Breaking the Stigma: Understanding Every Type of Diabetes

Forget everything you think you know about diabetes. Depending on where you learned it, there’s a good chance it’s limited—or just plain wrong. 

And that’s not your fault! Diabetes has been misdiagnosed and misunderstood for decades, and it’s time to move past the “my grandmother’s diabetes” narrative. 

We’re here to challenge the old assumptions and break down every type—taking a closer look at everything we actually know about the diagnosis today.

The Two-Type Stigma

Before we go any further, we need to address one of the biggest misconceptions about diabetes: that there are only two types. This misunderstanding also fuels the stigma surrounding each type. Not long ago, researchers believed type 1 diabetes was mostly diagnosed in children—yet at least over half of new type 1 diabetes cases actually occur in adults. And for years, people were told that type 2 diabetes was mainly the result of lifestyle choices. In reality, type 2 diabetes is driven by a complex mix of genetics, biology and environmental factors.

The Many Types of Diabetes

Pre-diabetes refers to when a person’s blood sugar or A1C levels—a test that measures average blood sugar levels over two to three months—are higher than normal but not high enough to be classified as diabetes, indicating early problems with how the body processes sugar into fuel for the body. If your A1C is 5.7% to 6.4%, that’s considered prediabetes. 

Type 2 diabetes makes up 90–95% of all diabetes diagnoses. It is a metabolic disease that happens when the body doesn’t use insulin well (insulin resistance) and doesn’t make enough of it to keep blood sugar in a healthy range (insulin deficiency). An A1C reading at or above 6.5% signals type 2 diabetes. Some cases can be treated with diet and physical activity changes, but many cases need medications like metformin or GLP-1s, while up to a quarter of people with T2D require insulin. This doesn’t mean the person with T2D did anything wrong! It just means their body needs more insulin to survive. Prediabetes can be reversed with lifestyle changes, but type 2 diabetes cannot—and remission happens in only about 5% of cases.

There are a handful of known contributors to type 2 diabetes including, but not limited to the following:

• Genetics and family history plays a major role in type 2 diabetes risk. Certain genes can affect how the body produces or responds to insulin, making some people more susceptible—especially if close relatives also have diabetes.
• Socioeconomic status, access to consistent healthcare and limited availability of nutritious food can increase diabetes risk and make management harder. Without regular care, diagnosis and treatment can lag.
• Prolonged stress can trigger the release of hormones like cortisol, which can raise blood sugar levels over time. 
• Advanced age brings a higher risk of type 2 diabetes, as metabolism, body composition and insulin sensitivity naturally change over time.
• Lifestyle factors, including smoking and low physical activity, raise diabetes risk. Smoking increases inflammation and insulin resistance, while a sedentary lifestyle reduces insulin effectiveness.

Type 1 diabetes is an autoimmune disease where the body can no longer make insulin, following an immune system attack of the cells that produce insulin. It develops differently from prediabetes and type 2 diabetes—no personal changes can prevent the disease, which has genetic and environmental contributors that researchers are still trying to understand. There is currently no cure and people with type 1 are insulin-dependent for life.

Idiopathic type 1 diabetes is a rare form of T1D in which individuals have permanent insulin deficiency, yet show no indication of an immune attack on beta cells. Very few people with type 1 diabetes fall into this category, but genetic and C-peptide testing can identify cases.

Type 1.5 diabetes, also called latent autoimmune diabetes in adults (LADA), is a rare form of type 1 diabetes that usually develops in adults over 30. It progresses slowly, so it’s often mistaken for type 2 diabetes—up to 40% of people diagnosed with T1D or LADA after the age of 30 are first misdiagnosed with T2D.

Pancreatic diabetes is diabetes that develops from problems with the pancreas. This includes type 3c (pancreatogenic diabetes), cystic fibrosis-related diabetes, and diabetes caused by surgery, pancreatitis or certain medications.

Monogenic diabetes is a rare type of diabetes that’s caused by a single gene mutation. While it only accounts for 1-2% of diabetes cases worldwide, it has characteristics of both type 1 and type 2 diabetes and is often misdiagnosed.

Maturity Onset Diabetes of the Young (MODY) is the most common type of monogenic diabetes and usually appears in children or teenagers—though it can be diagnosed in adulthood.

Neonatal diabetes mellitus is another type of monogenic diabetes that appears in the first six months of life, involving persistent hyperglycemia caused by problems with insulin.

Type 5 diabetes, also called malnutrition-related diabetes, is a growing health issue in low- and middle-income countries. It develops from chronic undernutrition, especially in childhood and adolescence, leading to severe insulin deficiency.

Gestational diabetes is a form of diabetes developed during pregnancy in people who don’t already have diabetes. While the exact cause isn’t fully understood, it’s thought to result from hormonal changes that affect how the body uses insulin, and treatment often involves diet, exercise and sometimes medication. People who have had gestational diabetes should monitor their blood sugar regularly, as they have a higher risk of developing type 2 diabetes later in life.

Lipodystrophic diabetes is a type of diabetes where the body loses fat, either all over or in certain areas (called partial lipodystrophy).

Ketosis-prone diabetes is seen mostly in people with obesity. It involves sudden, unexplained ketoacidosis and temporary problems with insulin-producing cells.

Even with all of these, there are still types that don’t fit neatly into any category.

A-Typically Speaking

There are many emerging forms of diabetes, often called atypical diabetes, that don’t align perfectly with type 1 or type 2. These forms of diabetes have highlighted differences in insulin secretion (how the body puts out insulin), insulin resistance (when you body isn’t listening to insulin) and islet autoimmunity (when your body starts attacking its own insulin-producing cells)—ultimately setting the stage for better classification.

What’s most important to remember for all types is that none are exactly the same, and none are anyone’s fault.

Reasons why proper diagnosis matters

• Guides appropriate treatment—Different types of diabetes require different management strategies—from medication to wellness adjustments.
• Prevents complications—Correct diagnosis helps maintain optimal blood sugar control and overall health, reducing the risk of long-term complications.
• Supports personalized care—Understanding the specific type of diabetes allows for tailored monitoring, education and support to meet individual needs effectively.

How to smash the stigma

Now that you know more about many types of diabetes and there’s nuances, what can you do? So glad you asked:

• Speak up with facts—Correct misconceptions when you hear them.
• Choose your words carefully—Avoid labels that shame or stereotype.
• Show empathy and support—Treat folks you do (and don’t) know who are living with diabetes with understanding and encouragement.

In short, know the facts and have people’s backs. Making life better for the diabetes community starts with you!