Most people refer think of diabetes as a single disease, but diabetes actually consists of two distinct types that are very different in their cause and presentation. What is the difference between type 1 and type 2 diabetes?
What Is the Difference Between Type 1 and Type 2 Diabetes?
Type 1 vs. Type 2 Diabetes: What’s Type 1?
Both forms of diabetes are related to problems with the body making or using insulin. This leads to elevated blood sugars and complications such as heart, kidney, eye or nerve disease, but there are some major differences.
Type 1 diabetes is a form of diabetes most commonly seen in children, and it’s less frequently diagnosed after early adulthood. People with this type of diabetes don’t produce insulin at all. This is because the insulin-producing cells in the pancreas called beta-cells have been destroyed.
Why this destruction occurs isn’t fully understood, but most experts believe type 1 diabetes is an autoimmune disease where the body produces antibodies against its own beta-cells. Some people may be more genetically susceptible to mounting the immune response that destroys beta-cells. One theory is that a virus triggers the immune system, which destroys the insulin-producing cells in a genetically susceptible individual.
People with type 1 diabetes need insulin to survive. Without it, glucose can’t get into cells to be used as energy. The glucose remains in the bloodstream, and some is lost in the urine. This leads to complications such as dehydration – and blood sugars can become dangerously high.
Since glucose can’t get into cells, because of the lack of insulin, the brain suffers since it can only use glucose as fuel. As a result the body breaks down fat and the liver modifies it to form ketone bodies the brain adapts as a fuel source. This leads to a dangerous condition called ketoacidosis. People with type 1 diabetes can also have problems with low blood sugar levels, or hypoglycemia, once they start taking insulin.
Type 1 vs. Type 2 Diabetes: How is Type 2 Diabetes Different?
In type 2 diabetes, the pancreas still makes insulin, but the cells that use insulin to get the glucose they need are more resistant to it. This means the insulin that’s produced doesn’t work as well and glucose can’t enter the cells as easily. This is a condition known as insulin resistance. To compensate, the pancreas pumps out more insulin so there’s more of it circulating in the bloodstream to move glucose into the cells.
This can go on for quite a while, but eventually the pancreas “tires” and is unable to keep pumping out high volumes of insulin. That’s when blood sugars start to rise and type 2 diabetes makes its appearance. Type 2 diabetes is more common in the older population, but more children and teens are being diagnosed due to the obesity epidemic. There’s also a strong genetic component to type 2 diabetes, although a healthy lifestyle may modify much of the risk.
Type 2 diabetes is a disease that’s preventable through a healthy lifestyle – staying active and maintaining a healthy body weight. Over 90% of people with type 2 diabetes are overweight or obese. Type 1 diabetes isn’t preventable according to what is currently known, although some small studies show that vitamin D during childhood helps to protect against it.
What Is the Difference Between Type 1 and Type 2 Diabetes: The Bottom Line?
They both can lead to serious complications, but, there are differences between the two types of diabetes in terms of what causes them and how they’re treated. The most important is that type 1 diabetics need insulin to survive, while type 2 diabetics can often be treated with diet and oral medications.
Merck Manual. Eighteenth edition. 2006.
Medscape.com. “Differentiating Between Type 1 and Type 2 Diabetes”