Rename Type 2?

A few weeks ago, we wrote about an online petition to change the name of Type 1 and possibly also Type 2 diabetes. That effort was begun by two mothers of sons with Type 1 diabetes, who didn’t feel that their children’s condition was being taken seriously enough by teachers and other parents. In the petition, which is addressed to the American Diabetes Association, the National Institutes of Health, and the International Diabetes Federation, they write that a name like “autoimmune beta cell apoptosis diabetes” could help teach people what is really going on in Type 1 diabetes. Similarly, they write, a name like “insulin-resistant diabetes” could do the same for Type 2.

Then, last week, a British professor and diabetes expert proposed a new reason for renaming Type 2 diabetes. Writing in the journal The Lancet, Edwin Gale, a professor emeritus at Bristol University, argues that unlike Type 1 diabetes, Type 2 does not actually describe a single condition in which the cause of high blood glucose levels is known. Instead, he writes, the Type 2 label is applied to a wide spectrum of conditions, ranging from diabetes that is accompanied by hypertension and obesity in which insulin resistance is clearly present, to diabetes in thin people who may exhibit signs of autoimmunity even though their pancreases still produce at least some insulin. Although, according to Gale, most doctors are aware of the variety of factors that may be present in Type 2 diabetes, using a single label that implies specificity can lead even experts to ignore this knowledge when making both clinical and research decisions.

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In a video accompanying the Lancet article, Gale outlines what he believes to be the negative consequences of the one-size-fits-all Type 2 label. Many doctors, he says, act as if there should be a single best approach or treatment to Type 2 diabetes, regardless of the patient’s specific condition. In reality, he suggests, the best course of treatment may depend on whether a patient has the metabolic syndrome (in which elevated blood glucose is accompanied by high blood pressure, obesity, and high blood lipid levels) or is, for example, a thin person with just diabetes and high blood pressure. Age, he notes, is also a relevant factor, and existing guidelines may lead some doctors to treat diabetes too aggressively in elderly people. Finally, Gale suggests renaming Type 2 diabetes “idiopathic hyperglycemia,” meaning high blood glucose for unknown reasons.

What do you think — does a name change for Type 2 diabetes make sense, or is “idiopathic hyperglycemia” no better as a name? Would this new name change the way you think about your diabetes, if you have Type 2? Does having a specific name like Type 2 diabetes give you more peace of mind than if you were told, essentially, that you have “mystery diabetes”? Leave a comment below!

  • Joe

    I had one health care worker tell me that type 2 should be renamed “Self-inflicted diabetes” in an attempt to use shame as a therapy.

  • lin

    Some people have WAY too much time on their hands.. If it is not broken,, leave it alone!!!!!!!

  • Ferne

    Please, just leave it Type 11 so everyone knows what we are talking about. Since when is it a self inflicted diabetes. Shame on the person who suggested that and especially a health care worker. I would never go to that one again. Has that person heard of genetics?

  • Kathleen

    I think that with all of the media attention on obesity and connecting it with diabetes, that people do think that we have more control over our illness than we do. If I did not read this newsletter I would not have know how many “type 2’s” there are, or the importance of knowing which type you have. For this reason it may be of use to rename the disease.

  • MEL

    How about insulin deficient and insulin resistant?

    Because people can take preventive measures to slow the onset of diabetes, too many people think that it’s a matter of not taking care of yourself.

  • Wayne Astin

    By all means, let’s have more accurate naming. I am continually encountering people who ask me whether I have type 1 or 2. Since I got diabetes at age 60, I have to say type 2. They then assume that I am either overweight or that I have recently lost a lot of weight. How do I explain that my diabetes is really more like type 1 except that it took 60 years to develop. I am not insulin resistant, my pancreas has just been slowly decreasing output for the past few years. From the sounds of things, there are a lot more than two kinds of diabetes.

  • Metaz

    I refer to type 1 diabetes as Autoimmune Diabetes and type 2 as Metabolic Diabetes.

  • Gaye

    A change for type 2 woukd be good. I do agree with the two mothers about their children’s tyoe 1 not being taken seriously but I think it’s because of type 2. There has been such an explosion of type 2 that people mix it up and mix up what they hear. So as it doesn’t affect people familiar with both it definitely affects the general public perception. I don’t like the term idiopathic because that would just continue dr.s practice of not investigating into cause. Insulin resistant diabetes or finding a way to drop the diabetes alltogether in type 2. Btw I do have type2.

  • jim snell

    The problem revolves around the issue of Diabetes.

    Frankly the results of each grouping end in a single issue. You have far too much glucose in your blood system.

    Type 1’s seem much straughtforward as a pancreas issue failure to create sufficient working insulin due to some pancreas islet failure.

    This failure is immediate, fast and needs proper treatment of insulin, diet control and discipline. There is no lets take tme and watch.

    Type 2 is truly a complex set of issues that result in excess glucose in blood system but can take years to resolve.

    What causes the type 2 issues – a catch bag of everything not Type 1 includes, digestion issues, liver leaks, pancreas falling off and producing less insulin, diet and exercise control as well as thyroid, kidney issues et all and some mix of that.

    Will a new suite of names, catagories help, I dunno know but we need to expand the science beyond pancreas issues and just add more insulin.

  • Tandi

    In 1991 @ the age of 39 in my first & only pregnancy I developed ‘gestational diabetes’. I went from eating for 2, to eating like a little bird & insulin injections. Fortunately the outcome produced a healthy baby boy, even though I was considered ‘high-risk’. Glucose metabolism returned to normal shortly after the birth of my son. Fast forward 10-yrs & I am diagnosed w/ type II, on Metformin bid & doing very well w/ last A1C of 5.5. I am neither overweight/obese….5’6″ & 138#. I am also ‘hypothyroid’, which leads me to believe that my entire ‘endocrine’ system is compromised. My 36-yr old nephew was diagnosed w/ Type I at 15-yrs old, on insulin, diet, exercise, etc. He has done really well in managing his diabetes & is 6’2″ tall & about 160#. So being over-weight/obese is NOT a true indicator of diabetes. You just never know what might happen w/ your health.

  • Sandy

    It’s been Type 2 forever, just let it be…

  • A Garramone

    If people are getting confused by simple terms like “Type I” and “Type 2″, I can’t think of anything that could make it more simple!! P.S. I am borderline diaabetic, and find these newsletters extremely informative and motivational.