What is Type 1 Vs Type 2 Diabetes? Do you know that according to the 2021 statistics, around 537 million people worldwide are living with diabetes? Despite such high prevalence, many people still do not know what are type 1 and 2 diabetes, and what makes them different from each other.

 Although both type 1 and 2 diabetics have high blood sugar levels and experience a similar set of symptoms, they have different causes, risk factors, treatments, dietary and lifestyle recommendations, etc.

Also, see, Effects Of High Blood Sugar On The Body and Foods To Eat To Lower Blood Sugar

Let’s talk about these differences in detail;

What Is Worse – Type 1 Vs Type 2 Diabetes?

Type 2 diabetes usually has a milder form, and reduces the life expectancy of a person, on average, by 10 years as compared to that of 20 years in the case of type 1 diabetes.

However, we can’t say that one is better or worse than the other because both type 1 and 2 diabetic patients require a good level of care and watchful management. If the blood sugar levels are not kept in the optimum range, both types can damage the nerves and small blood vessels of the kidneys, eyes, and legs. Besides, the risks of stroke and cardiovascular disease are also increased.

What Are Symptoms Of Type 1 and 2 Diabetes?

You may experience the following symptoms if you are diabetic; ^[1]

• Polyuria (frequent and excessive urination)
• Polydipsia (feeling very thirsty)
• Polyphagia (increased appetite)
• Weakness and fatigue
• Blurry vision
• Tingling or numbness in extremities (hands and feet)
• Poor healing of wounds
• Unexplained weight loss – etc

Symptoms of both types are almost the same; however, their time of onset and way of presentation makes them different. In type 1 diabetes patients, symptoms develop quickly within weeks. The onset is usually at a young age although some people may develop type 1 diabetes later in life.

On the other hand, symptoms of type 2 disease develop gradually with time. People may not have any symptoms for years. Some can even be living with it without knowing they have diabetes until their old age when complications occur. However, due to a recent rise in childhood obesity, the disease is being reported in children as well.

Causes and Risk Factors 

Although both type 1 and 2 diabetics observe more or less similar symptoms, each type has a different set of causes and risk factors.

Type 1 diabetes is an autoimmune disease in which the body’s immune system starts destroying the insulin-producing beta cells of the pancreas. As a result, very little or no insulin is synthesized in the body. It is still unknown why the immune system starts acting abnormally, and research is going on in this regard. However, your diet, lifestyle and body weight certainly have nothing to do with causing type 1 diabetes.

On the other hand, in type 2 diabetics, the pancreas is producing enough insulin but body cells are not able to use it. The exact reason for this insulin resistance is not clear; however, researchers have found that several factors, like sedentary lifestyle, obesity, hypertension, high blood cholesterol, etc, increase the risks of type 2 diabetes. ^[2]

Does Genetics Have Something To Do With Diabetes?

Genetics surely plays a causative role in both types of diabetes as is evident by the fact that people who have a family history of diabetes or belong to a certain race are more prone to develop it. However, your genes alone are not enough for causing the disease. Environmental factors also matter.

For instance, in type 1 diabetes, inheritance of certain HLA genes from parents is believed to increase disease predisposition as these genes are associated with autoimmune diseases. ^[3] However, despite attaining such genes, the disease does not occur until triggered by certain environmental factors, like cold weather, viral infection, etc.

Type 2 diabetes, on the other hand, has a relatively stronger association with family history and genetics. Twin studies have found that if one identical twin is type 2 diabetic, there is up to a 90% chance that the other twin will also develop it, while the odds are only 50% in the case of type 1 diabetes.^{[4, 5]}

Yet, lifestyle and environmental factors, as mentioned earlier, should also be present for the person to develop insulin resistance.

Can Type 2 Diabetes Turn Into Type 1?

It is a common misconception that type 2 diabetes can convert into type 1 because of the exogenous intake of insulin. However, it is not true. Although both forms of diabetes share many common features among them, there is no possible way that one type can transform into the other over time.

How Are Type 1 and 2 Diabetes Diagnosed?

Both are diagnosed by a similar set of tests, but certain tests may differentiate between the two;

Hemoglobin A1C Test

The primary test used to diagnose both type 1 and 2 diabetes, is glycated hemoglobin, or A1C test. It gives a percentage value of how much glucose is attached to the hemoglobin protein in your blood. This indirectly tells your average blood sugar levels for the past 2 to 3 months.

