What’s The Difference Between Type 1 And Type 2 Diabetes?

At Westchester Health, we have a number of patients who come to us with diabetes, both type 1 and type 2. What concerns us is that many of them aren’t sure which type they have, and/or don’t know the difference between the two. As endocrinologists, we thought we’d offer the following information about both types of diabetes so that there can be less confusion and more understanding about this chronic but manageable disease.

What exactly is diabetes?

Mindy Sotsky, MD, FACE

Diabetes is a chronic disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat, and insulin is the hormone that allows glucose to enter cells to produce energy.

Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys and nerves. It can also cause heart disease and stroke, and sometimes even amputation of a limb. Pregnant women can develop a form of diabetes, called gestational diabetes.

The CDC estimates that over 30 million people in the U.S. probably have diabetes, and 25% of them do not know it. A blood test called the A1C blood test, typically done a few times a year, is the best way to determine if you have diabetes. This test identifies your blood glucose levels so adjustments can be made if they’re not where they should be.

Type 1 diabetes

Type 1 diabetes, also called juvenile-onset diabetes or insulin-dependent diabetes, is an autoimmune condition caused by the body attacking its own pancreas with antibodies. Although type 1 diabetes usually appears during childhood or adolescence, it can also develop in adults, according to MedicalNewsToday. It can occur suddenly, and it tends to gets worse quickly.

What causes type 1 diabetes

If you have type 1 diabetes, your immune system mistakenly attacks your pancreatic beta cells, which produce insulin. Researchers do not know what causes this to happen, but childhood infections may play a role.

Once your immune system destroys these pancreatic cells, your body can no longer make enough insulin to regulate your blood glucose levels. This means that you will need to take supplemental insulin, starting from the time you are diagnosed with type 1 diabetes and for the rest of your life. Insulin will need to be injected through the skin into the fatty tissue underneath.

The Mayo Clinic reports that despite ongoing research, type 1 diabetes has no cure, but by managing blood sugar levels with insulin, eating an appropriate diet and maintain a healthy lifestyle, people with type 1 can prevent complications and lead long, active lives.

Risk factors include:

  • family history of diabetes
  • certain genetic features that affect the way your body produces or uses insulin
  • some medical conditions, such as cystic fibrosisor hemochromatosis
  • exposure to certain infections or viruses, such as mumps or rubella cytomegalovirus

A number of serious medical conditions are associated with type 1 diabetes, including:

  • diabetic retinopathy (damage to the tiny blood vessels in your eyes)
  • diabetic neuropathy (nerve damage)
  • diabetic nephropathy (kidney damage)
  • increased risk of heart disease and stroke

Having type 1 diabetes requires significant lifestyle changes to keep it under control, such as:

  • Frequent testing of your blood sugar levels
  • Careful meal planning
  • Daily exercise
  • Taking insulin and other medications as needed

Type 2 diabetes

By far, the most common form of diabetes is type 2, accounting for 95% of diabetes cases in adults. Type 2 diabetes used to be called adult-onset diabetes, but with the epidemic of obese and overweight children, more teenagers and even adolescents are now developing this condition.

Type 2 diabetes is often a milder form of diabetes than type 1. Nevertheless, type 2 diabetes can still cause major health complications, particularly to the eyes, nerves and kidneys (similar to type 1). Also, like type 1, type 2 diabetes increases your risk of heart disease and stroke.

What causes type 2 diabetes

With Type 2 diabetes, the pancreas usually produces some insulin. But either the amount produced is not enough for the body’s needs, or the body’s cells are resistant to it. This insulin resistance happens primarily in fat, liver and muscle cells. When glucose cannot enter the cells, it builds up in the blood, which can cause serious health problems.

Being overweight is a contributing factor

People who are obese—more than 20% over their ideal body weight for their height—are at particularly high risk of developing type 2 diabetes and its related medical problems.

Like type 1, there is no cure for diabetes type 2 but it can be controlled with weight management, nutrition and exercise. Unfortunately, type 2 diabetes tends to progress, and diabetes medications are often needed.

In the early stages, a person with type 2 diabetes does not need supplemental insulin. As the disease progresses, however, they may need it to manage their blood glucose levels in order to stay healthy.

Risk factors include:

  • family member with type 2 diabetes
  • being obese
  • smoking
  • unhealthy diet
  • lack of exercise, sedentary lifestyle
  • certain medications, including anti-seizure drugs and medications for HIV

People from certain ethnic groups are more likely to develop type 2 diabetes

These include:

  • African Americans
  • Hispanics
  • Native Americans
  • Native Alaskans
  • Pacific Islanders
  • Some people of Asian origin

Symptoms and complications associated with type 1 and type 2

The chart below from MedicalNewsToday does a good job of outlining the symptoms and complications of type 1 and type 2 diabetes, before and at the onset of each condition.

Treatment and prevent of both types 1 and 2

There is no cure for diabetes, but treatment can help people manage this disease and prevent it from getting worse. This chart from MedicalNewsToday explains the important details:

Read our blogs on the subject

We’ve written several informative blogs about diabetes which you can read here.

Helpful websites we recommend

Concerned that you might have type 1 or type 2 diabetes? Please come see us.

If you have diabetes, either type 1 or type 2, or are worried that you’re at risk of developing it and would like guidance about managing this condition, please call (914) 232-1919 to make an appointment with one of our Westchester Health endocrinologists.  We’ll examine you, evaluate your symptoms, possibly perform some tests, and together with you, decide on the best course of treatment and lifestyle changes that can improve your health and reduce your risk of complications. Whenever, wherever you need us, we’re here for you.

By Mindy Sotsky, MD, FACE, an endocrinologist with Westchester Health, member of Westchester Health Physician Partners