Joseph R. Anticaglia MD
Medical Advisory Board
Type 1 and type 2 diabetes are chronic conditions that damage the body’s ability to metabolize sugars; that is, break down sugars from our diet into glucose. Consequently, blood levels of glucose become and remain elevated unless treated with diet, lifestyle changes and medications. We need the energy of glucose in our cells for our bodies to function.
Both conditions require daily monitoring of blood glucose levels to minimize serious complications. In type 1 diabetes, the beta cells of the pancreas do not manufacture any insulin. In type 2 diabetes, insulin is initially available, but the body is insensitive to insulin. The body’s insensitivity to insulin prevents glucose from entering the cells, causing an elevation in blood glucose levels. There are other differences.
Differences Between Type 1 vs. Type 2 Diabetes
1) Prevalence
Type 1
There are 37.3 million Americans with diabetes.
Five to ten per cent of them have type 1 diabetes.
Type 2
Ninety per of Americans have type 2 diabetes
2) Age
Type 1
Often diagnosed in children and young adults under the age of twenty.
Type 2
Usually diagnosed in adults over the age of forty.
3) Cause
Type 1
It’s an autoimmune disease. The body attacks and destroys healthy insulin producing beta cells of pancreas. The pancreas does not make any insulin.
Type 2
It’s metabolic disease. The body makes insulin, but the cells are insensitive to insulin. They don’t respond to insulin — “insulin resistance” .. The cells don’t allow glucose to enter and be used as fuel. Over time, the beta cells of the pancreas may not produce enough insulin
4) Symptoms
Type 1
Relatively sudden onset of symptoms with increased thirst and elevated levels of blood glucose. The symptoms can develop in just a few weeks or months. Symptoms are unlikely to be ignored.
Type 2
Gradual onset of symptoms with mild to moderately elevated blood glucose levels. Symptoms may be ignore, and the disease undiagnosed for years.
5) Weight.
Type 1
May experience weight loss, or normal weight at time of diagnosis.
Type 2
At time of diagnosis of type 2 diabetes, many are overweight or obese.
6) Diagnosis
Type 1
Most cases occur in children or young adults with extremely elevated hyperglycemia (high blood glucose levels). The diagnosis is made by using A1C test that measures your average blood glucose level over the past three months (glycated hemoglobin test), A result of 6.5% or higher indicates you have diabetes.
Type 2
Type 2 diabetes most often occurs in overweight adults over the age of forty with a bulging waistline.
The A1C test is the primary test to diagnose both Type 1 and 2 diabetes.
7) Risk Factors
Type 1
Persons with a sibling or parent with a history of type 1 diabetes are at a greater risk of developing this disease.
The probability of having Type 1D increases the further you are away from the equator. For example, Finland has the highest childhood type1diabetes in the world.
Type 2
Men who have a waist size of forty inches or more and women with a waist of 34.5 inches or more have the higher risk of developing type 2 diabetes. Prediabetes, gestational diabetes and abnormal blood lipid levels are other risk factors for this condition. Inactivity and obesity are additional concerns regarding type 2 diabetes.
8) Treatment
Type 1
Children, young adults and older persons must use insulin in some form every day. Some will opt for minute-by-minute, continuous glucose monitoring (CGM) of their blood glucose to better manage their insulin dosage. They need insulin injections or the use of an insulin pump to keep blood glucose within a normal range,
Type 2
Lifestyle change and oral medications are the initial treatments. These individuals may require insulin at some point in their disease. CGM is usually not needed for type 2. A disturbing trend is the increasing need to treat the younger population who have developed type 2 diabetes.
9) Prognosis
Type 1
The prognosis is good with good management of type one diabetes. Type 1 cannot be reversed,
Type 2
Type 2 diabetes can be reversed at times with lifestyle choices and medications.
10) Cure
Type 1
There is no cure for type 1 diabetes.
Type 2
Although there is no cure for this condition, healthy eating habits with a healthy lifestyle plus maintaining a healthy weight, make it possible to achieve normal blood glucose levels without medications.
Type 1 diabetes is an autoimmune, insulin dependent disease that usually shows up early in life. It’s treated with insulin injections or an insulin pump that delivers small doses of short acting in insulin continuously. This disease is not reversible.
Type 2 diabetes is a metabolic, insulin resistant and insulin insensitive disease that usually makes its appearance after the age of forty in people making unhealthy life-style choices. It’s treated with oral medications, diet, weight control, exercise and, at times, with insulin. In some instances, this condition can be reversed.
References
- National Institute of Diabetes and Digestive and Kidney Diseases; What is Diabetes? July 18,2017
- CDC; Statistical Report; January 18, 2022
- Joseph R. Anticaglia, MD’ Type 1 Diabetes Four Key Players; Doctor’s Column, HC Smart, 2022
- Joseph R. Anticaglia, MD’ Type 2 Diabetes Watch Your Ps & Ss: Doctor’s Column, HC Smart 2022
Addendum
If you are a parent of a child with type1diabetes, close consultation with your physician is mandatory. How to deal with complications; for example, hypoglycemia (a precipitous drop in blood glucose) can be life-saving.
This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.