Glucose is a type of sugar. It comes from food and also is created in the liver. Glucose travels through the body in the blood. It moves from the blood to cells with the help of a hormone called insulin. Once glucose is in those cells, it can be used for energy. Diabetes mellitus is a condition that causes a buildup of glucose in the blood and makes it difficult for the body’s cells to get enough energy. There are two primary kinds of diabetes mellitus, type 1 and type 2.
In short, both types result in high levels of blood glucose. Type 1 is an autoimmune disease, caused by genetic and environmental factors, that results in too little insulin being produced by the body. Type 2 is influenced by lifestyle choices and results in the body not being able to use its insulin efficiently. According the Centers for Disease Control (CDC), “Type 2 diabetes accounts for about 90% to 95% of all diagnosed cases of diabetes, and type 1 diabetes accounts for about 5%.”
Overview of Type 1 and Type 2 Diabetes
Type 1—An autoimmune disease occurs when there is an abnormal immune response to a normal part of the body. Type 1 diabetes is an autoimmune disorder caused by destruction of the cells that secrete insulin from the pancreas. This results in too little insulin being produced to support the body’s needs. Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes.
Without insulin, glucose from the carbohydrate foods you eat cannot enter cells. This causes glucose to build up in the blood, leaving your body’s cells and tissues starved for energy. While a variety of tissue transplantation and genetically-based treatments are being studied, at this point the only widely-available treatments for type 1 diabetes are the injection of insulin and inhaled insulin.
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- Stomach converts food to glucose
- Glucose enters the bloodstream
- Pancreas produces little or no insulin
- Glucose unable to enter body effectively
- Glucose increases
Type 2—Type 2 is the most common form of diabetes and can be caused by a combination of factors. One factor is that your body begins to make less insulin. A second is that your body becomes resistant to insulin. This means there is insulin in your body, but your body cannot use it effectively. Insulin resistance is often related to excess body fat. Medication, lifestyle changes, and monitoring can help control blood glucose levels in those with type 2 diabetes.
Symptoms
Type 1—Symptoms of type 1 diabetes are caused by the buildup of glucose in the blood and the lack of glucose in body cells, known as hyperglycemia. Symptoms include:
- Unexplained weight loss
- Increased urination
- Extreme thirst
- Hunger
- Fatigue, weakness
- Blurry vision
- Irritability
- Headaches
- Nausea, diarrhea, or constipation
- Chest pain
- Confusion
- Coma
Type 2—You may have type 2 diabetes for years before you have symptoms:
- Increased urination
- Extreme thirst
- Hunger
- Fatigue
- Blurry vision
- Irritability
- Frequent or recurring infections
- Poor wound healing
- Numbness or tingling in the hands or feet
- Problems with gums
- Itching
- Problems having an erection
Risk Factors
Type 1—Risk factors for developing type 1 diabetes include:
- Family History of type 1 diabetes
- Other autoimmune conditions such as Hashimoto disease, Graves’s disease, lupus, and rheumatoid arthritis.
- Certain ethnic groups such as Northern European, Mediterranean, African American, Hispanic, or Native American
- Other risk factors that may influence getting type 1 diabetes are:
- Cystic fibrosis
- Bottle feeding or a short duration of breast feeding
- High birth weight
- Childhood obesity
- If a mother’s age at child birth was over 35 years
Type 2—Risk factors for developing type 2 diabetes include:
- Being over the age of 45
- Prediabetes—impaired glucose tolerance and impaired fasting glucose
- Metabolic syndrome—a condition marked by elevated cholesterol, blood glucose, blood pressure, and central obesity
- Excess weight or obesity
- Lack of exercise
- Poor diet—high intake of processed meats, fats, and sugar-sweetened foods and beverages
- Family history of type 2 diabetes
- High blood pressure
- History of cardiovascular disease
- Depression
- History of gestational diabetes, or having a baby that weighs over 9 pounds at birth
- Endocrine disorders, such as Cushing’s syndrome, hyperthyroidism, acromegaly, polycystic ovary syndrome, or acute pancreatitis
- Certain medications, such as glucocorticoids or thiazides
- Certain ethnic groups, such as African American, Hispanic, Native American, Hispanic American, Asian American, or Pacific Islander
Treatment
Type 1—Type 1 diabetes is a chronic disease that has no cure, but it can be managed with proper treatment and care. The goal of diabetes treatment is to maintain blood glucose levels before and after meals within a healthy range. By doing so, you will feel better on a daily basis and will help prevent or delay complications of diabetes. Talk to your doctor about what a healthy blood glucose range is for you.
The main components of treatment are:
- Insulin
- Blood glucose monitoring
- Diet
- Exercise
- Glucagon for emergency management of hypoglycemia
Type 2—Treatment aims to maintain blood sugar at levels close to normal, prevent or delay complications, and control other conditions that you may have, like high blood pressure and high cholesterol. Treatments include:
- Diet—Food and drinks have a direct effect on your blood glucose level. Eating healthy meals can control your blood glucose. It will also help your overall health. Some basic tips include:
- Follow a balanced meal plan that includes carbohydrates, proteins, and fats.
