What is Severe Insulin-Deficient Diabetes (SIDD)?

Severe insulin-deficient diabetes (SIDD) is a subtype of type 2 diabetes. Healthcare providers use subcategories to classify diabetes by the associated risk of complications, comorbidities, genetics, and response to treatment. Knowing the subcategory of your type 2 diabetes helps your provider offer more personalized treatment options.

Keep reading to learn what makes SIDD different than other types of diabetes and what a SIDD diagnosis means for you.

Types of Diabetes

There are three major types of diabetes, as follows:

• Type 1 diabetes is an autoimmune condition that prevents insulin production. This form of diabetes often develops in childhood and used to be referred to as juvenile diabetes.
• Type 2 diabetes usually develops later in life and is a condition in which your body doesn't make enough insulin to process the glucose you take in, or your body doesn't respond to the insulin you make, which is known as insulin resistance. Most people with diabetes have type 2 diabetes.
• Gestational diabetes is a form of diabetes that can develop in people who did not have diabetes before their pregnancy. It goes away when the baby is born; however, it can increase your chances of developing type 2 diabetes later in life. Untreated, gestational diabetes can cause pregnancy complications.

There are several subtypes of type 2 diabetes, including:

• Severe insulin-deficient diabetes (SIDD)
  
• Severe insulin-resistant diabetes (SIRD)
• Severe autoimmune diabetes (SAID)
• Mild obesity-related diabetes
• Mild age-related diabetes

Each subtype comes with specific criteria like the associated risk of complications, comorbidities, genetics, and response to treatment. SIDD is strongly related to certain complications, such as kidney disease and retinopathy.

SIDD Symptoms

The symptoms of the SIDD subtype are similar to other forms of type 2 diabetes. Some specific characteristics of SIDD include having:

• A low body mass index (BMI)
• Low insulin secretion
• Poor metabolic control
• High hemoglobin A1C (HbA1c) and fasting blood glucose levels
• High blood pressure
• High cholesterol
• Ketoacidosis at the time of diagnosis

Other symptoms common to other forms of type 2 diabetes include:

• Increased thirst
• Urinating more often
• Fatigue
• Blurry vision
• Tingling in your hand or feet
• Slow healing of cuts and wounds

SIDD Causes

Like other forms of type 2 diabetes, SIDD is primarily caused by genetics and lifestyle behaviors. This type of diabetes usually develops later in life as a result of things like:

• Obesity
• Inactivity
• Increased belly fat
• Insulin resistance
  

SIDD Complications

The biggest consideration with most subtypes of diabetes is the increased prevalence of particular complications. In particular, people with SIDD are more likely to experience the following:

• Neuropathy (nerve damage)
• Retinopathy (damaged blood vessels in the back of the eye)
• Albuminuria (a protein found in urine that can indicate kidney disease)
• Kidney disease

Other subgroups carry a higher risk of additional complications. All the subtypes share the general complications associated with type 2 diabetes, including:

• Foot problems
• Heart attack
• Stroke
• Gum and mouth disease

Diagnosis

Your provider will look at six data points to determine your diabetes subtype. These data points include the following:

• BMI
• Age at diagnosis
• HbA1c level
• Beta-cell (the cells that make insulin) function
• Insulin resistance
• Diabetes-related autoantibodies
  

Treatments for SIDD

SIDD and other subtypes of diabetes are treated with diet and lifestyle changes, like carbohydrate control and exercise. Treatment may include oral antihyperglycemics such as Glucophage (metformin) or injected insulin.

Your healthcare provider may also recommend additional treatments like:

• Glucagon-like peptide-1 receptor agonists (GLP-1 RAs): such as Byetta (exenatide), lixisenatide, Rybelsus (semaglutide), Trulicity (dulaglutide), Bydureon (exenatide extended-release), Victoza (liraglutide), and Ozempic (semaglutide)
• Sodium-glucose cotransporter 2 inhibitors (SGLT2i): such as Invokana (canagliflozin), Jardiance (empagliflozin), Farxiga (dapagliflozin), and Steglatro (ertugliflozin)

Prognosis

Diabetes is a lifelong condition. There is no cure, but you can manage the disease with the proper lifestyle changes, a proper diet, and medications. Adhering to the treatment plan you create with your provider can help keep your diabetes in check and prevent you from developing dangerous complications.

Coping With SIDD

Creating a plan that fits your lifestyle will help you adhere to your treatment regimen. You may find it helpful to involve your family, friends, healthcare provider, and technology. Below are some tips to improve your quality of life with diabetes:

• Let yourself get upset: Living with diabetes can be difficult. Acknowledge these feelings and talk to someone about them. Get help, or reach out to a support group to share your experience with others.
• Get financial help: The cost of diabetes supplies and medications can add up quickly. Talk to your healthcare provider or insurance company about financial assistance programs.
• Accept help: Whether it's financial help or assistance with cooking, don't be afraid to ask for and accept help when it's offered.
• Don't get overwhelmed: Do one thing at a time, and don't try to make too many changes at once.
• Find things you enjoy: Whether it's an activity you love or a healthy snack, continue seeking out ways to enjoy yourself.

Summary

Diabetes is a serious, lifelong disease that can lead to complications if not managed correctly. Specific forms of diabetes, like SIDD, can increase your risk of certain complications, including vision problems and nerve pain. Talk to your healthcare provider about the best way to manage your diabetes.