There are more than two types of diabetes.

Since you are reading my blog, this fact should not come as a surprise to you J Still, many people – AND healthcare workers! – are unaware of the many different types of diabetes. Most people have heard about type 1 and 2, but just think one is for children and the other for old people. Oh, and that we can’t have sugar. Surprise, we can!

So I think it’s time to talk a bit about what diabetes actually is and how MODY is different, or similar, to type 1 and 2 diabetes.

Diabetes is a general term for any type of chronic illness that results in unbalanced blood sugar levels. In case of MODY, the cause is a defect gene that stops the pancreas from producing enough insulin. MODY is typically diagnosed in early adulthood or late teens. At this point, the levels of insulin produced are no longer sufficient and will result in elevated blood sugars. In most cases, more family members are known to have diabetes. Even if they have a type 1 or type 2 diagnosis.. A person with MODY has a 50% chance of passing on the disease to his or her child.

MODY vs. type 1 diabetes:

- Type 1 diabetes is an auto-immune disease. This means your body is attacting (with anti-bodies) the insulin producing cells in your pancreas; the beta-cells. Therefore the body can’t produce insulin and you’ll end up with high blood sugars.

- In MODY, there are no anti-bodies. The lack of insulin production is caused by a gene defect that results in defect transcription pathway.

- Since people with type 1 diabetes don’t produce any insulin (except for maybe during the honeymoon period*), they have no other option than to inject insulin. Either through multiple daily injections or with an insulinpump.

- With MODY it’s a different story. Some types of MODY still produce (a bit) of insulin or just respond to late to raising sugar levels and therefore don’t always need insulin. They can often be helped with oral medication and some lifestyle changes.

- It is common for people with type 1 to have some relatives with diabetes, but the inheritability is much weaker than with MODY (1/2).

MODY vs. type 2 diabetes:

- In type 2 diabetes the core problem is insulin resistance. The insulin produced is no longer recognized as well and therefore the body can even produce very high levels of insulin, with no effect. Over time, the pancreas can get exhausted and stop making insulin.

- MODY is a problem of insulin production. BUT all people can suffer from insulin resistance if they adopt an unhealthy lifestyle. Lack of movement, highly processed foods and too much stress are some insulin resistance promoting factors.

- Both MODY and type 2 diabetes can often be managed with oral medication and lifestyle changes.

What other types of diabetes are there?

Apart from type 1, 2 and MODY there’s also (but not exclusively!):

- LADA: latent autoimmune diabetes in adults, also called type 1,5. LADA too has some similarities with both type 1 and type 2. I think more of it as a slow progressing and late onset type 1 since it’s also an auto-immune condition that attacks the beta cells.

- Gestational diabetes: diabetes that develops during pregnancy. In most cases, it goes away after giving birth.

- Type 3c: most commonly due to damage to the pancreas, for example pancreatitis or trauma. But this also includes cystic fibrosis related diabetes.

- Neonatal diabetes: this is also caused by a gene defect but results in high blood sugar (and diagnosis) before the age of 6 months.

You can see that the diabetes landscape is way broader than you would initially think and I think it’s extremely important to raise awareness about it. The more people receive a correct diagnosis, the more researchers will be able to learn about the different types of diabetes and the better treatments we can receive. Every person with diabetes is different and therefore requires a unique treatment plan, but I do think that if we have enough data, we can set general guidelines that can help people figure out their personal plan more easily. And as I said, this begins with correct knowledge and a correct diagnosis.

*Honeymoon period/phase: The Honeymoon Phase (or Honeymoon Period) amongst people with type 1 diabetes refers to the period of time shortly following diabetes diagnosis when the pancreas is still able to produce a significant enough amount of insulin to reduce insulin needs and aid blood glucose control.