Around 37.3 million Americans, or 11.3%¹ of the US population, have diabetes. There are different types of diabetes, but most people are diagnosed with either type 1 or type 2. Let's take a detailed look at the difference between these types and find out which type of diabetes is worse.
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Diabetes mellitus² is a condition caused by high blood sugar. Diabetes results from your cells being unable to access your blood sugar (glucose), which they need for energy, leading to a buildup in your bloodstream.
The body's ability to use glucose depends on your levels of a hormone called insulin. The pancreas makes insulin, and this hormone converts glucose from the food you eat to energy. If your pancreas doesn't produce enough insulin, that glucose will remain in your bloodstream.
Over time, too much glucose will build up in your blood, which can cause health problems such as:
Sexual and bladder issues
There are three types of diabetes:
Type 1 diabetes
There is also a stage of diabetes called prediabetes. This is where the blood glucose level is high but not enough to be diagnosed with type 2 diabetes.
Type 1 diabetes is an autoimmune condition that destroys the insulin-producing cells in your pancreas. This type of diabetes accounts for 1.9 million Americans with diabetes. It's more common in children and young adults but can be diagnosed at any stage of life. You should take insulin if you have type 1 diabetes.
Type 2 diabetes is when the body doesn't use insulin well, keeping the blood sugars at high levels. It's the most prevalent type of diabetes since it accounts for about 90–95%³ of people diagnosed with it. This type of diabetes takes time to develop, although it is becoming more common in young adults, teens, and children.
Symptoms associated with type 2 diabetes are not always noticeable. That's why it's important to test your blood sugar levels regularly. You can manage your blood sugar by having a healthy lifestyle, for example:
Eating healthy foods
Losing excess weight
If required, taking medications as prescribed
Gestational diabetes develops during pregnancy. This type of diabetes usually goes away once the baby is born. However, women diagnosed with gestational diabetes are at risk of developing type 2 diabetes in the future.
The main difference between type 1 and type 2 diabetes is that type 1 is an autoimmune disease, while type 2 is mainly lifestyle-related. Type 1 diabetes also often shows up early in life, while type 2 develops over time and tends to present in older age groups.
An autoimmune disease causes your immune system to attack its own body. In the case of type 1 diabetes, it attacks your insulin-producing cells.
Type 1 diabetes is considered worse than type 2 because it is an autoimmune disease, so there isn't a cure. Also, in a 2010 report⁴ from the UK, it’s estimated that the life expectancy of people with type 2 diabetes can be reduced by up to 10 years, while type 1 can reduce life expectancy by 20 years or more.
However, both types of diabetes are manageable, and the better controlled your diabetes is, the lower the risk of reduction in your life expectancy.
Type 1 diabetes occurs when your immune system mistakes your insulin-producing cells for bacteria or viruses and attacks them.
The immune system of people with type 1 diabetes usually misidentifies the beta cells of the pancreas as a threat to the body. It then attacks and destroys these cells, making them incapable of producing enough insulin to regulate glucose levels in your bloodstream.
It's not yet known why the body's immune system attacks the body's cells, but there is ongoing research⁵ to understand this phenomenon.
The primary cause of type 2 diabetes is the body's inability to adequately produce and use insulin. This affects the cells of your liver, fat, and muscle tissues, leading to insulin resistance.
Patients with type 2 diabetes also experience a steady decline of their beta cells, further elevating blood sugars. In the early phase, the body can produce enough insulin to overcome insulin resistance, but the production decreases over time, increasing blood sugar levels. This usually means that your body isn't using any available insulin effectively.
One major feature of type 2 diabetes is that the body has developed insulin resistance.
You might experience the following general symptoms if you have diabetes:
Feeling weak and tired
Slow healing of cuts and sores
Numbness or tingling in your feet or hands
Frequent unexplained infections
Men with diabetes might also experience symptoms such as erectile dysfunction⁶, decreased sex drive, and poor muscle strength. Women can experience vaginal yeast infections⁷ and female sexual dysfunction⁸.
Type 1 and type 2 diabetes share similar symptoms. However, type 1 symptoms appear more quickly than those of type 2.
In both type 1 and type 2 diabetes, patients experience elevated blood sugar levels and the presence of glucose in their urine at the early stages. A high amount of glucose in their urine leads to increased urine output and dehydration, causing thirst.
