Differences and Similarities of Type 1 and Type 2 Diabetes

It can be confusing to try to understand the differences and similarities between Type 1 Diabetes and Type 2 Diabetes so we decided to put together a simple guide. Since Diabetes affects people of all ages, races and gender, we wanted to compare and contrast it.

Whether it's from a commercial advertisement for medication or knowledge of a loved one that developed it, Type 2 Diabetes awareness appears to be more prevalent. This may be due to the fact that 90-95% of all diabetics diagnosed are Type 2.

Type 2 Diabetes

Type 2 Diabetes is when your blood sugar (also known as blood glucose) is too high. As explained on other posts, glucose comes from food we consume and is also made in muscles and your liver. Glucose travels through your blood to specific cells in your body for use as energy to power cellular mechanisms.

The pancreas is an organ which lays behind your stomach and helps with digestion by releasing the hormone insulin into your blood to help use up. If there is not enough insulin or it does not work the way it should, glucose stays in the blood and never reaches the cells. As a direct consequence of this, pre-diabetes and subsequent Type 2 diabetes can occur.

Pre-diabetes is sometimes viewed as a warning-phase when the body's level is above normal but not quite high enough to be considered diabetes (see our previous post about Insulin Resistance & Pre-Diabetes).

In Type 2 Diabetics, pancreatic cells which produce insulin (islets of Langerhans) are still functioning but the body does not produce enough insulin or has become resistant (or both).

Differences Between Type 1 and Type 2 Diabetes

The Differences Between Type 1 and Type 2 Diabetes
Sources: WebMD & American Diabetes Association

Type 1 Diabetes

Previously referred to as "Juvenile Diabetes", Type 1 Diabetes often, but not always, develops in young people. It is characterized differently than Type 2 Diabetes because in this case, your body no longer makes enough or any insulin due to the body's immune system. 

The immune system typically protects from infection, kills bacteria, viruses and other harmful substances. In Type 1 Diabetics, through a mechanism which is unknown, the immune system attacks and destroys the cells islet cells which make insulin in the pancreas. It is thought that genetics and certain environmental factors (such as viruses) may trigger the disease.

Since a significant number of islet cells are destroyed, the result is you produce little or no insulin. For Type 1 Diabetics, there is no insulin or not enough present to let glucose into the cells so it builds up in the bloodstream, causing similar complications to Type 2 diabetes, which can be life-threatening.

Both Type 1 and Type 2 Diabetics must worry about Hyperglycemia (when blood sugar levels are too high), but Type 1 Diabetics can also experience Hypoglycemia (when blood sugar levels are too low). Many people experience hypoglycemia as a side-effect of treatment with blood-sugar-lowering medication. There are a variety of symptoms and causes for both hyperglycemia and hypoglycemia, you should take note of these and call your healthcare provider if you have any concerns as they can be very detrimental to your well-being if left untreated.

Similarities Between Type 1 Diabetes and Type 2 Diabetes

The similarities between Type 1 and Type 2 Diabetes are vast, despite the way they differ in their mechanisms. People who suffer from Type 1 and Type 2 Diabetes experience many of the same symptoms and need to keep close tabs on the amount of sugar in their blood. Elevated blood sugar levels (hyperglycemia) are a common in both types of diabetes.

Almost all of the same complications can affect both Type 1 and Type 2 Diabetics. These can include, but are not limited to, circulatory problems, cholesterol, hypertension, stroke, and heart attack. Diabetes is also the leading cause of blindness and kidney failure.

Although Type 1 Diabetics use injections to replenish their body's supply of insulin, Type 2 Diabetics do not usually begin their treatments with injections but rather with medications. However, over time, even Type 2 Diabetics may have to use injections as their cells fade in their ability to produce enough insulin. It is important to stay in contact with a diabetes specialist (endocrinologist) and your management team often.

Managed diet and exercise are helpful for all kinds of diabetes, taking significant healthy steps can reverse or slow pre-diabetes development.


Sources & Further Reading:
National Institute of Diabetes and Digestive and Kidney Diseases - Your Guide to Diabetes: Type 1 and Type 2
WebMD - Diabetes Health Center - Diabetes: Differences Between Type 1 and 2
MayoClinic - Type 1 Diabetes
American Diabetes Association - Diabetes Basics
American Diabetes Association - Statistics About Diabetes
World Health Organization - 10 facts about diabetes
Joslin Diabetes Center - Ten Things You Might Not Know About Diabetes

What is Pre-Diabetes and Do I Have It?

The increasingly prevalent research of the harmful effects of excess sugar in our diets have led us to realize that not only does it cause seemingly benign problems such as hyperactivity and tooth decay, it is a prime cause of obesity, heart disease, prediabetes and type 2 diabetes.

How Do You Know?

I have been living a sugar-free lifestyle for 1.5 years since September 2014 when my physician told me that my A1C level (fasting glucose blood test) was so high that he considered me pre-diabetic. I was young, 28 years old at the time of diagnosis and certainly not obese and I'm sure some would argue I wasn't even overweight. I will say that my body mass index could definitely have been better and I was not what I would consider to be in shape. I felt fantastic aside from the obvious highs and lows in energy that I felt, attributing it often to just being tired or hungry.

