Difference between Type 1 and Type 2 Diabetes Mellitus

Diabetes is a condition in which the blood glucose/blood glucose is too high.

What is the significance of a blood glucose?

It is the primary source of energy. If you eat foods, the pancreas produces a hormone insulin which transports glucose from the food to the cells to be used as an energy.

If the body has problems with insulin production the glucose will stay in the blood and will not be utilized by the cells. Too much glucose in the blood leads to diabetes. (1, 2, and 3)

Type 1 diabetes is insulin dependent

(Type 1 diabetes is insulin dependent; the patient needs insulin shot throughout his lifetime.)

diabetes mellitus type 1 pathophysiology(An image of a healthy cell and a cell with diabetes mellitus type 1.)

There are four types of diabetes: type 1, type 2, gestational, and other types (monogenic diabetes and cystic fibrosis-related diabetes).

The most common types are the type 1 and type 2 diabetes mellitus.

Regardless of the type, they share common symptoms. What are the common signs of diabetes?

  • Frequent urination
  • Excessive thirst and hunger
  • Blurring of vision
  • Burn out/easily gets tired
  • Wounds/cuts/sores that do not heal properly (2, 3, and 4)

In this article, we are going to dig deeper into the two most common types of diabetes: diabetes type 1 and 2.

We are going to distinguish which is worse type 1 or 2 diabetes including the differences and similarities between type 1 and type 2 diabetes.

Type 1 Diabetes Mellitus

Type 1 diabetes is common in children

(Type 1 diabetes is common in children and adolescents.)

Diabetes mellitus type 1 is the body’s lack of ability to produce insulin. Those who have type 1 diabetes need to take insulin every single day. That is why type 1 diabetes is called insulin dependent diabetes mellitus.

It is once known as juvenile diabetes because it usually appears during childhood. It has no cure. The best way to deal with type 1 diabetes is to religiously manage the level of blood sugar through insulin, diet and lifestyle modification, and preventing possible complications. (4, 5, and 6)

What causes diabetes type 1?

The exact cause is unknown but is linked with the body’s immune system. It mistakenly destroys the cells in the pancreas responsible for creating insulin.

Some studies showed that the development of type 1 diabetes has something to do with genetics, family history of diabetes, and exposure to viruses, and environmental factors. (5, 6, and 7)

What are the possible complications?

  • Cardiac and blood vessel-related diseases
  • Neuropathy (nerve damage)
  • Nephropathy (kidney damage)
  • Foot damage (possible amputation)
  • Eye damage
  • Bacterial and fungal infection of the skin and mouth
  • Complications during pregnancy (6)

 

Type 2 Diabetes Mellitus

Type 2 diabetes insulin resistance

(A comparison image between a healthy cell and a cell with diabetes type 2.)

Type 2 diabetes is common in obese overweight(Type 2 diabetes is common in obese/overweight people.)

If you are wondering what is the most common diabetes the answer is diabetes type 2. People with type 2 diabetes do not make use of insulin well. Their body makes insulin but the cells don’t use it the way it supposed to.

That is why type 2 diabetes is called insulin resistance diabetes or non-insulin dependent diabetes mellitus. It commonly affects middle-aged people although it can develop at any age. (2, 6, 8, and 9)

What causes diabetes type 2?

  • Genetics
  • Metabolic syndrome (people with extra fat around the waist, high blood pressure, and high level of cholesterol)
  • Overweight
  • Excessive glucose in the liver (9)
  • Bad communications between cells
  • Broken beta-cells
  • Family history of diabetes (10)
  • Age (45 years old and above)
  • Race (it is common in Native American, African-American, Asian-American, Alaska Native, Hispanic, and Pacific Islander-American)
  • Pre-diabetes and gestational diabetes (diabetes during pregnancy)
  • Polycystic ovarian syndrome (PCOS)
  • High level of stress
  • Sedentary lifestyle (smoking, too much/too little sleeping time, and little to no exercise)

How are you diagnosed with type 2 diabetes?

The doctor will order for a lab procedure to check the level of glucose in your blood. The common tests are:

  • HbA1C – It measures the average blood glucose over the past three months.
  • Fasting Plasma Glucose – It measures the level of glucose in the blood on an empty stomach. You are not allowed to eat or drink except water eight hours prior to the procedure.
  • Oral Glucose Tolerance Test – It measures the level of glucose in the blood 2 hours before and after drinking a sweet drink. This is to track down how your body reacts to sugar. (10, 11, and 12)

What are the possible complications of type 2 diabetes?

  • Cardiac and blood vessel-related diseases
  • Neuropathy (nerve damage)
  • Nephropathy (kidney damage)
  • Foot damage (possible amputation)
  • Eye damage
  • Bacterial and fungal infection of the skin and mouth
  • Complications during pregnancy (2, 4)

Which is worse type 1 or 2 diabetes?

It really is hard to distinguish which one is worse as each case is unique. What you need to keep in mind is that type 1 needs insulin to live.

