A Guide to the Different Types of Diabetes

There are two major kinds of diabetes: diabetes mellitus and diabetes insipidus. Diabetes mellitus involves problems with the body’s ability to control blood sugar levels, either due to insufficient or nonexistent insulin production (types 1 and 1.5) or due to the patient’s body developing insulin reistance (type 2). Diabetes insipidus, which is much less common, involves the kidneys’ inability to properly regulate blood dilution/fluid levels, whether due to insufficient vasopressin (anti-diuretic hormone or ADH) production (central DI) or due to the kidneys not responding properly to ADH (nephrogenic DI).

Diabetes mellitus is what most people think of when they hear the word “diabetes.” Diabetes mellitus can be treated with insulin injections (most common with type 1 diabetes) or a variety of prescription medications designed to address blood sugar levels either by altering the way the body metabolizes food, increasing natural insulin production, or minimizing insulin resistance. Many of these other medications can only be used for type 2 diabetes.

Some women develop insulin resistance during pregnancy, which is known as gestational diabetes. Women who experience gestational diabetes once have a much higher incidence of gestational diabetes in subsequent pregnancies, and more frequently develop diabetes mellitus later in life, but in the short term gestational diabetes generally resolves spontaneously after the pregnancy is over. Gestational diabetes should be treated promptly, due to potential complications it can cause with the baby, and the mother’s health and safety.

Central diabetes insipidus is treated fairly simply, with vasopressin (ADH) prescribed to compensate for the body’s lack of ADH production. Nephrogenic diabetes insipidus can not be treated with vasopressin, so patients must increase their fluid intake to prevent dehydration, and may also take medications to inhibit urine output. In some cases, nephrogenic DI may be a side-effect of another prescription medication (lithium, for instance), and the DI will often disappear when the other medication is discontinued. Nephrogenic diabetes inspidius is best treated by addressing the underlying cause of the condition, when it can be determined.

Although diabetes inspidus and diabetes mellitus share a name, the two disorders are almost totally unrelated. The symptoms of increased thirst and frequent urination are seen in both types of diabetes, insipidus (both central and nephrogenic) and mellitus (type 1 and type 2), but that is almost the only commonality between diabetes inspidus and mellitus.

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