What Kind of Type 2 Diabetes Do You Have?

Diabetes called “Type 2” may actually be four different types, according to functional medicine. Functional medicine practitioner Brian Mowll described the four types in a recent webinar.


Although his doctorate is in chiropractic, not medicine, Dr. Mowll is certified by The Institute for Functional Medicine, an international medical group you can learn more about at this website, and he is also a certified diabetes educator. Here’s what he had to say:

Type O is the classic Type 2, about 50% to 60% of all diagnosed cases. Type Os are heavy, with rounded bellies. They are highly insulin resistant. They also produce a lot of insulin and have high insulin levels until late in the disease.

Type I is often seen as “thin” Type 2. People with subtype I may be underweight and have low insulin levels. They have high blood sugars and may be diagnosed with LADA (latent autoimmune diabetes of adults), but are usually called Type 2.

Subtype H stands for hormonal. People with subtype H often have low thyroid and worn out adrenal glands. They are usually a little overweight or of normal weight; their bodies get inflamed easily, and they may or may not have insulin resistance.

Subtype S stands for stress-induced. It can be caused by long-term chronic stress or one dramatic, high-stress, traumatic episode. People with subtype S have high levels of the stress hormones cortisol and adrenaline in the body. These hormones raise blood sugar levels.

Dr. Mowll says it is possible to have more than one of these types. In fact, most people probably do.

What difference does it make?
Dr. Mowll and his colleague Dr. Mark Hyman, author of The Blood Sugar Solution, agree that different subtypes need different diets. Type Os definitely benefit from low-carbohydrate (carb) eating and should avoid snacking. They need time without food to get their cells to open up to insulin.

Type Is do best with small frequent feedings, small enough for their low levels of insulin to handle. They should also eat low carb, but with a bit more protein.

Low carb does not work for everyone, though. People with type H need carbs, because the adrenal glands have to compensate for low levels of carbs. Dr. Mowll suggests starches like sweet potatoes or beets with dinner for type Hs, especially for people who have trouble sleeping.

People with type S should eat some carbs, but less than those with type H. They should limit stimulants such as caffeine and alcohol, and they probably would benefit from various supplements.

There are other important differences. In type S, blood sugar goes up with exercise rather than down. Exercise in type S can release cortisol, raising sugars. Probably they would do better with gentle movement like yoga or tai chi.

Although Dr. Mowll didn’t discuss drugs, it seems different types of Type 2 diabetes also respond to different medicines. A fascinating study from India tested 108 people newly diagnosed with Type 2. About half had high insulin levels and half had normal to low levels. The high-insulin group did well on metformin, while the normal- to low-insulin group benefited from sulfonylurea drugs that boost insulin production, but not from metformin.

How functional medicine views Type 2 diabetes
The webinar said that Type 2 is “not just high blood sugar.” It’s not loss of insulin production. Most newly diagnosed Type 2s have normal or high insulin levels, according to Dr. Mowll. It is not primarily genetic, not primarily caused by overweight or by eating too much sugar, and not easily fixed by cutting carbs.

Many organs are involved, including the brain, fat tissues, liver, and intestines. Causes include toxic chemicals, genes, stress, poor sleep, not exercising, and gut problems. Low levels of thyroid hormone or sex hormones, or a diet high in processed foods, can also promote Type 2. So can various nutritional lacks.

Dr. Mowll’s team tries to assess patients’ hormonal and nutritional status. Their treatment emphasizes physical activity, sleep quality, and gut health. They prescribe large numbers of supplements to boost hormones and restore the right gut bacteria.

Functional medicine doctors also do lots of blood tests if patients can afford them. They assess liver, kidney, heart, and other systems. Some supplements Dr. Mowll recommended are chromium; biotin; vitamin D; alpha-lipoic acid (ALA); the omega-3 fatty acids DHA and EPA, which are found in fish oils; the herbs and spices gymnema, berberine, curcumin (a compound of the herb turmeric), and cinnamon; B vitamins, fiber; magnesium; zinc; and probiotics.

All of this sounds time-consuming and expensive, but it may be worth looking into. Dr. Hyman and Dr. Mowll each say they have reversed Type 2 diabetes in countless patients. They believe Type 2 diabetes is not about overeating. It is about a chain of environmental causes that can be treated. Let us know what you think of this approach.

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  • Christie

    Not only do I think there are several kinds of type 2 diabetes but I FIRMLY believe that there are several kinds (subtypes is the word I prefer) of type 1. How else can you explain the huge discrepancies of folks who are diagnosed and do exactly what they are supposed to do and get complications and those who are diagnosed and do less than they should and live fairly healthfully? More than 1 subtype of both type 1 and 2 for sure…

  • Lorraine Starsky

    I have always said that diabetes is not a “one size fits all” disease. I found this article to be very thought provoking and it echoes some theories that I have had. Therapy for diabetes, like for many other diseases, needs to be more individualized. Medical providers need to encourage their patients to listen and pay attention to their bodies. In turn, health care providers need to listen attentively to what their patients are telling them. The current medical model in this county does not allow for this this. Private health insurers treat health care like a commodity with an assembly line approach. The patient is the chassis on the assembly belt that is going ever faster, while we as health providers run along throwing interventions (parts) at/on the patients. The patients and health providers are both frustrated.

  • Susan

    Ayurveda does say that there are several types of diabetes which need different approaches.
    I have been diabetic for over 10 years. Reversing diabetes is my dream.

  • Susan

    Ayurveda says there are different kinds of diabetes needing different approaches.

  • LeeAnn Flint

    By trial and error, I have found that I have best results from a low protein, low fat, high carb diet. Some doctors have called me “uncooperative”, whereas others have just been mystified as to why this is so. I crash when sulonylureas, even in low doses, as added, therefore I am certain that I am producing plenty of insulin. I was found to have fatty liver disease, but my pancreas and heart seem to be fine. Cutting protein and adding dandelion root and milk thistle have improved my kidney tests. I have Hashimoto’s thyroid disease. It is no surprise that I am a Type H. The suggestions given in this article are very good. I take ALA in the form of evening primrose oil and rather high doses of Vitamin D because I have neurological damage from epilepsy and Equal sweetener, and it truly makes a big difference in that regard. I benefit from flaxseed, but fish oils increase my cholesterol. But that’s just me… I keep this article in my medical info for doctors who are in the 19th century mentally when it comes to Type 2 diabetes.