Whether you have diabetes or just want to learn a little more about it, you probably know it has something to do with blood sugar. But how are type 1 and type 2 diabetes different — and is there anything about them that’s the same?
First, the basics: Diabetes is a condition that causes a person’s blood sugar, or blood glucose, to be too high.
Both type 1 and type 2 diabetes are related to problems with insulin, the hormone that transports blood sugar into the body’s cells so it can be used for energy.
Without enough insulin, glucose builds up in the bloodstream, which can cause high blood sugar and other serious health problems.
To break it down even further:
Type 1 diabetes
…is an autoimmune disorder that occurs when the pancreas doesn’t make any insulin, period. It usually begins in childhood or young adulthood. People with type 1 diabetes have to take insulin every day.
Type 2 diabetes
…occurs when the body doesn’t make enough insulin or doesn’t use it well. It’s usually the result of lifestyle factors, and it usually begins in middle age or older adulthood. Some people with type 2 diabetes have to take insulin, but often it can be managed with lifestyle changes and/or oral medications. Type 2 diabetes is more common than type 1.
Type 1 and type 2 diabetes are close cousins, so they share many symptoms.
Some of the most common are:
- increased thirst and frequent urination
- increased hunger
- unexplained weight loss
- blurred vision
Type 1 diabetes symptoms
T1D symptoms tend to come on quickly, often in just days or weeks.
Someone with type 1 diabetes might also experience diabetic ketoacidosis, a dangerous condition marked by fruity-smelling breath, dry or flushed skin, nausea or vomiting, stomach pain, trouble breathing, or confusion.
Type 2 diabetes symptoms
Symptoms of T2D often creep up slowly over several years, to the point where they’re barely noticeable.
In fact, some people with type 2 diabetes might not know they have it until they start to have more serious side effects, like sores that don’t heal or numbness or tingling in their hands or feet.
How does diabetes develop, exactly? Here’s where things start to get pretty different when it comes to type 1 versus type 2.
Type 1 diabetes causes
T1D is an autoimmune disorder. The cause isn’t fully understood, but it seems to strike when the immune system destroys insulin-producing cells in the pancreas.
The attack might be triggered by genetics or by environmental factors like viruses, but experts are still figuring it out.
Type 2 diabetes causes
We know a lot more about type 2 diabetes, which is caused by a combo of lifestyle factors and genes.
T2D can develop after a person becomes insulin resistant, which means their body needs more and more insulin because it isn’t using insulin effectively and the pancreas can’t keep up with the demand.
Insulin resistance can happen in response to a having a lot of body fat (especially belly fat) and not getting enough exercise. There’s also a genetic component: T2D tends to run in families.
People of African American, Asian American, American Indian, Hispanic or Latino, Native Hawaiian, and Pacific Islander descent also tend to be at higher risk.
The first step toward diagnosing diabetes is a blood test to measure your glucose levels.
Fasting plasma glucose and random plasma glucose tests determine how high your blood sugar is at a given time, and A1C tests show how long you’ve had high blood sugar. Your doctor will decide which test (or tests) is best based on your symptoms.
Your doctor might also opt to test your blood for immune system proteins called autoantibodies.
The presence of certain autoantibodies in your blood is a sign that your immune system is attacking your insulin-producing cells, indicating that your diabetes is type 1. If the autoantibodies aren’t there, your diabetes is type 2.
Managing your diabetes and keeping your blood sugar levels in check is key to feeling your best day to day and protecting your long-term health.
Chronically high blood sugar levels can lead to serious and even life-threatening complications like heart disease, nerve damage, kidney damage, and vision problems. (Hard pass.)
Type 1 diabetes treatment
People with T1D don’t produce insulin, so they need to take it every day (via a syringe, pen, or pump) to balance their blood sugar levels. If that isn’t enough, injectable medications taken with insulin, like pramlintide, can help.
Other medications, such as metformin, can also allow you to cut back on doses of insulin.
Another option: The FDA recently approved a hybrid closed-loop system (also called an artificial pancreas system), which is an insulin pump combined with a sensor device.
This device checks the user’s blood sugar and automatically delivers insulin when needed. It tests glucose levels every 5 minutes and can be used in adults and in children over age 7.
The user still needs to enter the number of grams of carbohydrates they’re eating into the pump calculator. Your doctor can help you decide whether it’s a good option for you.
Type 2 diabetes treatment
Lifestyle changes are often the first line of defense for managing type 2 diabetes. Losing weight, eating a healthy diet, and exercising regularly can all play significant roles in bringing your blood sugar levels down and keeping them closer to normal.
If lifestyle changes aren’t enough, medications can help. Metformin, which works by reducing sugar production by the liver and reducing insulin requirements, is often the next step. Some people may also need to take injectable insulin.
As for holistic treatment options? Despite what you might’ve heard, there’s no proof that vitamins, herbs, spices, or other home remedies are helpful for T2D (even cinnamon has mixed reviews). Some supplements may even mess with your medication.
Always get the green light from your doctor before trying an herb or another natural remedy.
Is there anything you can do to keep diabetes from happening in the first place? Type 1 diabetes can’t be prevented, but it’s still worth understanding your risk factors. Type 2 diabetes, on the other hand, can almost always be kept at bay.
Type 1 diabetes risk factors
T1D is an autoimmune disorder, and for now, it’s not preventable. But whether a person develops it might be affected by things like:
- Family history and genetics. Having a parent or sibling with T1D can increase your risk, as can carrying certain genes.
- Location. People living farther from the equator tend to be more likely to get T1D.
- Age. Research has shown that T1D is most likely to develop between the ages of 4 and 6 or the ages of 10 and 14, but it can develop at any age.
Type 2 diabetes risk factors
You may be able to do something about two of the biggest factors in your T2D risk:
- Weight. Having higher body weight, and especially carrying more weight around your middle, can up your T2D risk.
- Sedentary lifestyle. Regular physical activity plays an important role in managing blood sugar.
But not all T2D risks can be managed. Uncontrollable factors include:
- Family history. Having a parent or sibling with T2D makes you more likely to get it.
- Ethnicity. People of African American, Asian American, American Indian, Hispanic or Latino, Native Hawaiian, and Pacific Islander descent tend to be at higher risk.
- Age. The chances of getting T2D increase after age 45.
- Certain health conditions. Having gestational diabetes or polycystic ovary syndrome (PCOS) can make women more likely to develop T2D.
Type 2 diabetes prevention
Healthy lifestyle choices can help you avoid type 2 diabetes, even if you’re older or the disease runs in your family. Actions that have been proven to help include:
- Lose weight. Higher body weight is one of the biggest risk factors for T2D, but according to a 2011 study, losing just 5 to 10 percent of your weight is enough to make a difference.
- Eat a wholesome diet. Focus on fiber-rich foods like whole grains, fruits, vegetables, beans, and legumes. According to a 2012 study, fiber may help lower blood sugar levels (plus, it can help you feel full longer).
- Move every day. Try to be active for 30 to 60 minutes per day. It’s fine to break your activity into small chunks throughout the day.
- Don’t sit for too long. Even if you exercise daily, long periods of sitting can raise your blood sugar. Try to move around every 30 minutes or so, even if it’s just for a minute.
- Type 1 and type 2 diabetes are both serious conditions that affect your blood sugar.
- The risk factors and causes of the two types are different, and so are the options for treatment.
- If you’re having symptoms that seem like they could indicate diabetes, talk to your doctor ASAP.
- Your doctor will test your blood sugar to figure out whether you have diabetes and what type it is. Together, you can discuss the best treatment options for you.