Diabetes is a chronic disease that occurs when the body either cannot produce insulin or cannot properly use the insulin it produces. There are two main types of diabetes: type 1 and type 2. The causes and management of these two types of diabetes are very different.
What is type 1 diabetes?
Type 1 diabetes, formerly referred to as juvenile diabetes, is a disease in which an individual’s insulin-producing beta cells of the pancreas get destroyed, causing an absolute lack of insulin.
What is type 2 diabetes?
Type 2 diabetes, formerly referred to as adult onset diabetes mellitus, is a disease that increases in frequency with advancing age. Individuals can still produce insulin (unlike in type 1 diabetes), but do not produce enough insulin to meet their body’s needs.
What are the differences between causes of type 1 and 2 diabetes?
Type 1 causes:
Type 1 diabetes is an autoimmune disorder. It happens when the body’s immune system destroys the beta cells in the pancreas. As a result, the pancreas can no longer produce insulin. The exact cause of type 1 diabetes is unknown, but some possible causes include genetics, exposure to viruses and other environmental factors.
Type 2 causes:
Type 2 diabetes is not an autoimmune disorder. There are two reasons why type 2 diabetes occurs: 1) the body still makes insulin, but can’t use it properly (this is called insulin resistance); and 2) insulin production in the pancreas decreases (this is called insulin deficiency).
Risk factors that increase your risk of developing type 2 diabetes include:
- Genetics and/or having a family history of the diabetes
- Age over 45 years
- Being overweight or obese
- High blood pressure
- High LDL (“bad”) cholesterol
- Low HDL (“good”) cholesterol
- Being physically inactive
- Having polycystic ovarian syndrome, also known as PCOS
As you can see, some of these causes are things we cannot control (such as our genes), while many factors we can control (diet and exercise). Therefore, there are many ways we can reduce our risk of developing type 2 diabetes.
How many people have type 1 vs. type 2 diabetes?
In Canada, over 3,5 million people have diabetes. Of these, about 90% have type 2 diabetes.
What signs and symptoms are similar and different between type 1 and type 2 diabetes?
Generally, the symptoms of type 1 and type 2 diabetes are very similar. They include:
- Unusual thirst
- Extreme hunger
- Frequent urination (bed-wetting in children with type 1 diabetes)
- Weight change (gain or loss)
- Extreme fatigue or lack of energy
- Blurry vision
These symptoms arise due to untreated high blood sugar levels.
There are some symptoms that are associated only with type 2 diabetes, which are:
- Having frequent infections
- Numbness or tingling in the hands or feet
When is type 1 diabetes usually diagnosed?
Type 1 diabetes is usually diagnosed in childhood, adolescence or early adulthood. While it has been diagnosed in people who are over 40 years old, this is very rare.
Type 1 diabetes happens very quickly. The time between when the pancreas stops producing insulin and the start of dangerous symptoms is quite short (generally just a few weeks or a month).
When is type 2 diabetes usually diagnosed?
Type 2 diabetes is usually diagnosed in adulthood, usually in people over 40 years of age. However, due to the increasing numbers of overweight and obese people around the world, type 2 diabetes is now being diagnosed in adolescents and young adults.
Type 2 diabetes may not happen as suddenly as type 1 diabetes. In fact, a person may have type 2 diabetes and not notice any symptoms for many years.
How are type 1 and type 2 diabetes diagnosed?
Type 1 and type 2 diabetes are diagnosed similarly. Tests used to diagnose type 1 and type 2 diabetes include:
- Glycated hemoglobin (A1C) test: this blood test measures your average blood sugar level for the past 2-3 months. An A1C of 6.5% or higher on two separate tests would mean a diagnosis of diabetes.
If an A1C test is unavailable, or cannot be used, your doctor may use these tests:
- Random blood sugar test: a blood sample is taken at a random time, regardless of when you last ate. A blood sugar of 11.1 mmol/L or higher suggests diabetes, when occurring with any of the signs and symptoms discussed above.
- An oral glucose tolerance test: a blood sample is taken 2 hours after you consume an 8-ounce syrup containing 75 grams of sugar. A blood sugar of 11.1 mmol/L or higher suggests diabetes, when occurring with any of the signs and symptoms discussed above.
- Fasting blood sugar test: a blood sample is taken after a 12-hour fast. A fasting blood sugar level of 7mmol/L or higher on two separate tests would be a diagnosis of diabetes.
How does treatment differ between type 1 and type 2 diabetes?
Treatments for type 1 diabetes:
People with type 1 diabetes must inject insulin using an insulin pen, syringe or insulin pump. When taken in conjunction with a healthy diet, an exercise program and regular blood glucose monitoring, people with type 1 diabetes can reach their diabetes management goals and live well.
Insulin that is injected into the body is a replacement or supplement to your body’s natural insulin, and is used to treat both type 1 and type 2 diabetes.
Treatments for type 2 diabetes:
Treatment of type 2 diabetes begins with healthy behaviour which includes healthy diet and exercise. Depending on blood sugar levels, oral medication may be added; however, in some instances people may also start on insulin. Over time, the person with type 2 diabetes may use more than one oral medication and may also start taking insulin or other injectable medications.
Do people with type 1 and type 2 diabetes experience the same complications?
Complications of type 1 and 2 diabetes are related to severe and/or prolonged elevated blood sugar, or abnormally low blood sugar (also known as hypoglycemia).
Complications due to high blood sugar can be grouped into two categories:
- Macrovascular complications: involving large vessels, affecting the heart and blood vessels in the brain.
- Microvascular complications: involving small vessels, affecting the kidneys, eyes, and nerves.
Can either type of diabetes be prevented or cured?
There is no known way to prevent type 1 diabetes, as the cause of diabetes is unknown. While it is not always possible to prevent type 2 diabetes, making healthy living choices such as eating a healthy diet, getting regular exercise, and losing weight if you are overweight may help prevent or delay the development of type 2 diabetes.