Difference between Type 1 and Type 2 Diabetes
There are two main types of diabetes: type 1 and type 2 diabetes. Both types of diabetes are chronic diseases that affect the way your body regulates blood sugar, or glucose. Glucose is the fuel that feeds your body’s cells, but to enter your cells it needs a key. Insulin is that key.
People with type 1 diabetes don’t produce insulin. You can think of it as not having a key.
People with type 2 diabetes don’t respond to insulin as well as they should and later in the disease often don’t make enough insulin. You can think of this as having a broken key.
Both types of diabetes can lead to chronically high blood sugar levels. That increases the risk of diabetes complications.
Both types of diabetes, if not controlled, share many similar symptoms, including:
- frequent urination
- feeling very thirsty and drinking a lot
- feeling very hungry
- feeling very fatigued
- blurry vision
- cuts or sores that don’t heal properly
People with type 1 diabetes may also experience irritability and mood changes, and unintentionally lose weight. People with type 2 diabetes may also have numbness and tingling in their hands or feet.
Although many of the symptoms of type 1 and type 2 diabetes are similar, they present in very different ways. Many people with type 2 diabetes won’t have symptoms for many years. Then often the symptoms of type 2 diabetes develop slowly over the course of time. Some people with type 2 diabetes have no symptoms at all and don’t discover their condition until complications develop.
The symptoms of type 1 diabetes develop fast, typically over the course of several weeks. Type 1 diabetes, which was once known as juvenile diabetes, usually develops in childhood or adolescence. But it’s possible to get type 1 diabetes later in life.
What Causes Diabetes?
Type 1 and type 2 diabetes may have similar names, but they are different diseases with unique causes.
Causes of type 1 diabetes
The body’s immune system is responsible for fighting off foreign invaders, like harmful viruses and bacteria. In people with type 1 diabetes, the immune system mistakes the body’s own healthy cells for foreign invaders. The immune system attacks and destroys the insulin-producing beta cells in the pancreas. After these beta cells are destroyed, the body is unable to produce insulin.
Researchers don’t know why the immune system attacks the body’s own cells. It may have something to do with genetic and environmental factors, like exposure to viruses. Research is ongoing.
Causes of type 2 diabetes
People with type 2 diabetes have insulin resistance. The body still produces insulin, but it’s unable to use it effectively. Researchers aren’t sure why some people become insulin resistance and others don’t, but several lifestyle factors may contribute, including excess weight and inactivity.
Other genetic and environmental factors may also contribute. When you develop type 2 diabetes, your pancreas will try to compensate by producing more insulin. Because your body is unable to effectively use insulin, glucose will accumulate in your bloodstream.
How common is diabetes?
Type 2 diabetes is much more common that type 1. According to the 2017 National Diabetes Statistics Report, there are 30.3 million people in the United States with diabetes. That’s close to 1 in 10 people. Among all these people living with diabetes, 90 to 95 percent have type 2 diabetes.
The percentage of people with diabetes increases with age. Less than 10 percent of the general population has diabetes, but among those 65 and older, the incidence rate reaches a high of 25.2 percent. Only about 0.18 percent of children under the age of 18 had diabetes in 2015.
Men and women get diabetes at roughly the same rate, but incidence rates are higher among certain races and ethnicities. American Indians and Alaskan Natives have the highest prevalence of diabetes among both men and women. The black and Hispanic populations have higher rates of diabetes than non-Hispanic whites.
What are the Risk Factors of Type 1 and Type 2 Diabetes?
Risk factors for type 1 diabetes include:
- Family history: People with a parent or sibling with type 1 diabetes have a higher risk of developing it themselves.
- Age: Type 1 diabetes can appear at any age, but it’s most common among children and adolescents.
- Geography: The prevalence of type 1 diabetes increases the farther away you are from the equator.
- Genetics: The presence of some genes point to an increased risk of developing type 1 diabetes.
Type 1 diabetes can’t be prevented.
You are at risk of developing type 2 diabetes if you:
- have prediabetes (slightly elevated blood sugar levels)
- are overweight or obese
- have an immediate family member with type 2 diabetes
- are over age 45
- are physically inactive
- have ever had gestational diabetes, which is diabetes during pregnancy
- have given birth to a baby weighing more than 9 pounds
- are African-American, Hispanic or Latino American, American Indian, or Alaska Native
- have polycystic ovarian syndrome
- have a lot of belly fat
It may be possible to lower your risk of developing type 2 diabetes through lifestyle changes:
- Maintain a healthy weight.
- If you’re overweight, work with your doctor to develop a healthy weight-loss plan.
- Increase your activity levels.
- Eat a balanced diet, and reduce your intake of sugary or overly processed foods.
How are type 1 and type 2 diabetes diagnosed?
The primary test for both type 1 and type 2 diabetes is known as the glycated hemoglobin (A1C) test. An A1C test is a blood test that determines your average blood sugar level for the past two to three months. Your doctor may draw your blood or give you a small finger prick.
The higher your blood sugar levels have been over the past few months, the higher your A1C level will be. An A1C level of 6.5 or higher indicates diabetes.
How are type 1 and type 2 diabetes treated?
There’s no cure for type 1 diabetes. People with type 1 diabetes don’t produce insulin, so it must be regularly injected into your body. Some people take injections into the soft tissue, such as the stomach, arm, or buttocks, several times per day. Other people use insulin pumps. Insulin pumps supply a steady amount of insulin into the body through a small tube.
Blood sugar testing is an essential part of managing type 1 diabetes, because levels can go up and down quickly.
Type 2 diabetes can be controlled and even reversed with diet and exercise alone, but many people need extra support. If lifestyle changes aren’t enough, your doctor may prescribe medications that help your body use insulin more effectively.
Monitoring your blood sugar is an essential part of diabetes management because it’s the only way to know if you’re meeting your target levels. Your doctor may recommend testing your blood sugar occasionally or more frequently. If your blood sugars are high, your doctor may recommend insulin injections.
With careful monitoring, you can get your blood sugar levels back to normal and prevent the development of serious complications.
Nutritional management is an important part of life for people living with diabetes.
If you have type 1 diabetes, work with your doctor to identify how much insulin you may need to inject after eating certain types of food. For example, carbohydrates can cause blood sugar levels to quickly increase in people with type 1 diabetes. You’ll need to counteract this by taking insulin, but you’ll need to know how much insulin to take.
People with type 2 diabetes need to focus on healthy eating. Weight loss is often a part of type 2 diabetes treatment plans, so your doctor may recommend a low-calorie meal plan. This could mean reducing your consumption of animal fats and junk food.
Written by Corinne O’Keefe Osborn
Medically Reviewed by Suzanne Falck, MD