Diabetes: Type 1 vs. Type 2

By Doyle R. Jessup

As someone who has loved ones wrestling with the symptoms of diabetes, I became aware that many individuals don’t know there are two types of diabetes, let alone know about their differences. This can be dangerous as they may not recognize the symptoms in themselves because diabetes can strike anyone. According to the American Diabetes Association, over 11% of Americans are living with diabetes—that’s over 38 million individuals, including children. If not treated properly, it can lead to organ failure and even death.

So, what is diabetes? Let’s first start with insulin. Insulin is an essential hormone your pancreas naturally produces, which allows your body to use sugar (glucose) for energy. If your pancreas doesn’t make enough insulin (type 1 diabetes) or is unable to use insulin properly (type 2 diabetes), it leads to a condition that causes higher than normal blood sugar levels (hyperglycemia), which results in diabetes.

As you now may have learned, insulin lowers your blood sugar level. Glucagon, another hormone produced by your pancreas, naturally raises it. Your body uses these two hormones to balance out your blood sugar level to keep it within a healthy range. It’s a beautiful natural dance when all is working properly. Diabetics, however, need help with this process.

Diabetics use manufactured insulin to help lower their blood sugar. If you have diabetes, too much manufactured insulin can lead to low blood sugar (hypoglycemia). Should this occur, you might need to consume sugar to raise your blood sugar level. This is the manual process of trying to mimic the body’s natural process.

Importance of Monitoring

Many factors, such as your food choices, medicine, and physical activity level, can cause your blood sugar to fluctuate throughout the day. Some change is normal, but when your blood sugar is too high or too low, this is where problems can occur.

As a diabetic, monitoring your blood sugar level will help you figure out what affects your numbers, find patterns, and adjust as you go. By monitoring regularly, you’ll be more likely to achieve your blood sugar target ranges. Monitoring also helps your health care team make decisions about your diabetes care plan. Your doctor can educate you on how often to check your blood sugar levels.

If a diabetic fails to properly monitor and manage their blood sugar levels and leaves their blood sugar too high for too long, over time, this can damage nerves and blood vessels and lead to heart disease and other problems. Diabetes never takes a day off. It’s a 24-hour, 365-day-a-year condition that you must monitor and be vigilant about all the time.

Type 1 Diabetes

Type 1 diabetes is the most severe form of diabetes and is a condition in which the body is unable to produce insulin. About 5% of diabetics have type 1 diabetes, or insulin-dependent diabetes. Type 1 diabetes was previously known as juvenile diabetes because it usually develops in children and teenagers; however, people of all ages can develop type 1 diabetes. In type 1 diabetes, the body’s immune system attacks the insulin-producing islet cells in the pancreas. The islet cells sense glucose in the blood and produce the correct amount of insulin to regulate blood sugar. This attack on the body’s own cells is known as an autoimmune disease.

Scientists don’t yet know why this attack happens, but once the insulin-producing cells are destroyed, a person can no longer produce their own insulin. Without insulin, the sugar stays in the blood and builds up. As a result, the body’s cells starve. If left untreated, high blood sugar levels can damage the eyes, kidneys, nerves, and heart, and can also lead to coma and death. It’s imperative type 1 diabetes be treated through a daily regimen of insulin therapy.

Type 2 Diabetes

Type 2 diabetes, also known as insulin resistance, is the most common form of diabetes and is a condition in which the body’s cells have trouble responding to insulin. You may have also heard type 2 diabetes referred to as adult-onset diabetes since it typically develops after age 35. However, a growing number of younger individuals are now being diagnosed with type 2 diabetes.

Individuals with type 2 diabetes are able to naturally produce some of their own insulin, but often it is not enough. Sometimes, type 2 diabetics’ insulin will try to open the body’s cells to allow the glucose to enter, but the process won’t work because the cells just won’t open. This is called insulin resistance. Type 2 diabetes is usually attributed to people who are overweight with a sedentary lifestyle and unhealthy diet.

Warning Signs

The symptoms of both type 1 and type 2 diabetes can be similar and difficult to distinguish from one another. In some cases, people may even be misdiagnosed based on various factors like age. For example, latent autoimmune diabetes in adults (LADA) is commonly misdiagnosed as type 2 diabetes. Understanding your diabetes type and getting a proper diagnosis allows you to find the right treatment and management plan.

The major difference is the onset of type 1 diabetes occurs very quickly, and the symptoms are usually severe and hard to overlook. The symptoms of type 2 diabetes are similar to those of type 1 diabetes but are usually slower to occur and not as severe. For these reasons, many people mistakenly overlook the warning signs of type 2. They also might think that the symptoms are signs of other conditions, like getting older, overworking, or hot weather. Symptoms of diabetes can include:

• Increased thirst

• Increased urination (bed-wetting in children who have already been toilet trained)

• Rapid and unexplained weight loss

• Extreme hunger

• Extreme weakness or fatigue

• Mood changes, irritability

• Blurred vision

• Erectile dysfunction

• Nausea, vomiting, constipation

• Unpleasant breath odor

• Itchy skin

• A cut that is slow to heal

• Darkened patches of skin (usually around the neck, armpits, or groin area)

Seeking Remission

While you cannot cure diabetes, whether remission is possible depends on the type of diabetes you are living with and how far diabetes has progressed. At present, with type 1 being an autoimmune disorder, there is nothing a patient can do to prevent type 1 diabetes. There’s hope in the future. Scientists have made developments in donor cell transplantation, as well as artificial pancreas technology, that have shown promise in the search for achieving remission.

In the case of type 2 diabetes, remission may be possible for some people by making diet and lifestyle changes to stabilize blood sugar levels. Type 2 diabetes is considered a chronic, lifelong condition, so giving up the newly developed healthy habits creates a possibility of relapse.

Learning More

The American Diabetes Association has a very informative website at diabetes.org. If you suspect you have the symptoms of diabetes, make an appointment with your physician right away. Make a list of questions for your doctor, learn what your blood sugar range is and what the target should be. Your path to health always includes educating yourself about your body and self-care.