I was wrong, I changed. I am one of the most stubborn people I know, and maybe that helps, but I was not willingly going to get the Type 2 Diabetes that my doctor informed me I would almost certainly have within the next 5 years. I have a family history of diabetes ranging from my grandfather (Type 2) to my maternal cousin (Type 1). This was an imminent existential crisis, my wake-up call.

Honestly, I love sugar but I love and cherish my wellness even more. I didn't realize I even had an addiction, as I'm sure most of us don't, until I cut it out. Don't imagine for one second that I'm a fool who brazenly indulged in buckets of candy or anything of the sort. I ate like a normal American.

The Truth About Pre-Diabetes

The Centers of Disease Control have discovered that most people with pre-diabetes are not yet diagnosed. Recent statistics suggest up to 90% of adults of the 86 million in America (yes, that's more than 1 in 3 adults) are unaware of their condition.

If you are diagnosed with pre-diabetes, this means your blood sugar levels are higher than normal but not quite as high as a diabetic. This means your body is in a phase of developing insulin resistance (see previous post about Sugar & Insulin Resistance). Approximately 90% of those diagnosed with diabetes in the United States are Type 2 diabetics. In Type 2 diabetics, this means their body does not make enough insulin and becomes insulin-resistant.

It’s real. It’s frighteningly common. And most importantly, it’s reversible. You can stop prediabetes from developing into type 2 diabetes. It takes some simple and proven steps to adjust and adapt your lifestyle.

I am not ready to give up. I am not ready to perpetuate an unhealthy lifestyle just because it's easy. And I don't want you to accept that either. We're on this journey together.

Get Tested

Earlier, I mentioned that my doctor decided to run a panel of tests on me, including the A1C test. This was part of my annual check-up. I realize that I am lucky to have a caring and disease-prevention oriented physician and I couldn't be more thankful. This isn't the case for everyone, so I urge you to request the test from your doctor.

The A1C test is a blood test, which does not require fasting, that provides information about a person's average levels of blood glucose (also known as blood sugar) over the past 3 months. It is also commonly used for diabetes management and can be used to monitor the effectiveness of dietary and lifestyle changes. It is the primary way to gain insight into your risk for Pre-Diabetes and Type 2 Diabetes.

How Sugar Affects the Brain

How Does Sugar Affect the Brain? By Nicole Avena of TED-Ed

Want to know what happens in the brain that makes sugar-rich foods so hard to resist?

Does eating a little bit of sugar make you crave more? And can you become addicted?

Watch the beautifully animated video above by Neuroscientist Nicole Avena to learn the answer to these and many questions, including how we have confused evolutionary biology with our diets.

Sugar and Insulin Resistance

Sugar-Free Diets can offer many health benefits, but you may be wondering why you should take the leap into a sugar free lifestyle. "Natural" food labels do not necessarily indicate low carbohydrate and are not always representative of sugar free foods. Many sweeteners such as honey or agave are natural but can cause a significant increase in blood sugar. 

Why is blood sugar important? 

When our blood sugar is too high on a frequent basis (sometimes this elevated level can even last for years) it can lead to insulin resistance. This is a state in which the cells in our bodies fail to respond to heightened levels of the hormone insulin. In our modern day societies, the level of sugar and carbohydrate consumption has become a concern. This is alarming because Americans are now consuming roughly three times the recommended daily sugar consumption. It has become an increased public health concern, often perpetuated by the convenience of foods which have added sugars that we wouldn't even expect.

U.S. Sugar Intake Average (American Heart Association)

What does insulin do?

In a nutshell, insulin is made by the pancreas which has the primary function of helping the body store and use sugar (specifically in the form of glucose). Insulin is the pathway by which sugar is transported from the blood into the places it is required most, such as muscles and liver which use it as fuel. The regulation of insulin is a very specific and regulated process which is triggered by our dietary intake of sugar. The more sugar we eat, the more insulin is released. 

Pancreas produces the hormone Insulin in response to blood sugar levels

Carbohydrates & Diabetes

Constantly high levels of sugar (which are very commonplace in most of our diets) are a leading cause of insulin resistance and subsequently can cause further damage in the form of Type 2 Diabetes. It is often misunderstood that this is a disease of the elderly since it can affect people in all walks of life.

Diabetes indicates hyperglycemia or elevated blood sugar because ones body does not use insulin properly anymore (insulin resistance) or the body cannot product insulin (in Type 1). Type 2 diabetes is caused by the pancreas eventually not being able to produce enough insulin to keep blood sugar levels stable (see the American Diabetes Association definition). 

How can Sugar-Free foods help?

Sugar-Free foods do not contain glucose and usually contain sugar substitutes or artificial sweeteners (note: these are not identical, stay tuned for a post dedicated to explaining the difference between the two). Some sugar substitutes do not add calories or carbohydrates. In general, most sugar substitutes are much lower on the Glycemic Index, meaning that they have a lesser effect on blood sugar than glucose. Carbohydrates have the greatest effect on blood glucose. This means that if you are observing a sugar-free lifestyle, you may also want to consider lowering your carbohydrate intake for maximum benefits.

If you are concerned about heightened blood sugar or A1C levels, you can take proactive steps by significantly reducing the sugar dependency (do you get cranky headaches? feel tired often? these are pretty good signs of Sugar Addiction).

For pre-diabetics and diabetics, it is crucial to speak with your primary healthcare provider about the different types of foods you should be eating and snacking on. Likely this will include a carbohydrate and sugar counting meal plan to manage blood glucose.