Type 1 vs. Type 2 Diabetes

Diabetes-related complications make up approximately 50 percent of my practice as a hospital-based internist here in Central Texas. This fact surprises many of my friends who aren’t in the health-care field, even though almost everyone knows someone with diabetes. The prevalence of this disease that affects so many of our friends, family members, and coworkers means most of us are slightly familiar with diabetes, but may not understand how potentially dangerous it can be.

What is Diabetes?

Diabetes is a group of diseases characterized by high blood glucose levels that result from defects in the body’s ability to produce (Type 1) or use (Type 2) glucose.
Type 1 diabetes usually starts showing symptoms early in life and is often diagnosed in childhood or adolescence. In Type 1 diabetes, the body stops producing insulin, a hormone produced by the body that allows cells to take in glucose (a form of blood sugar)—an important step in the body’s daily functioning. By contrast, in Type 2 diabetes, the body becomes resistant to insulin. Type 2 diabetes is often symptom-free and can be preventable. According to the American Diabetes Association, 25.8 million Americans have diabetes—approximately 8.3 percent of the population.

Type 1 vs. Type 2

Physicians use the “polys” as clues to help diagnose Type 1 diabetes. These include polydipsia (drinking a lot of fluids), polyphagia (eating a lot), and polyuria (urinating a lot).  A blood check confirms the diagnosis. When the body becomes insulin-deficient, treatment includes the addition of insulin in the form of daily injections. There is a genetic or immune-system link to Type 1 diabetes in approximately 50 percent of diagnoses.
Type 2 diabetes is a condition where the body becomes insulin-resistant. This means the body can’t use insulin properly for the correct absorption of glucose. While there are some genetic links to Type 2 diabetes, it is mainly a disease that’s affected by lifestyle choices—such as diet, weight gain, and lack of exercise that stress the body.

Sometimes Silent—And Deadly—Disease

While Type 1 diabetes usually shows symptoms that make it easier for a physician to diagnose, Type 2 is often called “the silent disease” because of its lack of symptoms. Most often, this disease is picked up by physicians through a blood test given as part of an annual physical or as a diagnostic tool for another condition. The silent nature of the disease underscores the importance of regular check-ups with your family physician or internist.
Left untreated, diabetes causes high blood sugar to regularly circulate throughout the body. Hyperglycemia or high glucose levels in the blood damages small blood vessels in the eyes and kidneys and in other parts of the body. In fact, diabetes is the No. 1 underlying factor in patients receiving kidney dialysis, a treatment where machines must cleanse a patient’s blood on a regular basis as the kidneys no longer function properly. Damage to small blood vessels in the eyes, extremities (such as the toes), and kidneys sometimes leads to feared diabetic complications such as blindness, toe amputation, and kidney failure. In addition, diabetes causes damage to bigger blood vessels such as those supplying blood to the heart and brain and can lead to strokes and heart attacks.

By the Numbers

According to the American Diabetes Association, from 1980 to 2011, the number of U.S. adults with diagnosed diabetes more than tripled from 5.5 million to 19.6 million. It is estimated that by 2050, one in three adults will suffer from Type 2 diabetes. If you don’t know someone with diabetes now, it’s likely that you will at a not-so-distant point in the future. And Texas is not immune to these growing statistics. More than 1.8 million Texans currently suffer from Type 1 or Type 2 diabetes.
Unfortunately, some ethnicities have a much higher incidence of developing Type 2 diabetes: American Indians, Hispanics, and African-Americans all have a greater chance than Caucasians. While you may not be able to alter your ethnicity, you can control your weight, diet, and how much you exercise.

Developing Diabetes

Along the way to developing Type 2 diabetes, a patient’s body begins to process glucose less efficiently; this condition is known as pre-diabetes. Knowing your blood sugar levels, especially if you have a family history or ethnic link to diabetes, can allow you to take the necessary steps to avoiding the jump to full-blown Type 2 diabetes with its many possible complications.

Pre-diabetes can usually be controlled with healthy food choices, physical activity, and weight loss. Pre-diabetic patients still have time to help the body before major damage is done. If the pre-diabetes advances to Type 2 diabetes, insulin or oral medication may be necessary. Once diagnosed with Type 2 diabetes, patients can often be weaned off their medication once they apply a regimen of weight loss, exercise, and better nutrition.

Fifty years ago, Type 1 was commonly called “childhood” diabetes and Type 2 was “adult onset” diabetes. As the incidence of overweight and obese children and adolescents has increased over the years, those terms have fallen out of use. Physicians see more and more children whose bodies are becoming resistant to insulin. These Type 2 diabetics face a lifetime of medical complications.

Fitness and Diabetes

Type 1 diabetes can occur in any number of people because there is often a genetic or immune system link in approximately 50 percent of people diagnosed with diabetes. Since Type 2 diabetes usually develops when the body has been stressed by excess weight and lack of exercise, it is less likely that a fit person will develop Type 2 diabetes.
Since lifestyle choices play a strong factor in the development of Type 2 diabetes, this silent disease can often be prevented with a healthy diet that is low in carbohydrates and sugars and high in fruits and vegetables. Regular exercise plays an important role, as muscle mass helps the body use insulin more effectively.

According to the Centers for Disease Control, a person with diabetes has a shorter life expectancy and about twice the risk of dying on any given day as a person of a similar age without diabetes. You can avoid becoming a diabetes statistic by eating right, exercising daily, and checking your blood sugar levels on a regular basis.