The difference between type 1 and type 2 diabetes and how to manage your symptoms

From insider.com

The difference between type 1 and type 2 diabetes largely comes down to treatment.

People with type 1 diabetes cannot produce insulin and therefore must take multiple daily insulin injections to control their blood sugar levels.

People with type 2 diabetes may be able to control blood sugar with lifestyle changes to their diet and exercise routines, but medications and insulin injections are also options.

This article was medically reviewed by Samantha Cassetty, MS, RD, nutrition and wellness expert with a private practice based in New York City.

Diabetes is one of the most common chronic health conditions in the United States.
In 2018, the American Diabetes Association reported that 34.2 million Americans, over 10% of the population, had diabetes. And that equated to $237 billion in medical costs for 2017, alone.
There are three types of diabetes: type 1, type 2, and gestational. In this article, we focus on the different causes, symptoms, and treatments for type 1 and type 2 diabetes.

Diabetes disrupts the body's insulin response

Diabetes, regardless of type, affects how your body produces insulin. Insulin is what helps your body convert the sugars from food into fuel for your cells.

Normally, the pancreas releases insulin after you eat. But people with diabetes don't produce or use insulin properly, which means blood sugar, also called blood glucose, stays elevated at dangerously high levels. This can lead to a condition called hyperglycaemia.
All diabetics can experience hyperglycaemia, regardless of type. If not addressed, hyperglycaemia can result in a life-threatening coma. Meanwhile, chronic cases can cause organ damage.
"These long-term complications can be severe and can lead to blindness, foot ulcers, gangrene requiring amputation, and kidney failure," says Arnold Saperstein, MD, FACP, an endocrinologist and chief medical officer at Cecelia Health.

The difference between type 1, type 2, and gestational diabetes

There are three types of diabetes:

Type 1 diabetes: About 5-10% of diabetics are classified as type 1. Type 1 diabetes is when the body is unable to produce insulin on its own. This type is more often diagnosed during childhood or teens than as an adult.

Type 2 diabetes: Nearly 90-95% of diabetics are type 2 and the majority are adults. This type occurs when your body can't metabolize insulin properly and is progressive, meaning it often gets worse over time if not treated.

Gestational diabetes: Gestational diabetes occurs during pregnancy and can lead to high blood sugar levels that can be dangerous for both your health and the baby's. The condition often resolves after the pregnancy ends, but women who have had gestational diabetes are at a higher risk of later getting type 2 diabetes.

The causes for type 1 and type 2 diabetes are different 

The main difference between type 1 and type 2 diabetes is how people develop the condition.
Researchers don't yet know the exact cause of type 1 diabetes, says Saperstein. Many believe it may be caused by an autoimmune reaction, where the body attacks its own cells and is thus unable to produce insulin. However, researchers do know there are certain risk factors like:

• A family history of type 1 diabetes 
• A history of viral infections such as enterovirus, which usually includes respiratory and cold-type symptoms. 

Saperstein says these factors may trigger a lack of insulin production so the body struggles to regulate blood glucose.
Type 2 diabetes also has a genetic component. But other risk factors play a key role including:

• A history of being overweight. 
• A history of being inactive. 
• The inability to access quality medical care, safe playgrounds, and full-service grocery stores can also increase the risk of type 2 diabetes in certain demographics, such as African Americans and Latino Americans.

Type 1 and type 2 diabetes have similar symptoms 

The symptoms for type 1 and type 2 diabetes are similar. However, how quickly symptoms develop will vary between types.

Saperstein says that indicators of type 1 diabetes develop suddenly, within days or weeks, while those of type 2 diabetes develop more gradually, usually over a period of months to years. Some people may live with type 2 diabetes for years before seeing a doctor for a diagnosis.
If you notice a combination of the following symptoms, this could be a sign of diabetes and you should schedule an appointment with a doctor:

• Frequent urination 
• Constant thirst 
• Dry mouth
• Dry, itchy skin 
• Blurred vision 
• Frequent or chronic yeast infections 
• Slow-healing cuts and sores 
• Severe exhaustion 
• Unexplained weight loss

When your blood sugar is high, the kidneys can't filter enough glucose. Therefore, extra glucose is released in the form of urination. This excess urination causes dehydration and dry, itchy skin.

"Blurry vision can also occur due to changing fluid levels in the body leading to some swelling in the lenses of the eye," Saperstein says.
If your doctor suspects that you might have diabetes, they'll order a fasting blood sugar test, which is performed after you've had nothing to eat or drink for at least eight hours. Or, they may order an A1c blood test which tests for average blood glucose levels during the past 3 months.

Treatment for diabetes: Insulin shots and blood sugar monitors 

If you have diabetes you may need to take insulin injections to help your body regulate blood sugar levels. How frequently you need to take insulin, however, will vary on what type of diabetes you have.

Treatment for Type 1 Diabetes

Those with type 1 diabetes must take insulin with each meal and may need to take it at other times during the day. Insulin injections can be done with a needle and syringe, a pen, or an insulin pump, which provides a steady dose of insulin throughout the day.

Treatment for Type 2 Diabetes

Managing symptoms of type 2 diabetes largely depends on lifestyle choices. This includes eating a healthy diet with lots of fruits, vegetables, and whole grains, as well as being active and getting enough exercise. And for some, lifestyle changes are enough to keep blood sugar levels under control.

In a 2014 study published in the American Diabetes Association's Diabetes Care journal, a randomized control trial demonstrated that a low-carbohydrate, low-saturated fat diet helped participants manage their glucose levels effectively and reduced the risk of developing cardiovascular disease, compared to a diet that was low in fat but contained unrefined carbohydrates.

For some, weight loss helps reduce risks and symptoms of type 2 diabetes too, Saperstein says. A 2019 review in Advances in Therapy noted that while obesity is one of the main risk factors for type 2 diabetes, aggressive weight loss protocols, like metabolic surgery, should be evaluated extensively.

Additionally, some medications, including metformin, have been shown to reduce the symptoms of type 2 diabetes. Metformin reduces the amount of sugar your liver releases into your blood and improves the body's response to insulin, which helps in controlling blood glucose levels. However, in order to be effective, medications should be combined with lifestyle improvements like diet and exercise, Saperstein says.

Finally, people with type 2 diabetes may need to take insulin, similar to those with type 1 diabetes. Though, you may not need daily injections and can take insulin less frequently. The frequency may change if you become pregnant, so consult with your doctor.

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