How can you differentiate between type 1 and type 2 diabetes mellitus?

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diabetes

About the Writer

Lorraine Bunag, R.N.

Lorraine is a registered nurse who spends most of her time writing informative articles on health and wellness. At the end of the day, she relaxes by reading a book or watching documentaries about unsolved mysteries.

The hallmark concern for people with diabetes (also known as hyperglycaemia) – be it type 1 or type 2 – is high blood sugar levels or hyperglycemia, but what are the similarities and differences between the two?

For us to more effectively explain their similarities and differences, we need to first understand the following concepts:

• Our bodies get energy from the foods we eat; the preferred source is carbohydrate, which breaks down into simple sugars like glucose when digested.
• The glucose floats in the blood. For us to use them as energy, they need to enter our cells first.
• Interestingly, our cells are “locked” and sugars cannot enter them without the help of insulin, a hormone that the pancreas gland produces.
• When insulin is released in the blood, the sugars enter the “unlocked” cells, and the blood sugar levels return to normal.

In normal circumstances, the amount of insulin we produce is relative to our blood sugar levels. While our pancreas continually secretes small amounts of insulin, it adjusts accordingly and will release more insulin if it detects high amounts of glucose in the blood (such as after meals).

With these fundamental concepts, we’ll be better able to differentiate between the causes, symptoms, and treatment of type 1 and type 2 diabetes. 

Causes and Risk Factors

First, let’s learn about the causes and risk factors: why does someone develop type 1 or type 2 diabetes? What factors increase our risk of having the conditions?

What Causes Type 1 Diabetes?

The exact cause of type 1 diabetes remains unclear, but according to experts, it is usually an autoimmune condition.

Our immune system is designed to protect us by fighting off foreign bodies such as viruses, bacteria, and parasites. When someone has an autoimmune condition, their immune system mistakes their own healthy cells for foreign bodies and attacks them.

In type 1 diabetes, the immune system attacks the cells in the pancreas which are responsible for producing insulin. As a result, the body has little to no insulin.

The exact trigger for this autoimmune reaction is yet to be discovered, but reports say that genetics and environmental factors like viral infections can trigger the condition.

Risk Factors

Besides the possibility of an autoimmune condition, your risk of developing type 1 diabetes may be higher due to the following risk factors:

• Genetics: The presence of variants of genes HLA-DQA1, HLA-DQB1, and HLA-DRB1 may increase the risk of type 1 diabetes. These genes affect our immune system. However, there are also many people with these genes who do not end up developing the condition.
• Family History: People who have siblings or parents with type 1 diabetes are more likely to develop the condition.
• Age: People can develop type 1 diabetes at any age. However, it usually appears at two peaks: between 4 and 7 years old, and between 10 and 14 years old. This is why some people call type 1 diabetes “juvenile diabetes” as people tend to develop it when they are young.
• Geography. The incidence of type 1 diabetes is higher in areas further from the equator. 

What Causes Type 2 Diabetes?

Type 2 diabetes is the most common form of diabetes. It usually happens due to insulin resistance, a condition where our cells do not “recognise” insulin.

In other words, people with type 2 diabetes have no problems producing insulin; what happens is the fat, liver, and muscle cells do not respond well to the hormone, leading to the glucose’s inability to enter the cells.

As the cells do not recognise insulin, the pancreas will compensate by producing more insulin. Over time, the pancreas will no longer be able to keep up, and it, too, will not be able to produce enough insulin.

The exact reason why insulin resistance occurs is unknown, but it could be due to a combination of lifestyle and genetic factors.

Risk Factors

The following factors may increase an individual’s risk of developing type 2 diabetes:

• Excess Weight and Fat Distribution: People who are overweight or obese are at a higher risk. Where the excess fat is distributed appears to matter, too. Doctors say that people with more fat in their abdomen have a heightened risk of type 2 diabetes.
• Sedentary Lifestyle: With decreased physical activity, the risk of type 2 diabetes increases. Remember that physical activity helps use glucose and control weight. Interestingly, it also increases the cells’ sensitivity to insulin.
• Family History: Having a relative with type 2 diabetes increases your risk of developing the condition.
• Age: Unlike type 1 diabetes which commonly appears at a younger age, the risk of type 2 diabetes increases with age.
• Ethnicity: People of certain descents, including Blacks, Pacific Islanders, Hispanics, Native Americans, and Asians are more likely to develop type 2 diabetes.

