The word “diabetes” is often used to describe all types of diabetes, conditions related to high blood sugar and the body’s production and use of the hormone insulin. But the different types of diabetes, notably type 1 and type 2, are distinct. (There’s also gestational diabetes, which starts during pregnancy and usually goes away after the baby is born.)
The causes of type 1 and type 2 are very different, but these types do share many symptoms. Some treatments and lifestyle changes help both. Here’s more on what they have in common and how to tell them apart.
Understanding type 1 and type 2 diabetes
The major difference between type 1 and type 2 diabetes has to do with how the disease works inside the body. With both types, the body is unable to generate the energy that it needs from the carbohydrates, or sugars, that you consume. This results from problems related to insulin production. People with type 1 diabetes typically produce little or no insulin, while those with type 2 diabetes produce insulin but they have what's called “insulin resistance.” This means that their body can’t use this insulin efficiently. That's why insulin treatments are required for type 1 diabetes but may not be needed for type 2, at least not in the early stages.
Who gets type 1 and type 2 diabetes?
Only 5 to 10 percent of people with diabetes have type 1. Though anyone at any age can have this type of the disease, initially it was thought to affect mostly children (which is why type 1 used to be called juvenile diabetes). But according to the JDRF (formerly known as the Juvenile Diabetes Research Foundation), half the people diagnosed with type 1 are actually older than 30.
Type 1 diabetes is an auto-immune disease. That means there’s a problem with your immune system. In the case of type 1 diabetes, the immune system stops the pancreas from making insulin, the hormone that helps the body’s cells convert sugar into energy. However, it can take anywhere from months to years for insulin production to completely stop, according to the Centers for Disease Control and Prevention (CDC).
Type 2 diabetes is the most common type, affecting 90 to 95 percent of those who have diabetes. Type 2 is considered a metabolic disorder, according to JDRF. The body still produces insulin but is unable to properly metabolize, or convert, sugar to energy, causing blood sugar levels to rise.
What are the risk factors for type 1 and type 2 diabetes?
Having a family history of either type of diabetes is a risk factor, but for possibly different reasons. With type 1, your genes may be pre-wired for you to develop diabetes, although scientists don’t understand exactly why this happens, and it’s not something you could have prevented.
Though a family history of type 2 diabetes puts you at risk, it’s likely to also be influenced by the lifestyle choices you make. Two significant risk factors for type 2 diabetes are being overweight or obese and not exercising regularly. These circumstances set the stage for type 2 diabetes. Some ethnic groups, including people of African-American, American Indian, Hispanic and Alaska Native descent, are more susceptible, and it also appears to run in families. Having had gestational diabetes also increases your risk for type 2. Being older — over 45 — has been considered a risk factor because blood sugar tends to rise slowly over time, but childhood obesity has made this type of diabetes more common among kids, according to the CDC. Still, it can take years before higher-than-normal blood sugar turns into full blown type 2 diabetes.
What are the symptoms of type 1 and type 2 diabetes?
Type 1 and Type 2 diabetes can share many of the same symptoms:
- Frequent urination, including waking up at night to go
- Increased thirst (which adds to the frequent urination)
- Unexplained weight loss
- Blurred vision
- Slow healing of sores, cuts and other skin injuries
- Tingling in the hands and feet
- Frequent infections
People with type 1 diabetes may also have nausea, vomiting and abdominal discomfort.
A key difference, though, relates to the onset of symptoms. With type 1 diabetes, symptoms can come on suddenly and be severe. With type 2 diabetes, they’re often subtle at first and easy to brush off. In fact, they may take years to become obvious. You can be in a stage known as prediabetes for a long time — that’s when blood sugar is elevated, but not high enough to be called diabetes.
Diagnosing and treating type 1 and type 2 diabetes
The same blood tests are used to diagnose both types of diabetes and distinguish type 2 from type 1. These include the A1C test, random blood sugar tests and a fasting blood sugar test. If type 1 is suspected, your doctor may also check your blood for auto-antibodies.
Insulin therapy is the primary treatment for type 1 diabetes, and it's something you will have to take for life. You'll also need to monitor your blood sugar frequently, sometimes several times a day.
With type 2 diabetes, medications depend on the severity of your diabetes. When diagnosed, many people are prescribed a drug called metformin to lower their blood sugar, according to the Mayo Clinic. You may also need to regularly check your blood sugar level. Other diabetes medications, including insulin, may be needed as the disease progresses.
For both types of diabetes, successfully managing the disease includes eating a healthy diet, exercising regularly and maintaining a healthy weight. One key difference is that you may be able to reverse type 2 diabetes with diet and exercise. Managing type 1 diabetes, however, requires taking insulin to replace what the pancreas has stopped making.
The key to living well with either condition includes working with your doctor to develop a comprehensive diabetes management plan that best meets your needs and then closely following it.
- JDRF, Type 1 and Type 2 Diabetes: What You May Not Know https://www.jdrf.org/blog/2017/11/01/type-1-type-2-diabetes-may-not-know/
- Cleveland Clinic, Diabetes Mellitus: An Overview https://my.clevelandclinic.org/health/diseases/7104-diabetes-mellitus-an-overview
- Mayo Clinic, Type 1 Diabetes https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011
- Mayo Clinic, Type 2 Diabetes https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/diagnosis-treatment/drc-20351199
- Mayo Clinic, Diabetes overview https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444
- JDRF, Basics https://www.jdrf.org/t1d-resources/about/
- CDC, Type 2 Diabetes https://www.cdc.gov/diabetes/basics/type2.html
- CDC, Type 1 Diabetes https://www.cdc.gov/diabetes/basics/type1.html
- CDC, Diabetes: Symptoms https://www.cdc.gov/diabetes/basics/symptoms.html
- CDC, Who’s at Risk? https://www.cdc.gov/diabetes/basics/risk-factors.html
- Mayo Clinic, Diabetes Diagnosis & Treatment. https://www.mayoclinic.org/diseases-conditions/diabetes/diagnosis-treatment/drc-20371451