The Double Diabetes Epidemic

An increasing number of diabetic patients are facing a new disease complication called "double diabetes," the term used to describe having symptoms of both type 1 and type 2 diabetes.

Researchers say they have strong evidence that double diabetes could be a growing phenomenon. Recent studies have found that as many as one in three newly diagnosed childhood diabetics now have both type 1 and type 2 diabetes.

Double Diabetes, Double Trouble
Type 1 diabetes is an autoimmune disease that occurs early in life, often in children. For unclear reasons, the body’s immune system begins attacking and destroying the beta cells in the pancreas needed produce the hormone insulin. Insulin is what ushers blood sugar (glucose) from the bloodstream into the cells to create energy. Without insulin, glucose levels in the bloodstream rise.

Type 2 diabetes usually has a later onset. Because of a combination of poor diet, lack of exercise, and too much body fat, the cells of the body become resistant to the insulin the pancreas has been making. Glucose levels remain elevated: The pancreas tries to keep up with the added demand by producing more insulin, but over time burns itself out.

Double diabetes occurs when a person with type 1 diabetes develops resistance to the insulin they are taking, insulin resistance being the hallmark of type 2 diabetes. It can also occur in a patient who appears at first glance to have the more common type 2 version of diabetes because they are overweight. However, blood tests to look for the specific proteins that attack pancreatic beta cells will reveal that they also have type 1 disease.

Obesity is the main risk factor for double diabetes. Patients with double diabetes are most often overweight. Doctors suspect double diabetes might be partly caused by type 1 diabetics who take insulin, but haven't made the other healthy lifestyle changes needed to help manage the disease. Because insulin use causes weight gain, if the type 1 diabetic patient doesn't take steps to eat healthy food and exercise regularly, weight gain could begin making his or her cells insulin-resistant.

Treating Double Diabetes
Treating a person with double diabetes is complicated because the preferred methods of treating type 1 and type 2 diabetes are different:

• Type 1 diabetic patients take insulin to treat their disease because they cannot produce the hormone on their own.
• Type 2 diabetic patients take oral medicine to manage the amount of glucose in their bloodstream, by either stimulating insulin production or helping cells use insulin more efficiently. It's not until the later stages of the disease that they must begin taking insulin to survive.

Medication. Doctors are weighing different combinations of medications that could help double diabetes patients. Some double diabetes patients might be best served by a treatment plan that includes both insulin and oral medication.

Diet and weight loss. One approach that seems to work is a low-calorie diet for weight loss that features foods high in fiber and bulk. Fiber helps stabilize blood glucose and reduce the need for insulin, while the increased amount of food prevents hunger.

Exercise. Physical exercise is also considered a prime means of treating double diabetes. Workouts help to improve the body's response to insulin, decreasing insulin resistance.

Preventing Double Diabetes
The best treatment for double diabetes is prevention.

Doctors recommend that children who are obese or overweight develop a healthier diet based on smaller portion sizes and get a good amount of exercise, especially if they have type 1 diabetes, to keep from developing type 2 as well.