There are two main type of diabetes — diabetes type 1 and diabetes type 2 — and whilst they both affect the way your body regulates blood sugar, or glucose, they are not the same condition. Here, we outline the main differences between diabetes type 1 and 2, and how each affects the body.
What is diabetes?
Diabetes is a rather complex condition where blood glucose levels become too high because the body produces little or no insulin — a hormone produced by the pancreas that regulates your blood sugar levels. It does this by breaking down the glucose (sugar) that's in your blood so that it can be stored or used for energy. Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy.
With diabetes, the body does not properly process food for use as energy. This is because your body either doesn’t make enough insulin, or it can’t effectively use the insulin it does make. As a result, this can lead to a drastic increase in blood sugar levels. If left untreated, high blood sugar from diabetes can damage your nerves, eyes, kidneys, heart, and other organs, and lead to a number of health issues, including heart disease, stroke, kidney disease, blindness and circulation problems.
What causes diabetes?
This is where it gets a little confusing. The amount of blood glucose that you have in your body typically depends on the foods that you eat. Therefore, when you eat sugary foods, your blood sugar levels will rise. But that doesn’t necessarily mean that if you eat too much sugar you’ll develop the condition, of if you stop eating sugar you won’t. It’s a little more complicated than that.
There are two main types of diabetes — type 1 and type 2. Whilst both types of diabetes essentially affect your body’s ability to process glucose that it needs for energy, there can be a number of factors — including genetics — that can cause the illness, and the cause of each type differs from person to person.
So what’s the difference between type 1 and 2 diabetes?
Type 1 Diabetes
Type 1 diabetes is, to put it simply, when your body doesn’t produce insulin.
It’s an autoimmune disease that occurs when a person’s immune system attacks and destroys insulin-producing cells in the pancreas — the pancreas is an organ below and behind the stomach that produces the hormone insulin — which results in little to no insulin in the blood. Insulin moves glucose into the cells to be stored and used for energy.
In type 1 diabetes, the pancreas is unable to produce insulin, which means the glucose that your body stores for energy stays in the bloodstream, rather than distributing to the cells like it’s supposed to. If the amount of glucose in the blood is too high, it can, over time, seriously damage the body's organs.
What happens to your body without insulin?
The digestive system breaks down carbohydrates into glucose, or sugar. This ‘sugar’ is then transported to each cell via the bloodstream. The pancreas then steps in to help the glucose migrate from the blood into the cells; it does this via insulin — the hormone produced by the pancreas that regulates your blood sugar levels. That glucose is then burned along with oxygen, to produce your body’s energy.
In type 1 diabetes, the pancreas stops making insulin because the cells have been destroyed by the body’s immune system. Without insulin, the body’s cells cannot turn glucose (sugar), into energy, so sugar builds up in your bloodstream instead.
When there’s not enough insulin in the body to let the glucose into the cells, it then tries to provide the cells with other sources of fuel, such as stored fats, instead of being used by your cells and muscles as fuel for energy.
Without insulin, cells are unable to use glucose as fuel and they will start malfunctioning.
If the glucose level is high enough, excess glucose is lost in your urine. This drags extra water into the urine causing more frequent urination, thirst and dehydration.
In type 1 diabetes, high blood sugar causes symptoms like thirst, hunger, and fatigue, and as a result, can cause devastating consequences that include damage to the nerves, blood vessels, and internal organs.
In addition, if your blood glucose becomes too high, the body will start to break down its own fat and muscle resulting in tiredness, fatigue and weight loss. If this continues, patients can become seriously ill and develop a short-term condition called diabetic ketoacidosis — when the bloodstream becomes acidic. This is when the body attempts to make new energy from fat and causes acids to be produced as waste products, called ketones.
High amounts of ketones can be extremely dangerous, and in severe cases can lead to coma and death if medical attention is not sought.
