The jury is still out on the best way to treat Type 1.5 diabetes. Maintaining tight blood glucose control may help to slow the destruction of the beta cells (and delay insulin dependency) as well as reduce the risk of long-term diabetic complications.
Gestational diabetes
Gestational diabetes is diabetes diagnosed during pregnancy. It may disappear after childbirth, but it is likely to develop again during subsequent pregnancies. Gestational diabetes affects about 4% of all pregnancies, resulting in roughly 135,000 cases in the United States each year. Women with gestational diabetes are also at a higher risk of developing Type 2 diabetes later in life.
Gestational diabetes usually develops during the second or third trimester of pregnancy. Certain hormones released at that time work against the action of insulin and cause insulin resistance. If the pancreas is unable to produce enough insulin to meet the increased need, gestational diabetes develops. Women with gestational diabetes are at increased risk of giving birth to babies with respiratory problems or high birth weights.
Gestational diabetes is most likely to affect women who are over 25, are overweight, have a close family member with diabetes, or belong to an ethnic group at high risk for diabetes (African-Americans, Asian-Americans/Pacific Islanders, Hispanic Americans/Latinos, and Native Americans fit into this category). These women should be screened for gestational diabetes between the 24th and 28th week of pregnancy.
Screening consists of a oral glucose tolerance test, or OGTT, which is designed to determine how well a person’s body handles glucose. The woman drinks 50 grams of pure glucose dissolved in water. One hour later, her blood glucose level is checked. A blood glucose level of 140 mg/dl or higher indicates that the woman may have diabetes, and another test is done. In this test, the woman fasts, then ingests 100 grams of glucose. Her blood glucose level is checked up to four times: once before ingesting the glucose and at one hour, two hours, and three hours afterward. If any two of these values is equal to or above a certain level (95 mg/dl while fasting, 180 at one hour, 155 at two hours, or 140 at three hours), then the diagnosis of diabetes is confirmed.
Women diagnosed with gestational diabetes must strive to keep their blood glucose levels under control for their own health and that of their baby. Diet, exercise, and insulin are the most common treatments. Doctors do not typically prescribe oral drugs as a treatment for gestational diabetes.
Gestational diabetes usually disappears when the stress of pregnancy is over. However, women who have had gestational diabetes should continue to eat a healthy diet, avoid gaining weight, and exercise regularly after giving birth due to their higher risk of developing Type 2 diabetes.
Maturity-onset diabetes of the young
Usually called MODY, maturity-onset diabetes of the young is a type of diabetes associated with single genetic defects that lead to impaired functioning of the insulin-producing beta cells of the pancreas. It generally causes mild, chronic high blood glucose at an early age — usually before age 25.
MODY is distinctly different from either Type 1 or Type 2 diabetes. In MODY, the primary problem is a defect in insulin secretion. When the pancreas does not produce enough insulin, abnormalities in glucose transport and metabolism result. This in turn leads to high blood glucose, which can contribute to insulin resistance. The impaired secretion of insulin seen in MODY is similar to the deficiency found in Type 1 diabetes, but unlike Type 1 diabetes, MODY develops slowly and does not completely destroy the ability of the pancreas to secrete insulin. However, it impairs insulin secretion enough so that the body cannot adequately control blood glucose levels from one moment to the next.
