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Know the Difference Between Type 1 and Type 2 Diabetes

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Finding out that you or a loved one has diabetes can be overwhelming. There's a lot to learn about managing the condition. And there are many factors that can affect your treatment plan, starting with whether your diabetes is type 1 or type 2.

The two conditions need to be managed differently. That's why as an endocrinologist who treats diabetes, I think it's important that everyone understand the differences between the two types, even though they have many things in common.

What to know about diabetes

Both types of diabetes are chronic conditions. They each cause a person to have too much glucose (sugar) in their bloodstream. That glucose comes from eating carbohydrates, such as bread, pasta, or fruit. Your digestive system breaks down the carbs into glucose, which enters your bloodstream.

A hormone called insulin, produced by the pancreas, is what lets glucose move from your bloodstream to your cells, where it can be used as energy. When a person has diabetes, there is a problem with the way their body makes or uses insulin. Instead of entering cells to be used as energy, glucose builds up in the bloodstream, leading to high blood sugar. That can lead to long-term complications, including damage to the heart, kidneys, eyes, and nerves.

It can also cause symptoms such as:

  • Increased thirst or dry mouth
  • Frequent urination
  • Feeling weak or tired
  • Blurred vision
  • Numbness or tingling in the hands or feet
  • Slow-healing cuts or sores
  • Unexplained weight loss
  • Frequent infections, including urinary tract infections

The difference between type 1 and type 2 diabetes has to do with the type of insulin problem a person has. Let's take a look at what those problems are and how they can be managed.

What to know about type 1 diabetes

Type 1 diabetes happens when a person's immune system attacks insulin-producing cells in the pancreas. The result is that people can't produce insulin. Instead, glucose builds up in the bloodstream and leads to high blood sugar. My patients with type 1 diabetes need to take insulin every day to prevent glucose from building up in their bloodstream.

Anyone can develop type 1 diabetes, but you're more likely to get it if a parent or sibling has the condition. Type 1 diabetes symptoms usually develop over a matter of weeks in children, and may develop much slower in adults. This can make it difficult to tell if it is Type 1 or Type 2 without some specialized tests.

Living with type 1 diabetes

There's no readily available cure for Type 1 diabetes, but it can be managed. The goal of treatment is to keep a patient's blood sugar within the target range — typically between 80 and 130 milligrams per deciliter before a meal and less than 180 mg/dL two hours after the start of a meal.

Since people with type 1 diabetes don't produce insulin, they need to take it regularly throughout the day and check their blood sugar often. Common options for taking insulin include injecting with a needle and syringe or with a device called an insulin pen. Some patients use an insulin pump — a small, wearable device that delivers insulin throughout the day. Other patients might use an inhaler to deliver powdered insulin to their lungs, where it can be absorbed into the bloodstream. You and your healthcare team can decide on the right insulin regimen for you and the best times to test your blood sugar.

Healthy habits are also a must for managing your blood sugar. When you have type 1 diabetes, you need to closely track the carbohydrates in your food and drinks to determine how much insulin you need to take. You'll also need to coordinate the timing of your meals and medication to prevent your blood sugar from getting too high or too low.

Regular exercise is important too: It can help your body use insulin more efficiently. But since physical activity can lower your blood sugar, you'll need to track your levels before, during, and after exercise. Continuous glucose monitors have become readily available and make frequent monitoring of blood sugar much easier.

What to know about type 2 diabetes

Type 2 diabetes is much more common than type 1. A person develops type 2 diabetes when their cells become resistant to insulin and their pancreas does not make enough insulin for their needs. When cells become resistant, insulin is still produced by the pancreas, but the insulin can't bring glucose from the bloodstream into cells like it's supposed to. That causes glucose levels in the bloodstream to rise and result in high blood sugar.

Type 2 diabetes often develops in middle age or older age, but it can affect people at any age, including children and young adults. Anyone can develop the condition, but certain factors increase a person's risk. These include:

  • Having a parent or sibling with prediabetes or type 2 diabetes
  • Not being at a healthy weight
  • Being Black, Hispanic, Native American, Asian American or a Pacific Islander
  • Having high blood pressure
  • Having low HDL ("good") cholesterol and high triglycerides
  • Having a sedentary lifestyle
  • Being 45 or older
  • Having had gestational diabetes, a type of diabetes that occurs during pregnancy, or having given birth to a baby weighing more than 9 pounds
  • Having polycystic ovary syndrome (PCOS)
  • Having a history of heart disease or stroke
  • Smoking

Blood glucose tests are used to diagnose type 2 diabetes. Sometimes a doctor will order a test because a patient is experiencing symptoms. Many providers also screen for it as part of a routine health visit, especially in people at risk.

Living with type 2 diabetes

The goal when managing type 2 diabetes is to keep your blood sugar within your target range. Most people with type 2 diabetes do not need insulin. Some can manage it with lifestyle changes alone but most need medication. There are a number of different types of medication used to prevent high blood sugar — some are pills and others are given by injection. Some of these medications also help with weight loss.

A healthy diet is crucial. Choosing carbohydrates that also contain fiber (like whole grains, fruits, and vegetables) over more starchy or sugary foods (such as white bread, white pasta, white potatoes, or desserts) can help prevent your blood sugar from getting too high. So can eating balanced meals that offer a mix of carbs, protein, and healthy fats.

Exercise is also important. Physical activity helps your body use insulin more efficiently, which can make it easier to keep your blood sugar under control.

If patients are obese and diet and exercise aren't enough to manage their blood sugar, I'll sometimes talk to them about weight loss surgery. Procedures such as sleeve gastrectomy or gastric bypass can improve type 2 diabetes or even cure it in a high percentage of these patients. Some individuals even see their diabetes go into remission within days of surgery. The benefits tend to be the biggest when surgery is done sooner rather than later after a diabetes diagnosis.

Take control of your diabetes

Diabetes is a complex disease, but it's one that can be managed when you understand the care required for your specific type. Diabetes education programs like the Temple Health Diabetes Program can help you make lifestyle changes that work for you. Getting the right information can help you better manage your blood sugar — and protect your health.

To make an appointment with a diabetes expert at Temple Health, call 800-TEMPLE-MED (800-836-7536) or request an appointment online.

Helpful Resources

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Jonathan R. Anolik, MD, FACE, FACP

Dr. Anolik specializes in Endocrinology, Diabetes and Metabolism at Temple Health. He was been awarded Philadelphia magazine's Top Doctor award every year since 2013.

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