Unexplained weight loss is caused because insufficient insulin prevents your body from transporting glucose to your cells to produce energy. Therefore, the body starts to burn fat and muscle for energy, leading to an overall loss of weight.
Some people with untreated type 1 or type 2 diabetes also experience generalized symptoms like vomiting, nausea, and fatigue.
Type 1 diabetes is common among children and young adults but can appear at any age. If your parents or siblings have type 1 diabetes, you have a higher chance of developing this condition.
Type 2 diabetes is more likely to affect different people, including:
Obese or overweight people
People aged 45 years or older
Anyone born in a family with a history of diabetes
African Americans⁹, American Indians, Hispanic¹⁰ people, Pacific Islanders, and Alaskan natives
Those with low levels of HDL ('good' cholesterol) or high levels of triglycerides¹¹ (TG). High TG levels signal insulin resistance. This means that the cells are not absorbing insulin as they should, leading to higher than normal blood sugar levels.
Women with a history of gestational diabetes¹² or who gave birth to a child weighing 9 pounds or more
People who are not physically active
Anyone with depression¹³
Unmanaged diabetes can lead to:
High blood glucose levels caused by diabetes can damage your blood vessels and the nerves controlling your heart’s blood vessels. This can result in heart attack and death.
Unmanaged diabetes can damage your blood vessels and cause a stroke¹⁴. You can prevent the risk of stroke by managing your blood pressure and blood glucose and avoiding smoking.
This is a type of nerve damage associated with diabetes. It can affect any part of the body.
You can develop diabetic ketoacidosis if you have type 1 diabetes. However, people with type 2 diabetes are also at risk of this condition.
DKA results from insufficient insulin to allow blood sugar into your cells. Therefore, the liver breaks down fat for energy, producing acids known as ketones. Too many ketones upset the chemical balance in your blood and can poison the body.
Unmanaged diabetes can lead to diabetic nephropathy or diabetic kidney disease¹⁵. You can protect yourself from this disease if you manage your diabetes and maintain normal blood pressure.
Unmanaged diabetes can lead to severe eye conditions. It’s recommended to check with an optician regularly to monitor for diabetic eye complications. They will advise you on the best lifestyle changes to reduce the chances of getting eye disease.
People with diabetes are likely to suffer from sexual and bladder issues¹⁶. This includes loss of sexual interest, erectile dysfunction, bladder leaks, and retained urine. These problems usually result from damage to blood vessels and nerves.
There are different ways to diagnose type 1 and type 2 diabetes. Let’s have a closer look at these methods:
This test is also referred to as a glycated hemoglobin test, glycosylated hemoglobin test, or HbA1C test. It enables your physician to check your average blood sugar levels for the previous three months to determine whether you have diabetes.
If your blood sugars over the past few months are shown to be high, you have high A1C levels. These levels are indicated in percentages. An A1C level of 6.5% or higher indicates that you have diabetes.
The A1C test can give a false positive or false negative result¹⁷ if you have sickle cell anemia. Therefore, your physician will opt for a different test if you suffer from this condition.
This test expresses blood sugar levels in mg/dL or mmol/L of your blood. A reading of 200 mg/dL or 11.1 mmol/L suggests you have diabetes, regardless of the last time you ate. A doctor will most likely conclude that you're diabetic if you show signs and symptoms of extreme thirst or frequent urination.
In this test, doctors take your blood sample after you have fasted overnight. They will interpret your results as follows:
A reading of less than 100 mg/dL indicates that your blood sugar level is normal
A reading ranging from 100 to 125 mg/dL indicates that you have prediabetes
A reading of 126 mg/dL or higher recorded on two separate tests shows that you have diabetes
This test is usually considered during pregnancy. You might need to fast overnight and drink a sugary liquid at your physician's office. Your doctor will then test your blood sugar levels in the next two hours. They will interpret the results as follows:
A reading of less than 140 mg/dL shows that your blood sugar level is normal
A reading ranging from 140 to 199 mg/dL confirms that you have prediabetes
A reading of 200 mg/dL or higher after two hours suggests that you have diabetes
Your physician may use autoantibody testing to determine whether you have type 1 diabetes. Autoantibodies are antibodies that attack healthy cells and tissues by mistake. The presence of particular antibodies indicates that you have type 1 diabetes.
