Diabetes is a chronic condition that is characterized by blood sugar instability. There are several different types of diabetes, but for the purpose of this article, we are going to discuss type one and type two.
It is important to understand the difference between these types of diabetes, as they are usually treated quite differently and also have different presentations.
Recognizing the differences and being accurately diagnosed is imperative for better management and optimizing the efficacy of the treatment plan.
What Is Diabetes?
As previously mentioned, diabetes is a chronic condition where the body has difficulty regulating blood sugar.
Insulin is a hormone in the body that is excreted with the purpose of moving glucose in the bloodstream to the cells to be used for energy.
For people with diabetes, this mechanism of action is not working correctly. Some glucose in the bloodstream is normal, but when the levels become elevated and the insulin is not working correctly to bring glucose levels back to normal, this is considered diabetes.
The two main types of diabetes are type one and type two diabetes.
Type 1 vs Type 2 Diabetes: Key Differences
The main difference in type 1 vs type 2 diabetes is the presentation of the insulin.
In type one diabetes, the person‘s body eventually quits making insulin altogether. In type two diabetes, often the person’s body continues to produce insulin, but it is not working effectively. This is usually caused by insulin resistance.
See table below for side-by-side comparison between cause, onset, symptoms, risk factors, and treatment:
Feature | Type 1 Diabetes | Type 2 Diabetes |
Cause | Autoimmune destruction of insulin-producing cells | Insulin resistance and gradual beta-cell failure |
Age of Onset | Usually childhood or young adulthood - but also increasing in older adult populations as well | Typically adulthood, but increasing in younger populations |
Insulin Production | Little to none | Still produces insulin, but the body becomes resistant |
Risk Factors | Genetic, environmental triggers | Lifestyle factors (obesity, diet, inactivity), genetics |
Treatment | Insulin therapy required | Lifestyle changes, oral medications, insulin if needed |
Causes and Risk Factors of Type 1 vs Type 2 Diabetes
The causes and risk factors also differ for type 1 vs type 2 diabetes. Type one diabetes is an autoimmune disorder, whereas type two diabetes is usually caused by insulin resistance.
Both type one and type two diabetes often have a genetic component to them, but where type two is strongly linked to lifestyle (in addition to genetic predisposition), type one is not.
Type 1 Diabetes Causes
Autoimmune response destroys pancreatic beta cells.
Genetic predisposition and potential environmental triggers (e.g., viruses).
Type 2 Diabetes Causes
Insulin resistance develops over time.
Strongly linked to obesity, poor diet, sedentary lifestyle, and genetics.
Symptoms of Type 1 vs Type 2 Diabetes
The symptoms of type 1 vs type 2 diabetes can be very similar, but may present differently.
Common symptoms of both type one and type two diabetes include – frequent urination,
extreme thirst, fatigue, and blurred vision.
One of the major differences is that in type one diabetes, symptoms usually appear suddenly, whereas in type two diabetes, the symptoms develop gradually and often go unnoticed for a long time.
Diagnosis and Testing for Type 1 vs Type 2 Diabetes
Both type one and type two are often diagnosed using the same diagnostic testing. But again, they usually present differently.
Oftentimes a person with type one diabetes does not know what’s going on, the symptoms appear suddenly, and frequently they end up in the hospital in diabetic ketoacidosis (DKA).
It is in the hospital that blood glucose is tested and if the person is in DKA, the glucose level will be quite elevated.
They then will order an A1C while they’re in a hospital, stabilize the DKA, and order a C-peptide, which is the diagnostic test that helps to differentiate between type one and type two.
For a person with type two diabetes, it often goes unnoticed for a while and is identified at a routine doctor's visit when a fasting glucose or a random glucose is done and or when periodic lab tests are done and an A1c is drawn and identified as elevated.
For both type one and type two diabetes, early diagnosis is extremely important as DKA can be deadly if not treated promptly. Type two diabetes, if unnoticed for too long will also often result in complications of unmanaged elevated blood sugar levels.
Some of these complications include cardiovascular disease, diabetic foot ulcers,
retinopathy, neuropathy, and kidney disease. Type one diabetics are also at risk for these complications if their glucose is unmanaged.
Treatment and Management Strategies for Both Types
The management and treatment strategies differ for these two diagnoses. Type one requires insulin upon diagnosis, whereas type two, especially if caught early, can be managed with lifestyle changes, if the person is willing and able.