- Eat normal serving sizes. Measure your food control portion sizes, if necessary.
- Do not skip meals. Having meals throughout the day can maintain steady glucose levels.
- Eat plenty of vegetables and fiber.
- Limit the amount of fat, especially saturated and trans fats, in your foods.
- Eat moderate amounts of protein and low-fat dairy products.
- Carefully limit foods containing high concentrated sugar.
- Keep a record of your food intake and create a meal plan with your dietician or doctor.
- Weight Loss—If you are overweight, weight loss will help your body use insulin better. Talk to your doctor about a healthy weight goal. These options may help you lose weight:
- Use a portion control plate
- Use a prepared meal plan
- Eat a Mediterranean-style diet
- Exercise— Physical activity can:
- Make the body more sensitive to insulin
- Help you reach and maintain a healthy weight
- Lower the levels of fat in your blood
- Aerobic exercise increases your heart rate and resistance training build muscle strength. Both types of exercise help to improve long-term glucose control
- Medication—Certain medications will help to manage blood glucose levels. Talk to your doctor about special medication to help control your diabetes.
- Insulin— Insulin usually is given through injections and may be needed if:
- The body does not make enough of its own insulin
- Blood glucose levels cannot be controlled with lifestyle changes and medications
- Blood Glucose Testing—You can check the level of glucose in your blood with a blood glucose meter. Checking your blood glucose levels during the day can help you stay on track. It will also help your doctor determine if your treatment is working. Keeping track of blood sugar levels is especially important if you take insulin.
More information can be found on the American Diabetes Association website- www.diabetes.org. For individual diagnosis and treatment recommendations for type 1 and type 2 diabetes, please consult your physician. Joyce Vivian, MSN, NP, is available to screening, treatment options, and lifestyle tips. To schedule an appointment, call the office at (540) 772-3490 or schedule an appointment online.
Book An Appointment Online with Joyce Vivian, MSN, NP
Sources:
Centers for Disease Control (CDC): www.cdc.gov
CDC - Diabetes (PDF)
American Diabetes Association: diabetes.org
Medically reviewed by Michelle L. Griffith, MD — Written by Hannah Nichols on July 8, 2021
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Type 1 and type 2 diabetes both occur when the body cannot properly store and use glucose, which is essential for energy. This glucose then collects in the blood and does not reach the cells that need it, leading to serious complications.
Type 1 diabetes usually appears first in children and adolescents, but it can also occur in adults. In type 1 diabetes the immune system attacks pancreatic beta cells so that they can no longer produce insulin.
There is no way to prevent type 1 diabetes and it is often hereditary. Around 5-10% of people with diabetes have type 1.
Type 2 diabetes is more likely to appear as people age, but children may still develop it. In this type, the pancreas produces insulin, but the body cannot use it effectively. Lifestyle factors appear to play a role in its development. The majority of people with diabetes have type 2 diabetes.
Both types of diabetes can lead to complications such as cardiovascular disease, kidney disease, vision loss, neurological conditions, and damage to blood vessels and organs.
The CDC estimates that more than 34 million people in the United States may have diabetes, and almost 25% of them may not know they have it.
This article will look at the similarities and differences between type 1 and type 2 diabetes.
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A person with diabetes may experience adverse symptoms due to poorly-regulated blood sugar.
Other aspects of metabolic syndrome also occur alongside type 2 diabetes, including obesity, high blood pressure, and cardiovascular disease.
The chart below outlines the symptoms of type 1 and type 2 diabetes.
Hyperglycemia
If a person’s blood sugar is too high, they may experience the signs and symptoms of hyperglycemia, including frequent urination and increased thirst.
This can lead to ketoacidosis, a potentially life-threatening condition that needs urgent medical attention.
Symptoms of ketoacidosis include:
- difficulty breathing
- a fruity smell on the breath
- nausea and vomiting
- a dry mouth
- coma
Learn more about hyperglycemia here.
Hypoglycemia
Hypoglycemia is when blood sugar levels are too low. Symptoms typically appear when blood sugar levels fall below 70 milligrams per deciliter (mg/dL).
Early symptoms include:
- sweating, chills, and a pale face
- feeling shaky, nervous, and anxious
- rapid heartbeat
- feeling dizzy and lightheaded
- nausea
- feeling weak and tired
- headaches
- tingling
A person should consume a high-glucose food or drink to relieve the symptoms and prevent the problem from getting worse. Ideally, a person should follow this with protein-rich food.
Without treatment, the person may experience:
- seizures
- loss of consciousness
- coma
This condition can be life-threatening and needs immediate medical attention.
A person with diabetes should carry a medical ID so that others will know what to do if a problem occurs.
Find out more about hypoglycemia here.
The onset of type 1 diabetes tends to be sudden. If a person has symptoms, the person should see a doctor as soon as possible.
By contrast, a person in the early stages of type 2 diabetes may show no symptoms. However, a routine blood test at this stage will show elevated blood sugar levels.
People with obesity and other risk factors for type 2 diabetes should have regular checks to ensure their glucose levels are healthy. If tests show they are high, they may have diabetes or prediabetes.