Besides these risk factors, certain medical conditions also predispose a person to type 2 diabetes. These health conditions are as follows:

• Prediabetes, a condition where someone’s blood sugar is higher than normal, but not high enough to be classified as diabetes. The good news is, it is possible to “reverse” prediabetes.
• Having high levels of bad cholesterol and low amounts of good cholesterol.
• Polycystic Ovary Syndrome (PCOS), a condition in women where they experience irregular periods and excessive hair growth. Often, women with PCOS are also predisposed to insulin resistance and obesity.
• Gestational diabetes, where a woman develops diabetes during her pregnancy.

Signs and Symptoms

Now that we know about the differences between type 1 and type 2 diabetes regarding their causes and risk factors, let’s discuss the symptoms.

Both type 1 and type 2 diabetes produce similar signs and symptoms, with only minimal differences.

What are the Common Symptoms of Type 1 and Type 2 Diabetes?

The following symptoms are present in both type 1 and type 2 diabetes:

• Frequent urination
• Increased thirst
• Extreme hunger
• Unintentional weight loss
• Fatigue
• Blurry vision
• Sores or wounds that heal slowly
• Numbness and tingling sensation in hands and feet

What are the Differences in Symptoms between Type 1 and Type 2 Diabetes?

While type 1 and type 2 have largely similar signs and symptoms, the manners by which they appear are different.

The symptoms of type 1 diabetes usually occur while the individual is still young (although it is important to keep in mind that a person can develop it at any age). Furthermore, type 1 diabetes symptoms can appear suddenly, often in a matter of weeks.

On the other hand, symptoms of type 2 diabetes usually do not show up until individuals are in their 40s or older. Additionally, the signs and symptoms typically develop slowly in years. In fact, since the symptoms are mild at first, the condition tends to go unnoticed and undiagnosed for many years until they face a pressing, related concern, such as blurry vision or wounds that do not heal.

Treatment

For the most part, the management of type 1 and type 2 diabetes remains the same but may require different medications.

What are the Medications for Types 1 Diabetes?

When someone is diagnosed with type 1 diabetes, he or she will most certainly receive insulin therapy. In this treatment, insulin will be administered either through injections or a pump.

Insulin medications are categorised based on how soon they work and how long their effect lasts. Short-acting and rapid-acting insulin mimic how our pancreas releases insulin during mealtimes. Meanwhile, long-acting and intermediate insulin mimics how the pancreas continually secretes small amounts of insulin.

Insulin injection requires the patient to be attentive as they may need to inject different kinds of insulin at specific times within the day.  While most individuals are able to manage the injection on their own at home, others may prefer having a private nurse perform the procedure for them.

Insulin pumps (which are attached to the body) are more convenient. Not only is it programmed to release steady amounts of insulin, but it will also release higher doses of insulin after meals – you only need to input your blood sugar level and the amount of carbohydrates you consumed.

What are the Medications for Type 2 Diabetes?

The medication for type 2 diabetes varies depending on the individual’s overall health condition and how deeply diabetes has affected their lives.

Case in point, some mild type 2 diabetes cases, when diagnosed early, can be managed through lifestyle modifications alone without the need for medication.

Should a patient need medication, their healthcare team will figure out the drug and the dose.  Type 2 diabetes medications are typically oral pills that promote insulin production, lower blood glucose or make the cells more sensitive to insulin.

Patients with type 2 diabetes whose pancreas is already damaged may also need to receive insulin therapy.