Type 1 Diabetes Treatment
For type one diabetics, they must start on a basal and bolus insulin regimen and are strongly urged to wear a continuous glucose monitor.
Insulin pumps have started to be placed early on newly diagnosed as well, as studies show the efficacy of treatment for insulin pump users.
Type one diabetics also need to learn how to count carbohydrates, for dosing purposes, how to balance their meals correctly to be less impactful on glucose levels, how exercise can impact a blood sugar, as well as how to treat a low blood sugar, high blood sugar, how to prevent rebound high blood sugars, and prevent DKA.
Type 2 Diabetes Treatment
Type two diabetics are often encouraged to make lifestyle adjustments, start eating a healthy and well balanced diet, lose 5 to 10% of their weight (if applicable), and start a regular exercise routine.
Medications such as metformin or GLP-1s are often started and if the case is advanced at diagnosis, insulin may also be started right away. Usually if insulin is needed, they will be started on an insulin sliding scale.
Long-Term Complications of Type 1 vs Type 2 Diabetes
Both type one and type two diabetes, if left untreated, can lead to similar complications
As previously mentioned, these complications include heart disease, kidney disease, nerve damage, and eye disease.
In both type one and type two diabetes, it is of utmost importance that it is diagnosed early and a treatment plan put into place right away.
Managed blood sugar, and a frequently assessed and adjusted treatment plan is essential in decreasing the risk of long-term complications of diabetes.
Can You Prevent Type 1 or Type 2 Diabetes?
Type 1 Diabetes: unfortunately, currently there is no known prevention for type one diabetes, but early detection can help with management. There are risk screening studies to detect early stages of type 1 diabetes, years before symptoms appear.
Type 2 Diabetes: for type two diabetes, this condition is often preventable through diet, exercise, and weight control.
It is important for every person to know their risk, and if there is a genetic predisposition.
For type two, it’s important to know if you live a sedentary lifestyle and if your dietary choices may contribute to insulin resistance and a diagnosis of prediabetes or type two diabetes.
For all people, it is important to attempt to normalize your glucose naturally when possible by staying active and eating a well balanced diet of whole foods, and eliminating, or at least limiting processed foods and sugary treats and beverages.
Type 1 vs Type 2 Diabetes: Myths and Misconceptions
"Type 1 diabetes is caused by eating too much sugar" - this is false and has absolutely nothing to do with a diagnosis of type one. In fact, this is where a lot of the differing emotions come in for people who are diagnosed with diabetes. When people hear, and believe these things, they tend to have guilt, frustration, and a bunch of other negative emotions in response to this because of the myths and misconceptions.
"People with Type 2 diabetes always need insulin" - this is not necessarily true and in many cases, people diagnosed with type two diabetes never need to go on insulin. This is another important reason for early detection. If type two diabetes is detected early, oftentimes lifestyle adjustments is all that is needed to reverse the diagnosis.
"Only overweight people get Type 2 diabetes" - this is false and also another reason for the negative emotions many people feel. Genetics plays a major role, and there are many people who are very thin that end up with a diagnosis of type two diabetes as well.
“You must eliminate all carbs in order to manage your blood sugar“ - this has been a dialogue that has been going on for quite some time and is completely false and actually leading people to eliminate many elements of their diet that are actually extremely beneficial and nutritional.
Key Takeaways for Type 1 vs Type 2 Diabetes
There is a difference between type one and type two diabetes, but the symptoms can be very similar.
The onset is usually very abrupt for the diagnosis of type one diabetes, whereas a person can have type two diabetes for quite some time before it is detected and diagnosed.
Early detection is key for both type one and type two diabetes in order to drastically minimize the risk for long term complications.
As a nurse and certified diabetes educator, I urge you to find out if you are at risk and if you are, to get tested and adopt a healthy lifestyle as soon as you possibly can.
If you have been recently diagnosed with prediabetes, type 1, or type 2, or living with it for some time and need help to manage your blood sugar, book a call today and speak directly with me about working with me.
You will receive constant 1:1 support and I will be by your side every step of the way, teaching you exactly how I live to manage my blood sugar!
Meet the Author  Hi! I’m Beth, a Registered Nurse and Certified Diabetes Educator. I provide diabetes coaching for newly diagnosed people with diabetes and also work with people who have been living with diabetes for some time. With 1:1 coaching, you will feel empowered and supported to confidently manage your diabetes effectively - without it controlling your life! I can help you make sure that you feel good, stay in optimal health and take care of your well-being at all times. First call is on me! Let’s talk. |
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