Type 1, type 2 and gestational diabetes are the most well-known and commonly diagnosed forms of diabetes, but other rarer types of diabetes exist.
Approximately 1.5-2% of people with diabetes live with rare forms of the condition, which can fall into nine categories. These less common types of diabetes may not receive as much attention as the more prevalent forms. However, they still pose a significant health threat to those affected by them.
Rare forms of diabetes require specialised treatment and management, often involving genetic testing and personalised approaches to insulin therapy. Of these rare forms of diabetes, LADA, MODY and neonatal diabetes are the most diagnosed. Raising awareness and diabetes education are particularly important so healthcare professionals can provide accurate diagnoses and appropriate care.
LADA, or Latent Autoimmune Diabetes in Adults, develops when antibodies damage insulin-producing beta cells in the pancreas.
While LADA — sometimes called type 1.5 diabetes — shares certain similarities with type 1 diabetes, such as the destruction of beta cells and the need for insulin therapy, its onset and progression differ. Unlike type 1 diabetes, which typically develops in childhood or adolescence, LADA usually develops in adulthood.
Additionally, LADA progresses at a slower pace than type 1 diabetes. Initially, the pancreas can produce some insulin before insulin treatment becomes necessary. This slower progression can sometimes lead to misdiagnosis or delayed diagnosis. LADA is often initially mistaken for type 2 diabetes.
Unlike type 1 diabetes, which typically develops in childhood or adolescence, LADA usually develops in adulthood.
As the name suggests, monogenic diabetes is the mutation or alteration of a single gene. It accounts for roughly 1-4% of all diabetes and is characterised by the pancreas’s inability to produce enough insulin. Two common forms of monogenic diabetes are MODY (Maturity-Onset Diabetes of the Young) and neonatal diabetes. Differing from LADA and type 1 diabetes, MODY is usually diagnosed before the age of 25. It is frequently found in multiple generations within a family. Genetic testing is often necessary to confirm a diagnosis of MODY and identify the specific gene mutation involved.
The gene mutations associated with MODY determine the severity of the condition. Likewise, the onset age can be valuable in developing a treatment plan and reducing the risk of diabetes-related complications.
Genetic testing is often necessary to confirm a diagnosis of MODY and identify the specific gene mutation involved.
Neonatal diabetes usually appears within the first six months of life and can have genetic and non-genetic causes. In some cases, neonatal diabetes results from gene mutations that disrupt the normal functioning of the pancreas, impacting insulin production and blood glucose levels. Neonatal diabetes can also occur because of non-genetic factors such as infections or complications during pregnancy. Early diagnosis and treatment are crucial for managing neonatal diabetes and ensuring optimal growth and development in infants affected.
For some people with MODY and infants with NDM, sulfonylurea, an oral diabetes medication that stimulates insulin production in the pancreas, can be used to manage their condition. Others may require insulin injections.
In some cases, neonatal diabetes results from gene mutations that disrupt the normal functioning of the pancreas, impacting insulin production and blood glucose levels.
Double diabetes occurs when a person with type 1 diabetes develops insulin resistance, a characteristic feature of type 2 diabetes. Type 1 diabetes is constant in these cases, but it is possible to moderate the effects of insulin resistance.
If not properly managed, double diabetes can progressively worsen. Regular insulin treatment is required, and lifestyle interventions are crucial to managing insulin resistance.
Understanding the unique characteristics of different forms of diabetes is crucial for appropriate diagnosis, treatment, and management. While these forms of diabetes may be less common, they highlight the condition’s complexity and diversity. Furthermore, they underscore the importance of personalised treatment plans and lifestyle modifications in managing diabetes effectively.
As with type 1 and type 2 diabetes, rarer forms of diabetes can also increase the risk of diabetes complications such as heart disease, stroke, and kidney disease. Good blood glucose management and maintaining a healthy body weight are important to reduce the risk of diabetes complications.
Diabetes educators play a pivotal role by providing accurate information and promoting self-management strategies
LADA, monogenic and double diabetes represent important challenges to diabetes management. However, advancements in genetic testing and a deeper understanding of these conditions allow for more accurate diagnoses and effective treatment strategies. Raising awareness about these less common forms of diabetes is an essential step towards better healthcare outcomes. Healthcare professionals and people affected must understand the complexities of diabetes for appropriate diagnosis and treatment. Diabetes educators play a pivotal role by providing accurate information and promoting self-management strategies to ensure positive health outcomes for people diagnosed with rare and more prevalent types of diabetes.
By understanding the diverse nature of diabetes, we can work towards a future where everyone receives the personalised care they need, leading to healthier lives for all.