Medicine Delivery with Homage

With Homage’s medicine delivery service, you can now have insulin and diabetes medications delivered to your home anywhere in Singapore. It only takes 3 simple steps:

1. Consult a doctor: Download our app and consult a doctor in the comfort of your home via teleconsultation or by engaging a house call doctor.
2. Get a prescription: After a thorough assessment and evaluation of your condition, the doctor will issue you a prescription if necessary.
3. Receive medicine at home: With the prescription, you can get your medication at a nearby pharmacy or clinic, or have them directly delivered to your doorstep with Homage.

Lifestyle Modifications for Diabetes

Whether you have type 1 or type 2 diabetes, lifestyle modifications are recommended. Here are some ways you can manage your blood glucose levels:

• Make healthier food choices by formulating a diabetic diet.
• Ensure regular physical activity.
• Monitor and record blood sugar levels.
• Assess for warning signs of hyperglycemia or hypoglycemia.
• Assess for new or worsening symptoms; especially pay attention to vision and feet.
• Manage stress.
• Manage other existing health conditions and take medications for them where needed.

Of course, these modifications are best achieved under the supervision of a healthcare team. With the help of our team of doctors, nurses, caregivers and therapists, you can receive a personalised diabetes care plan based on your unique care needs.

How About Prevention?

Currently, there is still no way to prevent types 1 diabetes. For type 2 diabetes, the best that we can do is to eliminate or at least reduce our risk factors.

For instance, people with obesity can work on achieving a healthier weight. Those who have a sedentary lifestyle can start increasing their level of physical activity. However, do make sure to take it slow and listen to your body to avoid potentially life-threatening diseases like rhabdomyolysis.

The best way to do these steps is, of course, to consult a doctor first. 

The Bottom Line

Basically, type 1 diabetes occurs because the pancreas cannot produce enough insulin; in contrast, type 2 diabetes happens due to insulin resistance.

The symptoms of type 1 and type 2 diabetes are similar, with only a few differences, such as when and how fast they develop.

Treatment for type 1 diabetes requires insulin, either through injections or a pump. For type 2 diabetes, the medications can address high blood glucose, lack of insulin, or insulin resistance. They might also need insulin therapy in the future.

Are You Worried About Diabetes?

If you are worried about diabetes, do not hesitate to contact your healthcare provider. If going to the hospital or clinic is not yet possible at the moment, consider booking an appointment with our house call doctors. You can also consult our doctors online.

Here at Homage, we also offer personalised diabetes for you or your loved one. Our healthcare experts can help in various areas such as physical activity, medicine administration, and vital signs monitoring. Learn more about diabetes care here.

References

1. Diabetes and insulin. (2019). Retrieved February 28, 2021, from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetes-and-insulin
2. Diabetes in Singapore. (n.d.). HealthHub. Retrieved February 28, 2021, from https://www.healthhub.sg/a-z/diseases-and-conditions/626/diabetes
3. Diabetes overview. (2016, November 30). National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved February 28, 2021, from https://www.niddk.nih.gov/health-information/diabetes/overview
4. Diabetes | Type 1 diabetes | Type 2 diabetes | MedlinePlus. (n.d.). MedlinePlus – Health Information from the National Library of Medicine. Retrieved February 28, 2021, from https://medlineplus.gov/diabetes.html
5. Type 1 diabetes – Symptoms and causes. (2017, August 7). Mayo Clinic. Retrieved February 28, 2021, from https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011
6. Type 2 diabetes – Symptoms and causes. (2019, January 9). Mayo Clinic. Retrieved February 28, 2021, from https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193
7. Type 2 diabetes. (2020, April 20). Centers for Disease Control and Prevention. Retrieved February 28, 2021, from https://www.cdc.gov/diabetes/basics/type2.html
8. What is type 1 diabetes? (2021, January 19). Centers for Disease Control and Prevention. Retrieved February 28, 2021, from https://www.cdc.gov/diabetes/basics/what-is-type-1-diabetes.html

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Category

Tags

diabetes

About the Writer

Lorraine Bunag, R.N.

Lorraine is a registered nurse who spends most of her time writing informative articles on health and wellness. At the end of the day, she relaxes by reading a book or watching documentaries about unsolved mysteries.

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