T1D vs T2D
This may seem basic to some but the reality is that when you or a loved one is diagnosed with T1D you may really know nothing about it. Immediately you are overwhelmed with a medical crisis that needs 24/7 attention. Soon, you learn, more than you ever wanted to.
For most people Diabetes is a single condition, they are not really sure what Type 1 and Type 2 are, and pretty much have no idea of the dramatic differences between the two…..so, here is a little guide for those uninitiated.
There are 37 million diabetics in the US (as of 2023) and 90-95% of them are Type 2. There are 1.4 million people in the US living with Type 1.
Type 1 diabetes was formerly known as insulin dependent diabetes or more commonly as juvenile diabetes. It was once thought that only children develop Type 1 and only adults develop type 2. We now realize that 50% of those diagnosed with Type 1 are actually over the age of 18. Historically many adult onset Type 1 people were mistakenly identified as having Type 2.
Type 1 diabetes is an autoimmune disease. The immune system attacks the cells (known as beta cells, located in the pancreas) that produce insulin. Over a period of months or years the beta cells are slowly killed off until the body cannot produce enough insulin to survive. Insulin is critical for the body to utilize sugar (glucose) for energy. When the cells cannot use the sugar that is in the blood stream from the food we eat then the cells think they are starving and start to burn fat for energy. As a result of fat burning, ketones and acids build up in the body. Patients become severely ill and can die from a condition known as Diabetic Keto Acidosis (DKA).
My son Brian was 21 when he was diagnosed. He texted from his college internship in San Francisco: “Mom, I think I have diabetes, I have lost a ton of weight, am thirsty all the time and pee all the time. I am craving sugar.” Brian exhibited some common signs. We flew him home the next day and his blood sugar was 4 times normal. He got his first shot of insulin and his life long diagnosis: T1D
He was lucky, an adult who grew up with a diabetic grandmother (if you have a close relative with T1D your risk of developing it is increased 17 times). He knew the signs and diagnosed himself before he developed DKA. Unfortunately it is not unusual for the first sign of T1D that is recognized is the development of DKA which lands them in the hospital, critically ill. Then there is a crash course in insulin, diet, needles, syringes and constant vigilance to stay well.
Who gets T1D? T1D starts with a certain genetic make up. It is unknown what triggers the immune system to attack the beta cells in these susceptible people. We do know that it is currently irreversible, although there are drugs that can delay the onset of T1D if caught very early.
The first thing that happens (that we can detect) is the person develops autoantibodies in the blood. These can be detected with a simple screening blood test. Someday, all children will be screened to identify who will eventually develop Type 1. Once identified, treatments that slow it down can be given and the risk of DKA will be all but eliminated.
Type 2 diabetes is more of a problem with metabolism. Insulin is being produced but not being used effectively because of excess weight and lack of exercise. It can be reversed by improving life style. My own brother developed Type 2 . He was able to reduce is diabetes medications by losing a significant amount of weight.
My son with Type 1 cannot survive without outside insulin no matter what life style changes are made.
Breakthrough T1D is the largest supporter of T1D research in the world. The vision is a world without T1D. The mission is to accelerate life-changing breakthroughs to cure, prevent and treat Type 1 Diabetes.
The ultimate goal is a CURE!