Learn more about prediabetes here.
Prediabetes is where a person has elevated blood glucose levels but does not yet meet the levels necessary for a type 2 diabetes diagnosis.
The following tests can help diagnose type 1 or type 2 diabetes, but they may not all be useful for both types:
- A1C test: For an A1C test, a doctor will take a blood sample that gives the doctor an indication of a person’s average blood glucose level over the past 2-3 months.
- Fasting plasma glucose (FPG) test: This measures a person’s blood glucose levels after a period of fasting. Patients must not eat for at least 8 hours before the test, and as a result, many take the test before breakfast.
- Oral glucose tolerance test (OGTT): This test measures how a person processes glucose. A patient will take a blood glucose test 2 hours before and 2 hours after drinking a sugary drink.
- Random plasma glucose (RPG) test: A doctor will use an RPG test to measure a person’s blood glucose level at any point in a day. A patient does not have to fast before taking this test.
Depending on the results, the doctor may diagnose diabetes or prediabetes.
The following table shows which results indicate diabetes:
The ADA recommends regular screening for type 2 diabetes in people aged 45 years and above. Younger people who may be more at risk of diabetes, such as those with a family history of the condition, should also regularly screen for type 2 diabetes.
People can check their own blood glucose levels at home. A person without known diabetes who has concerns about values taken with a home meter should visit their doctor for evaluation.
Testing kits are available for purchase online.
Both type 1 and type 2 diabetes can lead to long-term complications if a person does not adequately manage them. These complications can include:
Type 1 and type 2 have different causes, but they both involve insulin.
Insulin is a type of hormone. The pancreas produces it to regulate the way blood sugar becomes energy.
Type 1 diabetes
In this type, scientists believe that the immune system mistakenly attacks the pancreatic beta cells, which produce insulin. They do not know what causes this to happen, but childhood infections may play a role.
The immune system destroys these cells, which means that the body can no longer make enough insulin to regulate blood glucose levels. A person with type 1 diabetes will need to use supplemental insulin from when they receive the diagnosis through the rest of their life.
Type 1 often is first diagnosed when people are children and young adults, but it can happen later in life. It can start suddenly, and it tends to worsen quickly.
Type 2 diabetes
In type 2 diabetes, the body’s cells start to resist the effects of insulin. This means glucose cannot enter the cells. Instead, it builds up in the blood and higher levels of insulin are required to allow it to enter the cells. This is called insulin resistance.
In time, the body stops producing enough insulin, so it can no longer use glucose effectively.
Symptoms may take years to appear. People may use medications, diet, and exercise from the early stages to mitigate the progression of the disease.
In the early stages, a person with type 2 diabetes does not need supplemental insulin. As the disease progresses, however, they may need it to manage their blood glucose levels.
Genetic and environmental factors may trigger both type 1 and type 2 diabetes. However, many people may be able to avoid type 2 by making healthy lifestyle choices.
Risk factors for type 1 diabetes include:
- having a family history of diabetes
- being born with certain genetic features that affect the way the body produces or uses insulin
- possibly, exposure to some infections or viruses, such as mumps or rubella cytomegalovirus
Some medical conditions, such as cystic fibrosis or hemochromatosis, reduce the person’s insulin production and cause a type of diabetes very similar to type 1 diabetes.
Risk factors for type 2 diabetes include:
- having a family member with type 2 diabetes
- having obesity
- smoking
- following an unhealthy diet
- a lack of exercise
- the use of some medications, including some medications for HIV and chronic steroids
People from certain ethnic groups are more likely to develop type 2 diabetes. These include Black and Hispanic people, Native Americans and Native Alaskans, Pacific Islanders, and some people of Asian origin.
Vitamin D
Low levels of vitamin D may play a role in the development of both type 1 and type 2 diabetes.
A review published in 2017 suggests that when a person lacks vitamin D, certain processes in the body, such as immune function and insulin sensitivity, do not work as well as they should. According to the review’s authors, this may increase a person’s risk of diabetes.
The primary source of vitamin D is exposure to sunlight. Food sources including oily fish and fortified dairy products are also high in vitamin D.
There is no cure for diabetes, but treatment can help people manage the condition and prevent it from worsening. Here are some points about treating and managing diabetes.
Gastric bypass surgery, lifestyle changes, and medication can result in remission of type 2 diabetes.
Find out more about non-insulin drugs for type 2 diabetes here.
Breastfeeding
Reviews suggest that breastfeeding or chestfeeding infants may help prevent them from developing type 2 diabetes later in life. Other studies suggest that a person who breastfeeds or chestfeeds an infant may benefit from a reduced risk of type 2 diabetes.
Diabetes is a serious condition.
It is not currently possible for a person to prevent type 1 diabetes, but insulin and other drugs can help manage symptoms.
While there may be a hereditary link for both types of diabetes, people can both reduce the risk and manage the progress of type 2 diabetes by following a healthy, active lifestyle.
Anyone with a diagnosis of prediabetes should also make healthy lifestyle choices, as this can reduce or eliminate the risk of type 2 diabetes developing.
Last medically reviewed on July 8, 2021
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