Describe the difference between type 1 and type 2 diabetes

What Causes Diabetes?

Diabetes is a disease in which the body cannot properly store and use fuel for energy. The fuel the body needs is called glucose. Glucose comes from foods such as breads, cereals, pasta, rice, potatoes, fruits, and some vegetables. To use glucose, the body needs insulin. Insulin is made by a glandular organ called the pancreas.

When the body doesn't produce or process enough insulin, it causes an excess of blood glucose (sugar). When the body's level of glucose is too high, that becomes the chronic condition known as diabetes.

Diabetes arises when the body:

1. Suddenly makes little or no insulin. This is called type 1 diabetes, which usually develops in children and teens; however, type 1 can develop at any time in a person's life.
2. Gradually becomes resistant to the insulin it makes. This is called type 2 diabetes, and it is the most common form of diabetes, mainly affecting overweight adults over the age of 40 who have a family history of type 2 diabetes.

Type 1 (a.k.a., juvenile-onset or insulin-dependent) diabetes develops due to a virus or autoimmune disorder in which the body does not recognize an organ as its own and attacks that organ. To be exact, the body's immune system destroys certain cells in the pancreas. These cells are called beta cells, and they make insulin, a hormone that prompts cells to absorb glucose. Because of this disorder, the body stops making insulin.

The most common diabetes, type 2, is known as adult-onset or non-insulin dependent diabetes. It is typically closely related to genetics, obesity, and physical inactivity. In type 2 diabetes, insulin production is too low or the cells have become resistant to the hormone, essentially ignoring it. This means that insulin levels can be low, high, or normal, and may even fluctuate if a diabetic is not careful with treatment.

Comparison chart of type 1 and type 2 diabetes

Who Uses Insulin?

Because people with type 1 diabetes can’t produce enough or any insulin, they are required to take insulin every day. This is why type 1 diabetes is known as insulin-dependent diabetes.

People with type 2 diabetes may or may not have to take insulin, as the pancreas may still be capable of some insulin production that can be regulated through lifestyle changes (i.e., diet and exercise). As such, type 2 diabetes is known as non-insulin dependent diabetes. While some type 2 diabetics manage to avoid needing insulin for decades or even their whole lifetime, type 2 diabetes is a progressive disease, meaning it worsens over time in most individuals. Because of this, type 2 diabetics may require insulin and other medications later in life or if they do not carefully manage their diets and exercise.

What Insulin Does

The pancreas produces and secretes insulin, a hormone that helps the body turn food into energy. Insulin also helps store nutrients as excess energy that the body can make use of at a later time. When a person eats, insulin releases blood glucose to the body's cells, where it becomes an energy source for making proteins, sugars, and fat. Between meals, insulin regulates the body's use of these stored proteins, sugars, and fats. The brain receives insulin signals to reduce or shut down appetite. Insulin also alerts the hypothalamus to prevent the liver from overproducing glucose. Insulin resistance causes an over-release of fatty acids, a negative condition frequently seen in obesity-related diabetes.

With low levels of insulin, the blood glucose (sugar) level rises or declines beyond normal range; fluctuating levels are especially common in type 2 diabetes. Without insulin, the body cannot metabolize sugars. Instead of being broken down in cells, the sugar stays in the blood and causes two major problems: it starves cells for energy, possibly damaging them permanently, and can create long-term damage to the eyes (e.g., glaucoma), kidneys, nerve cells, and heart. Untreated high blood glucose levels can eventually cause death.

Rick Factors: Who is Affected?

Only about 5% to 10% of diagnosed diabetes cases are type 1. The disease is usually diagnosed in children and young adults, although it can technically strike at any age. Scientists do not know yet exactly what causes type 1 diabetes but suspect the disease involves a combination of genetic, environmental, and autoimmune factors.

An overweight person who does not exercise, is over 30, and/or has close relatives who have type 2 diabetes, runs a very high risk of developing type 2 diabetes. Higher-risk ethnic groups include African Americans, Latinos and Hispanics, Native Americans, Alaskan Natives, Asians, and those with Pacific Islander American heritage.