These autoantibodies include:
Islet cell cytoplasmic autoantibodies
Glutamic acid decarboxylase autoantibodies
If your test shows a combination of these antibodies, you have type 1 diabetes or have a high chance of developing it.
Type 1 diabetes occurs due to an autoimmune disorder for which there is currently no cure. There is also no cure for type 2 diabetes, but both types are manageable.
Lifestyle changes can help you manage diabetes, especially if you're diagnosed with prediabetes or have just been diagnosed with type 2 diabetes. Here are a few lifestyle changes that you can make to prevent full-blown diabetes:
Smoking can lead to insulin resistance. Stopping smoking can reduce your chances of getting type 2 diabetes.
Sticking to water as your primary drink limits your dependence on high-sugar beverages. Sugary beverages like sweetened fruit juice and soda increase the risk of type 2 diabetes.
Losing excess weight can help you reduce the risk of diabetes. Losing 5%–10% of your body weight can help you prevent diabetes progression. The more weight you lose, the higher the chances of achieving better results.
Regular physical activity has many health benefits, including losing weight, boosting insulin sensitivity, and lowering blood sugar.
There are different types of physical activity to practice:
Aerobic exercise: Engage in moderate to vigorous aerobic exercise for 30 minutes daily. You can try swimming, running, biking, or brisk walking.
Resistance exercise: Engage in resistance exercise two to three times every week. These activities include weightlifting and yoga.
Limit your inactivity: Break your long bouts of inactivity, like sitting at your computer, to control your blood sugars. Take a few minutes to walk around or do light activities for at least 30 minutes.
Plant foods are rich in vitamins, carbohydrates, and minerals. Carbohydrates contain sugar and starches, which are your body's energy source. They also contain fiber, a part of plant foods that the body cannot digest.
Eating foods rich in fiber promotes weight loss and reduces the risk of diabetes. This includes foods such as:
Fruits: For example, peppers, fruits from trees, and tomatoes
Non-starchy vegetables: For example, cauliflower, broccoli, and leafy greens
Legumes: For example, lentils, chickpeas, and beans
Whole grains: For example, whole-grain bread, whole-grain rice, quinoa, and whole oats
Eating these foods will benefit you because they:
Interfere with the absorption of cholesterol and dietary fat
Slow the absorption of sugar, lowering your blood sugar levels
Manage other risks associated with diabetes, such as inflammation and blood pressure
Help you eat less since fiber-rich foods are more filling and contain a lot of energy
Fatty foods contain a lot of calories. Anyone with prediabetes should moderate their intake of fatty foods. Consume foods containing unsaturated fats or 'good fats' if you want to manage your diet.
Unsaturated fats also maintain healthy blood cholesterol levels, vascular (blood vessel) health, and a good heart. You can get good fats from:
Fatty fish: For example, mackerel, tuna, cod, and salmon
Nuts and seeds: For example, peanuts, pumpkin seeds, almonds, and flaxseed
Healthy oils: For example, canola, cottonseed, safflower, sunflower, and olive oil
Foods high in refined carbohydrates increase your insulin levels. Some foods with high levels of refined carbohydrates include:
Sweetened breakfast cereals
You should limit your sugar intake to complex carbohydrates available in:
It's recommended to seek routine screening for diabetes, especially if you fall into the high-risk category. If you aren't at high risk, talk to your doctor if you experience symptoms such as constant urination or more thirst than usual.
There is a high risk of getting diabetes if you fall into the risk categories described in this article. Fortunately, the risk of getting type 2 diabetes is reduced if you follow the described advice.
Preventing type 1 diabetes is difficult since it’s caused by an autoimmune reaction. However, it’s manageable, and well-controlled diabetes reduces the risk of developing diabetic complications.
In short, if you are at high risk, or experiencing symptoms of diabetes, seek medical help to determine which type of diabetes you're suffering from, the best treatment, and ways to manage it.
Statistics about diabetes | American Diabetes Association
Type 2 diabetes | Centers for Disease Control and Prevention
Autoimmunity | Nature
Diabetic kidney disease | NIH: National Institute of Diabetes and Digestive and Kidney Diseases
People with diabetes and sickle cell trait should have reliable A1C test | NIH: National Institute of Health
Diabetes life expectancy | Diabetes.co.uk
Diabetes, heart disease, & stroke | NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Diabetes autoantibody panel | University of Rochester Medical Center
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