People with type 1 diabetes need to have a regular insulin shot or else may lead to emergency situation and even death.

On the other hand, people with type 2 diabetes need an enormous amount of insulin because their body is resistant to it. Type 1 diabetes is easily diagnosed whereas people with type 2 can go undiagnosed for years. (2, 4, and 5)

Do Type 2 diabetics take insulin?

People with diabetes type 2 usually manage their blood glucose level with oral medication and lifestyle modification such as losing weight, quit smoking, and regular exercise.

However, there will come to a point when they will eventually need insulin shots such as in the case of people with symptomatic hyperglycemia, as the beta cell reserve gets depleted after many years of diagnosis with type 2 diabetes, multiple intakes of diabetes medication, and uncontrolled diabetes during pregnancy. (1, 5, and 7)

What is the difference between Type 1 and Type 2 Diabetes?

Causes

  • Type 1 – It is caused by an immune response. It has mistaken insulin-producing beta cells as foreign invaders. It destroys beta-cells until such time that no insulin is produced. The immune system’s response to beta-cells can be linked with genetic and environmental factors.
  • Type 2 – The body is unable to use insulin effectively which is linked with excess weight, genetics, and environmental factors. (6, 10)

Commonality/incident rate

  • Type 1 – Not common, about 10% of the total diabetic population.
  • Type 2 – It is the most common, about 90% to 95% of the total diabetic population.

Onset

  • Type 1 – Rapid
  • Type 2 – Slow

Risk factors

  • Type 1 – Family history of diabetes
  • Type 2 – Prediabetes, overweight/obese, inactivity, family history of diabetes, diabetes during pregnancy (gestational diabetes), Polycystic ovarian syndrome (PCOS)

Age

  • Type 1 – Can appear at any age but common among children and adolescents.
  • Type 2 – It is more common in people 45 years old and above. (11)

Geography

  • Type 1 – Prevalent in people located in countries farther away from the equator.
  • Type 2 – African-American, American Indian, Hispanic or Latino American, and Alaska Native

Prevention

  • Type 1 – It cannot be prevented
  • Type 2 – Can be prevented through a healthy lifestyle

Insulin

  • Type 1 – Regular insulin shot is needed as the body no longer produce insulin/insulin pump can be used too (steady amount of insulin through a small tube)
  • Type 2 – Not necessarily. The blood sugar can be controlled with diet and exercise. Some need medications to help the body utilize insulin effectively. May need insulin in late stages or in emergency conditions (eg : during surgery) (12)

 

Difference between Type1 and Type 2 Diabetes Mellitus Table

Differences Type 1 diabetes Type 2 diabetes
Causes Immune-response Genetic/hereditary/excess weight/obesity
Commonality/incident rate Not common/about 10% of the population Common/about 90% to 95%
Onset Rapid Slow
Risk Factor Family history of diabetes Prediabetes/overweight/obesity/family history/gestational diabetes/polycystic ovarian syndrome
Age Common in children and adolescents Common in people 45 years old and above
Geography Prevalent in people living farther away from the equator African-American, American Indian, Hispanic or Latino American, and Alaska Native
Prevention Cannot be prevented Can be prevented through a healthy lifestyle
Insulin Insulin shot/insulin pump Not necessarily/blood sugar can be controlled with exercise and diabetes medication might be needed by the body to utilize insulin effectively. Insulin may be needed in late stages and in emergencies.

 

References

  1. Difference between Type 1 and Type 2 Diabetes Mellitus
  2. https://www.healthline.com/health/difference-between-type-1-and-type-2-diabetes
  3. https://www.webmd.com/diabetes/guide/types-of-diabetes-mellitus
  4. https://www.medicalnewstoday.com/articles/7504.php
  5. https://jdrf.org.uk/information-support/about-type-1-diabetes/what-is-the-difference-between-type-1-and-type-2-diabetes/
  6. https://jdrf.org.uk/information-support/about-type-1-diabetes/what-is-the-difference-between-type-1-and-type-2-diabetes/
  7. https://www.medicinenet.com/diabetes_mellitus/article.htm
  8. https://www.everydayhealth.com/diabetes/difference-between-type-1-type-2-diabetes/
  9. https://www.health24.com/Medical/Diabetes/About-diabetes/see-how-to-tell-the-difference-between-type-1-and-2-diabetes-20180517
  10. https://www.t1everydaymagic.com/type-1-and-type-2-diabetes-whats-the-difference/
  11. https://www.diabetessa.com.au/ndw15/what-is-the-difference-between-type-1-type-2-and-gestational-diabetes.html
  12. https://www.lifespan.org/conditions-treatments/diseases-and-conditions/diabetes-type-1-2-and-gestational
  13. https://www.diabetesselfmanagement.com/blog/type-1-diabetes-vs-type-2/

Published by Dr. Rajesh MD under Diabetes Information.
Article was last reviewed on January 8th, 2022.

Leave a Reply

Back to Top