People are more likely to get diabetes if they smoke, have high blood pressure or cholesterol, or, in women, if they had gestational diabetes or gave birth to a baby who weighed more than 9 pounds. A free diabetes risk test is provided by Diabetes.org and only takes a few minutes to complete.

Symptoms of Type 1 vs. Type 2 Diabetes

Symptoms of Type 1 diabetes include increased thirst and urination, constant hunger, weight loss, blurred vision and extreme tiredness.

Type 2 symptoms appear gradually and are more subtle than those seen with type 1. This makes catching the onset of type 2 diabetes harder to recognize for early treatment. Symptoms include unexpected weight loss, blurred vision, feeling tired or sick more frequently, more frequent urination (especially at night). Higher levels of thirst, frequent infections and slower healing of cuts and scrapes.

Treatment

• Type 1 diabetics are required to take regular insulin injections to move sugar from the bloodstream.
• Type 2 diabetics can use diet, weight management, expercise, and—in many cases—medication as the treatment. Occasionally, especially later in life, a person with type 2 may be placed on insulin to better control blood sugar.

There is some scientific evidence that Type 2 diabetes can be reversed with a strict dietary regimen. Specifically, this "Newcastle diet" recommends reducing calorific intake to 800 calories for 8 weeks. Researchers who studied this diet found that Type 2 diabetes is caused by fat clogging up the pancreas, preventing it from producing sufficient insulin to control blood sugar level. When the body is starved, it uses up this fat in the pancreas. The daily 800-calorie diet comprises either three 200g liquid food supplements of soups and shakes, and 200g of non-starchy vegetables or the tastier 800g equivalent of calorie-shy meals you measure out yourself, plus 2-3 liters of water. After the 8 weeks of "starvation", calorific intake can be increased but only to a maximum of two-thirds of the pre-diagnosis level. Ongoing exercise and diet are needed to keep blood glucose levels healthy.[4]

Similarities

People with type 1 and 2 diabetes experience many of the same symptoms. They also both need to keep close tabs on the amount of sugar in their blood. It’s also very important for people with type 1 and 2 to keep in close contact with a diabetes specialist (endocrinologist). These specialists work with other professionals (diabetes nurse educators, dietitian educators, etc.) to give patients the best care possible. People with diabetes should see their treatment team at least once every three months.

Statistics

A study published in May 2014 found that from 2001 to 2009, prevalence of type 1 diabetes increased 21%, and type 2 diabetes increased 30% among children and adolescents in the U.S. [5][6]

One month later, in June 2014, the CDC released the latest statistics on diabetes and pre-diabetes. The highlights are provided below, but for further information see this infographic (all numbers pertain to the United States):

• 29 million people have diabetes, 8 million (1 in 4) of whom are undiagnosed
• 86 million people — more than a third of the population — have blood sugar levels high enough to indicate pre-diabetes. 90% of these people don't know they have pre-diabetes.
• Without weight loss and physical activity, 15 to 30% of those with pre-diabetes will develop diabetes within 5 years.
• The risk of death for people with diabetes is twice that of people without diabetes. They are also at increased risk for serious health problems like blindness, kidney failure, heart disease, and loss of toes, feet, or legs.
• More than 18,000 youths are diagnosed with type 1 diabetes every year.
• Over 5,000 youths are diagnosed with type 2 diabetes every year.
• 5% of all diagnosed cases of diabetes in adults every year are for type 1 diabetes.
• Being overweight and leading a sedentary lifestyle are the biggest risk factors for diabetes. Adults who lose weight and engage in even moderate physical activity can significantly increase their chances of preventing or delaying the onset of diabetes.

References

• Diabetes Information NIH.gov
• Wikipedia: Diabetes mellitus#Classification
• Diabetes risk test - Diabetes.org
• National Diabetes Statistics Report, 2017 (pdf) - CDC.gov
• Type 2 Diabetes is Preventable - NIH.gov