosis, pancreatic cancer, surgery to remove part of the pancreas
• Symptoms: Increased thirst, frequent urination, fatigue, numbness or tingling in extremities, slow-healing cuts, digestive symptoms like abdominal pain, bloating, gas, diarrhea, fatty or oily stools (yum)
• Common treatments: Blood glucose management, pancreatic enzyme replacement, dietary support

10. Type 5 Diabetes

Type 5 diabetes is a newly recognized form of diabetes that’s also known as malnutrition-related diabetes. It develops primarily in children, teens, and young adults who’ve experienced long-term undernutrition. Because of this, the pancreas doesn’t develop fully, so it makes less insulin than the body needs.

The condition is primarily seen in regions with chronic undernutrition, and is estimated to affect 20 – 25 million people worldwide. Researchers are working on the best guidelines for recognizing and treating it.​

Quick Facts:

• Risk factors: Long-term undernutrition
• Symptoms: Increased thirst, frequent urination, headache, fatigue, slow-healing cuts and sores
• Treatment: Currently often treated with insulin and nutritional support

Honorable Mentions

We’ve covered the main types of diabetes, but here’s a shout-out to a few of the lesser-known variations:

• Double Diabetes: This is when someone has both type 1 and type 2 diabetes, which can happen! 
• Neonatal Diabetes: This is a rare form of diabetes that occurs in infants under 6 months old. 
• Type 3 Diabetes: At TCOYD®, we’ve always playfully labeled “type 3s” as friends and family of people with diabetes. However, type 3 diabetes is now a proposed term to describe the link between insulin resistance in the brain and Alzheimer’s disease and other dementias.
• Type 4 Diabetes: This is a proposed term for age-related diabetes that occurs in lean older adults who have insulin resistance. (We used to define type 4s as a previous type 3 who got divorced!)