A1C test does not require any pre-test fasting and is easily checked by drawing a small sample of your blood.

Other Tests

In case when the A1C test cannot be done either due to unavailability, or the presence of certain medical conditions which can give false readings, your doctor may utilize the following tests to diagnose your disease;

• Random blood sugar test – checked at a random time
• Fasting blood sugar test – done after an overnight fast
• Oral Glucose Tolerance Test (OGTT) – an overnight fast is required after which you are asked to drink a liquid containing a calculated amount of sugar. Blood glucose levels are then checked after two hours.

Reference Values for Diagnosing Diabetes

According to the guidelines of WHO and the American Diabetes Association (ADA), the following are the reference ranges for diagnosing pre-diabetes and diabetes;

When there is no symptom present, at least two blood sugar tests, done on separate days, with values falling in the diabetic range, are required to diagnose somebody with diabetes.

Tests to Differentiate between Type 1 and 2 Diabetes

Although no diagnostic test has been standardized yet to differentiate between the two types; however, the following tests show some utility in this regard;

• C-peptide test
• Autoantibodies test

How Are Type 1 and 2 Diabetes Treated?

Type 1 diabetics are not able to synthesize insulin in their bodies, so they need regular insulin injections or the use of insulin pumps to keep their sugar levels in the optimum range. Although transplantation of insulin-producing cells of the pancreas can be an option, the treatment poses some serious risks. Besides, you will later require a lifetime cover of immunosuppressant drugs that have their side effects.

In contrast, type 2 diabetes can be easily managed and treated by a healthy diet, exercise, and lifestyle changes. If these measures are not sufficient, the doctor will also prescribe insulin and certain medications as well.

Are Type 1 and 2 Diabetes Curable or Preventable?

There is no cure or prevention for type 1 diabetes. You are bound to take exogenous insulin for life. Besides, you have to be vigilant about your blood sugar levels and the number of carbs you are taking in your diet.

However, strong pieces of evidence are present that maintaining a healthy weight, doing exercise regularly, eating a healthy balanced diet, and keeping your blood cholesterol levels in check, etc, can not only prevent type 2 diabetes but also help in its remission once you get it. ^{[6, 7]}

Which Type of Diet Should I Eat If I am a Type 1 or 2 Diabetic?

As discussed earlier, type 1 diabetics should be more concerned about the number of carbohydrates they are eating because carbs cause blood sugar levels to rise quickly. They will then need more units of insulin to counteract it.

Type 2 diabetics, on the other hand, are recommended to eat a healthy and low-calorie diet rather than focusing on how many carbs they are taking. A low-calorie meal plan will help in reducing weight and increases insulin sensitivity of the body cells.

Summary of the Differences between Type 1 and Type 2 Diabetes

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References

1. Ramachandran A. Know the signs and symptoms of diabetes. The Indian journal of medical research. 2014 Nov;140(5):579.
2. Fletcher B, Gulanick M, Lamendola C. Risk factors for type 2 diabetes mellitus. Journal of Cardiovascular Nursing. 2002 Jan 1;16(2):17-23.
3. Noble JA, Valdes AM. Genetics of the HLA region in the prediction of type 1 diabetes. Current diabetes reports. 2011 Dec;11(6):533-42.
4. Redondo MJ, Jeffrey J, Fain PR, Eisenbarth GS, Orban T. Concordance for islet autoimmunity among monozygotic twins. New England Journal of Medicine. 2008 Dec 25;359(26):2849-50.
5. Medici F, Hawa M, Ianari A, Pyke DA, Leslie RD. Concordance rate for type II diabetes mellitus in monozygotic twins: actuarial analysis. Diabetologia. 1999 Jan;42(2):146-50.
6. Crandall JP, Knowler WC, Kahn SE, Marrero D, Florez JC, Bray GA, Haffner SM, Hoskin M, Nathan DM. The prevention of type 2 diabetes. Nature clinical practice Endocrinology & metabolism. 2008 Jul;4(7):382-93.
7. Marín-Peñalver JJ, Martín-Timón I, Sevillano-Collantes C, del Cañizo-Gómez FJ. Update on the treatment of type 2 diabetes mellitus. World journal of diabetes. 2016 Sep 15;7(17):354.

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