Diabetic Ketoacidosis is a serious condition that requires immediate attention. If someone with diabetes becomes confused or unconscious, call triple zero 000 for an ambulance.
What are the symptoms of type 1 diabetes?
The onset of type 1 diabetes is usually abrupt and the symptoms are obvious. Symptoms can include:
- feeling very thirsty
- passing urine more often than usual, particularly at night
- feeling very tired and weak
- always feeling hungry
- unexplained weight loss and loss of muscle bulk
- persistent infections such as thrush
- itching, skin infection and cuts that heal slowly
- blurred vision
- irritability and mood changes
- nausea and vomiting
What causes type 1 diabetes?
This condition commonly occurs in childhood, though it can be diagnosed later in life. It can start suddenly, and it tends to worsen quickly.
It’s not exactly known why the immune system starts attacking these cells, although experts know it’s not contributed to lifestyle choices. It’s thought that environmental factors can play a part, such as a viral infection — as the immune system fights against the virus, it starts to work unnecessarily against healthy cells, in this case, insulin-producing cells in the pancreas — or genetics. Type 1 diabetes can be passed down through families.
Type 1 diabetes can happen at any age but it tends to be more common in young people — more than 60% of people diagnosed with type 1 diabetes in Australia are aged under 25.
Currently there’s no way to prevent type 1 diabetes, and there is also no known cure.
What are the treatments for type 1 diabetes?
Although there is currently no cue for type 1 diabetes, it can be efficiently managed with insulin — people with type 1 diabetes will need to inject insulin in order to survive — and a healthy lifestyle.
It’s important that diabetes is diagnosed as early as possible. If left untreated, type 1 diabetes is a life-threatening condition. If your doctor thinks you might be diabetic, you will need to have various blood tests to measure your glucose levels, either after you’ve fasted between 12 and 14 hours, or a random blood glucose test, checked at various times during the day.
You may also be given an oral glucose test — a high-glucose drink followed by blood tests at regular intervals.
If you have type 1 diabetes, you’ll need insulin replacement, through regular injections or an insulin pump, to control your blood glucose levels. You'll be taught how to do this and how to match the insulin you inject to the food (carbohydrate) you eat, taking into account your blood glucose level and how much exercise you do. To keep your glucose levels normal and improve your overall health, it’s extremely important to stay physically active and maintain a healthy diet.
It’s also important to monitor your blood sugar levels regularly. You can do this by regularly testing droplets of blood in a glucose meter. You can also self-test urine with a test strip for high levels of ketones, but this is only necessary when symptoms of ketoacidosis arise — when your blood sugar is severely high and you experience symptoms such as:
- loss of appetite
- weight loss
- vomiting
- excessive passing of urine
- altered consciousness
Other treatments that can also help manage your symptoms include:
- regulating your diet — food intake must match insulin and exercise
- introducing more ‘slow’ carbohydrates into your diet, such as beans and fruit, which take longer for your body to absorb
- exercising regularly
- regular health check ups (including monitoring blood pressure and kidney function) to monitor for diabetes complications
- regular eye check ups
- podiatrist check ups monitor your feet for ulcers and other problems
Is type 1 diabetes dangerous?
If left untreated, type 1 diabetes can lead to a number of long-term health complications, and in severe cases, can be life-threatening. This is why early diagnosis and treatment is essential to prevent any further long-term health concerns.
Over time, having blood sugar levels that are consistently above the normal range can lead to serious complications, including:
- heart disease
- kidney disease
- stroke
- eye complications (blindness)
- foot infections (nerve damage and foot ulcers)
- nerve damage
- cognitive decline
- high cholesterol
- high blood pressure
In fact, cardiovascular disease – such as heart attack and stroke – is the main cause of death among people with diabetes. If you have diabetes, you can be up to four times more likely to have a heart attack or stroke than people who don’t.
Managing your blood pressure and your cholesterol is also extremely important to lower your risk.
