Diabetes or more properly called, diabetes mellitus is a disease of high blood glucose (sugar). It is diagnosed when the body cannot properly use or store glucose so it accumulates in the bloodstream which can lead to poor health and long-term health complications if not treated.
- What is the difference between type 1 and type 2 diabetes?
- What is the difference in risk factors for type 1 and type 2 diabetes?
- What are the symptoms of type 1 and type 2 diabetes?
- What is the difference in screening methods for type 1 and type 2 diabetes?
- What is the difference in treatment methods for type 1 and type 2 diabetes?
What is the difference between type 1 and type 2 diabetes?
Type 1 diabetes (which used to be called juvenile diabetes) is an autoimmune disorder in which antibodies produced by the immune system attack the cells in the pancreas that make insulin.
This leaves the individual without the ability to make insulin. Without insulin we cannot live. Thus, individuals with type 1 diabetes must be on insulin treatment. While type 1 diabetes is often diagnosed in children or young adults, it can also be diagnosed later in life as well.
Type 2 diabetes is the most common type of diabetes (90-95%) and used to be called “adult onset diabetes”.
Type 2 diabetes has a stronger genetic component than type 1 diabetes and is commonly associated with overweight and obese adults. Individuals of certain ethnic and racial backgrounds also have a much higher risk for developing type 2 diabetes especially in the obesogenic environment. While type 2 diabetes is most often diagnosed in adults, we are diagnosing it more frequently in children and young adults with obesity.
In sum: Type 1 diabetes was once referred to as juvenile-diabetes whereas type 2 diabetes was once referred to as adult-onset diabetes. Type 1 diabetes is an autoimmune condition, whereas type 2 diabetes is a condition that is caused by both genetics and lifestyle.
What is the difference in risk factors for type 1 and type 2 diabetes?
Risk factors for type 1 diabetes
The main risk factor for type 1 diabetes is a personal or family history of other autoimmune disorders. It is still not known what triggers the immune system to produce the insulin destroying antibodies.
Individuals with type 1 diabetes or their family members may have other autoimmune disorders such as lupus, rheumatoid arthritis, Hashimotos thyroid disease and celiac disease to name a few.
Historically individuals with type 1 diabetes were lean or of normal body weight, but more recently we have been seeing more overweight and obesity in individuals with type 1 diabetes.
Risk factors for type 2 diabetes
There are more known risk factors for type 2 diabetes than type 1 diabetes.
These risk factors include:
- Age (≥45)
- Family history/genetics
- Metabolic dyslipidemia: low HDL and high triglycerides
- Women with a history of gestational diabetes or polycystic ovarian syndrome
- History of vascular disease
What are the symptoms of type 1 and type 2 diabetes?
Symptoms of type 1 diabetes:
Individuals who newly develop type 1 diabetes generally present quite ill with the classic symptoms of high blood glucose which include:
- Excessive urination and thirst
- Blurred vision
- Weight loss
Excessive urination and thirst
With elevated glucose in the blood, the kidneys start to excrete glucose which draws water with it leading to excessive urination. That then leads to dehydration and therefore excessive thirst.
Glucose gets into the lens of the eye along with water which changes the shape of the lens and as a result a change in vision.
Fatigue & Weight Loss
Cells and organs are not getting enough glucose as an energy source so the body is in a starvation mode leading to unintentional weight loss and fatigue.
If not picked up early enough these patients can then develop a condition called diabetic ketoacidosis (DKA) in which blood acid levels rise leading to severe illness with nausea, vomiting, shortness of breath, weakness and loss of consciousness. This is a medical emergency.
Symptoms of type 2 diabetes:
If picked up early type 2 diabetes can present without any symptoms at all.
However, individuals with type 2 diabetes can also develop the classic symptoms of high blood glucose as described above.
Rarely patients with type 2 diabetes can present with DKA. Because the diagnosis of type 2 diabetes can sometimes be subtle and thus picked up late, sometimes patients can have evidence of end-organ damage when they first get diagnosed, such as with symptoms of neuropathy (numbness, tingling, pain in the toes and feet), retinal damage on an eye exam or evidence of kidney disease on blood or urine tests.
What is the difference in screening methods for type 1 and type 2 diabetes?
Type 1 and type 2 diabetes can be screened for using the same testing methods.
You should talk to your healthcare provider about the best way to screen for diabetes. The most commonly performed test now is the Hemoglobin A1c test or “A1c”.
This test gives us information on whether the blood glucose has been elevated over the last 3 months. It is a relatively inexpensive test and can be done at any time of day.
A value of <5.7% is considered normal. Prediabetes is diagnosed when the A1c is ≥5.7% but <6.5%. Diabetes is diagnosed when the A1c is ≥6.5%.
A fasting blood glucose or a two-hour glucose tolerance test can also be performed.
Blood tests must be confirmed with at least two abnormal tests before a diagnosis of prediabetes or diabetes should be made.
In addition, different organizations such as the American Diabetes Association have also developed “risk scores” based on history, weight, etc.
It is recommended that all adults 45 years old or older be screened for diabetes. Younger individuals with overweight/obesity or with multiple other risk factors should be screened earlier.
There is not a clear consensus on how often testing for diabetes should be done if the tests are normal. Higher risk individuals should probably screened on a yearly basis. Those at lower risk can probably be screened less frequently unless their risk factors have changed.
What Is The Difference In Treatment Methods For Type 1 and Type 2 Diabetes?
Type 1 Diabetes
The treatment for diabetes is complex and depends on the type of diabetes you have. For individuals with type 1 diabetes, they must be on insulin therapy either through injections or via insulin pump therapy.
Type 2 Diabetes
Type 2 diabetes can be treated with lifestyle changes and weight loss, oral medications, non-insulin injectable medications, and insulin. Bariatric surgery is also one of the most effective treatments for type 2 diabetes.
A note from LetsGetChecked
Whether you suspect that you have type 1 or type 2 diabetes, getting screened on a regular basis in the only way to know for sure.
If you are experiencing symptoms of diabetes, it’s good to know that you can get tested in the comfort of home with online results and one to one support all available in one week.
Written by Dr. Marc Cornier | Edited by Hannah Kingston