Type 4 diabetes: Most people know about type 1 and type 2 diabetes. A few might have heard of gestational diabetes, the kind that shows up during pregnancy. But “type 4 diabetes”? It sounds like something made up, like a sequel nobody asked for. Yet, it’s a real term researchers have started using, and it’s not what you’d expect.
What are the causes of type 4 diabetes?
Unlike type-2 diabetes, which is often linked to lifestyle factors like diet, exercise, and weight, type 4 diabetes shows up in people who aren’t overweight. That’s part of what makes it confusing. You can eat reasonably well, walk every morning, maintain a normal body weight, and still be at risk.
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The culprit isn’t cupcakes or soda, but it’s ageing. Scientists think type 4 diabetes develops because of how the body’s immune system and fat tissue change as we get older. It’s been studied mostly in older adults, particularly those who were never classified as overweight.
A sneaky kind of insulin resistance:
In simple terms, the body starts resisting insulin, but not for the usual reasons. In type 2 diabetes, fat cells often expand, disrupting insulin. With type 4, it’s different. Certain immune cells, known as T cells, infiltrate fat tissue, making it harder for the body to use insulin properly. That means blood sugar levels creep up, even if someone’s lifestyle looks pretty healthy on paper.
If you’ve ever met an older relative who stayed slim their whole life but suddenly developed high blood sugar “out of nowhere,” that’s the situation researchers think may fall into the type 4 category.
Is type 4 diabetes officially recognised?
Labelling this as “type-4” isn’t just about naming something new. It’s about helping doctors recognise that not all diabetes fits the old boxes. If a lean 75-year-old shows signs of diabetes, it doesn’t make sense to give them the same advice as a 45-year-old with type 2 who needs to lose weight and exercise more. The causes and probably the treatments aren’t the same.
Here’s the catch: type 4 diabetes isn’t officially recognised as a standard medical diagnosis yet. Right now, it’s more of a research concept. Studies on mice have shown this immune-related mechanism, and scientists believe it translates to humans, but we’re still in the early days. Don’t expect your doctor to write “Type-4” on your chart just yet.
How should you deal with type 4 diabetes?
If you’re older, especially past 65, and your blood sugar levels are creeping up even though you’re not overweight, it’s worth asking your doctor about it. Maybe you don’t fit the “classic” type 2 profile, and that’s okay. Medicine evolves. What we thought was one disease often turns out to be many.
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At the end of the day, whether we call it type-2, type-4, or something else, keeping an eye on blood sugar, getting regular checkups, and being honest with your doctor about your health habits still matter most.
Type-4 diabetes isn’t about sugar binges or weight gain; rather, it’s about ageing and the immune system. It’s a reminder that sometimes, even when you do things “right,” biology has its own plans.
