Type 1 Vs. Type 2: The (Exceptionally Brief) Lowdown

One of the biggest misconceptions about Diabetes is that it’s all pretty much the same. Or that of the two main types, one is the good one, and one is the bad one. Or one is the bad one, and one is the really bad one. I always sort of want to laugh at this when someone asks which one I have or my son has, because I’m not sure anyone is particularly enjoying having either type of Diabetes. I always end up sort of awkwardly tilting my head and asking which one is considered which. And the person never really knows. 

More than once I’ve found myself wishing they just had two completely different names. I know they both involve the pancreas, that they both affect the way our bodies regulate blood sugars, and they can both lead to dangerously high glucose levels and medical complications if uncontrolled. Both, if unmanaged, share many of the same symptoms too: excessive thirst and drinking, frequent urination, excessive hunger, fatigue, and wounds failing to heal properly. But they’re also very, very different. So which one is which?

Type 1 Diabetes:

People with Type 1 Diabetes can’t produce insulin. Their pancreas, after a spell of trying-but-not-really-succeeding to stay afloat, just sort of abandons the insulin ship. No more insulin = not very useful. Type 1 Diabetes occurs when the immune system gets confused, takes issue with the unsuspecting pancreas, and unceremoniously attacks its own insulin-producing beta cells until there aren’t any left. Or at least, not enough to be of much help. The body thinks it’s doing a good thing, but obviously it isn’t. Once these beta cells are gone, they’re gone. And with them is our insulin. 

It’s still not clear why this mix up happens, but it’s thought that a combination of genetics and environmental factors trigger the whole accidental attack. Many people are trying to figure it out, just as many people are trying to find the as-of-now elusive cure. For now, treatment for Type 1 Diabetes looks like insulin shots and pumps. Blood sugar monitoring, whether through finger pricks or a continuous glucose monitor, is essential, because blood sugar can be a finicky thing. 

The amount of insulin you need depends on your blood sugar, your individual needs, and the amount of carbs you’re consuming. You’ll need a base level of insulin (long-lasting insulin if you’re injecting, or just small increments of fast-acting insulin delivered throughout the day if you’re on a pump), and then rapid-acting insulin which you’ll have just before you eat, or sometimes just after (if you’re a toddler with an appetite an order of magnitude less predictable than the weather). Ultimately though, Type 1 Diabetics need insulin to survive.

Type 2 Diabetes: 

So leveling with you here, Type 2 Diabetes isn’t really my jam. My Grandfather (one of my favorite people to ever have existed) had it, but even though we were inseparable, little kid me I didn’t know much of it other than he checked his blood sugar every afternoon (which icked me out a bit at the time – oh, the irony), watched what he ate and had this super weird flan thing instead of a normal birthday cake one year. But here’s the little I have managed to piece together: Type 2 Diabetics can still produce insulin, but they sometimes don’t produce enough, or their bodies can’t use what insulin they do produce effectively. Because insulin helps glucose get into our cells to be used for energy, the body being unable to use insulin well means that too much glucose stays in the blood, and not enough reaches the cells where it’s meant to go.

A grainy picture of my T2D Granddad, with his low sugar birthday flan of weirdness that he accepted with such grace, no-one would know how weird it actually was.

Type 2 Diabetes can occur at any age, but is most commonly found in middle-aged or older adults. It’s believed that both genetics and lifestyle factors (such as diet, a lack of physical activity or obesity) play a part in the onset of Type 2 Diabetes. Unlike Type 1 Diabetes, which always requires insulin therapy, Type 2 Diabetes can sometimes be managed with diet and exercise, although more severe cases may require insulin therapy or other medications.

So there we are. Two pretty different diseases, neither one better or worse than the other, just different. Different, and inconveniently hanging out nearby each other with almost the same name.

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