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Diabetes is an epidemic in African American communities. Approximately 4.9 million non-Hispanic African Americans aged 20 years or older have been diagnosed with diabetes, according to the Centers for Disease Control and Prevention (CDC). African Americans also have a high risk for type 2 diabetes. So, we’ve all heard of type 1 diabetes (an autoimmune illness commonly diagnosed in children and teens), type 2 diabetes (linked to genetic and lifestyle factors), and gestational diabetes (diagnosed during pregnancy). But are you familiar with type 4 diabetes?

What is type 4 diabetes?

Type 4 diabetes is characterized by insulin resistance in older adults without being overweight or obese. In the past, many doctors thought insulin resistance and type 2 diabetes only occurred in overweight individuals. However, we now know that is not true. But due to this weight stigma associated with a diabetes diagnosis, it is possible that those considered to be at a ‘healthy weight’ may not get diagnosed. Because of this, we do not know the complete statistics for type 4 diabetes. It is estimated that about 20% of all newly diagnosed diabetes cases in folks over age 65 should be classified as type 4 diabetes.

What causes type 4 diabetes?

The latest form of type 4 diabetes is still being investigated, so its development and progression are not fully understood. However, clinicians agree that the aging process brings on the condition. Age-related insulin resistance varies physiologically from obesity-related insulin resistance.

Type 4 diabetes has been linked to excessive amounts of regulatory T cells, one type of immune cell in the body. These regulatory T cells accumulate as part of the aging process and are unrelated to the amount of fat that is present in the body.

There’s no need to panic because not all seasoned folks will get type 4 diabetes! Scientists are still trying to figure out the underlying causes that can bring on the disease.

What are the type 4 diabetes symptoms?

Type 4 diabetes symptoms will fall right in line with those of type 2 because the illness is a result of insulin resistance:
  • Blurry vision
  • Frequent urination
  • Increased thirst
  • Increased appetite
  • Unexplained weight loss
  • Sores that won’t heal
  • Fatigue

How is type 4 diabetes diagnosed?

Believe it or not, type 4 diabetes is not considered an official diagnosis yet. Since the form of diabetes is similar to type 2, diagnosing age-related insulin resistance is difficult.

If you are over age 65, have been experiencing any of the symptoms above, and are considered to be at a ‘healthy’ body weight, do schedule an appointment with your healthcare provider for insulin resistance testing. You may be asked to undergo additional testing if your doctor suspects you have insulin resistance or another condition. Word to the wise, ask for a referral to an endocrinologist specializing in diabetes and other hormonal disorders.

Bottom line

Managing type 4 diabetes differs from managing other forms of diabetes since the underlying physiology differs. What is recommended with regards to a diagnosis of diabetes is to maintain a blood sugar level that is balanced. This can be achieved through blood sugar monitoring and learning how to balance your meals or count carbs. Consider consulting with a registered dietitian (RD or RDN) who is a certified diabetes educator (CDE). Your dietitian will help you learn how to eat to regulate your blood glucose effectively to alleviate your symptoms.

Since type 4 diabetes isn’t a diagnosis yet, there aren’t specific treatments. Some doctors will prescribe medications used to treat type 2 diabetes, which can help with blood sugar regulation but won’t address the underlying root cause. Research is currently underway on this disease and potential treatments to reduce the regulatory T cell count and improve insulin resistance.

Need more information on diabetes? Visit the American Diabetes Association (ADA) website.