Complications can also arise if your insulin is not balanced correctly with your food intake and exercise. If a person with type 1 diabetes skips a meal, exercises heavily, drinks too much alcohol, or takes too much insulin, their blood sugar levels will fall. This can lead to a ‘hypo’ (hypoglycaemic reaction), when the blood sugar levels are too low.
Symptoms of hypoglycaemia include dizziness, sweating, chills, hunger, headache, nausea, rapid heartbeat, fatigue and change in mood.
In mild cases, this can usually be remedied with a quick boost of sugar like jellybeans, glucose tablets, half a can of regular soft drink, half a glass of fruit juice or 3 teaspoons of sugar or honey, followed by something more substantial such as fruit, a tub of rice, pasta or a slice of bread. A person with type 1 diabetes should have sweets or lollies on hand at all times, just in case.
If blood sugar levels remain drastically low, or someone becomes slurred, unconscious or starts fitting, this is classed as severe hypoglycaemia and requires urgent medical attention. Call triple zero 000 for an ambulance.
A person with untreated type 1 diabetes is also at risk of developing diabetic ketoacidosis, which can be life threatening. Unlike hypoglycaemia where blood sugar levels are too low, DKA is related to hyperglycaemia, which occurs when there is too much sugar in the blood.
Without enough insulin, your cells don't get the glucose they need for energy, so the body begins to burn fat for energy instead. This leads to accumulation of dangerous chemical substances in the blood called ketones, which also appear in the urine. It’s a serious condition that can lead to diabetic coma (passing out for a long time) or even death.
Ketoacidosis is a medical emergency. If someone experiences any of the symptoms below, seek medical advice immediately:
- loss of appetite
- weight loss
- vomiting
- excessive passing of urine
- altered consciousness
- coma
Type 2 Diabetes
Unlike type 1 diabetes, when your body doesn’t produce insulin, with type 2 diabetes, the body still makes insulin, but it doesn't respond normally to the insulin the body makes. It’s therefore, more difficult for glucose to enter the cells and do its job of supplying energy.
Type 2 diabetes occurs when a person develops high blood glucose levels (known as hyperglycaemia). This is the most common type of diabetes, and it can develop later in life.
Blood sugar levels tend to rise when a person develops insulin resistance. This causes excess glucose to stay in the blood, reducing the cells’ ability to absorb and use blood sugar for energy. The body essentially becomes resistant to the normal effects of insulin and slowly loses its ability to produce enough insulin in the pancreas to break down glucose into energy stores. This can result in many of the same short-term and long-term health complications as type 1 diabetes.
It can take years to develop, and there are various contributing factors, including age, diet, lifestyle and genetics, that puts you more at risk.
What are the symptoms of type 1 diabetes?
Many people don’t have any symptoms, or symptoms are overlooked and can go undiagnosed for years. If they do experience symptoms, these can include:
- being very thirsty
- passing more urine
- feeling tired
- feeling hungry
- having cuts that heal slowly
- itching, skin infections
- blurred vision
- gradual weight gain
- mood swings
- headaches
- dizziness
- leg cramps
What causes type 2 diabetes?
Again, it’s not exactly known what causes type 2 diabetes, although it’s often associated with certain lifestyle factors — i.e. being overweight or obese, eating an unhealthy diet, not exercising enough — and it tends to run in families.
Eating large amounts of sugary foods for long periods of time can certainly increase your risk — obesity is one of the leading causes of type 2 diabetes — but there are a wide range of contributing factors, including genetics, and the natural rise of blood sugar that occurs as we get older, that can all increase the risk of developing the illness.
Type 2 diabetes is more likely to appear as people age, but it’s now becoming more prevalent in children, too. In this type, the pancreas produces insulin, but the body cannot use it effectively. This means glucose cannot enter the cells. Instead, it builds up in the blood, and can often lead to further health complications. Lifestyle factors appear to affect its development, although genetics and family history also play a part.
Risk factors for developing type 2 diabetes include:
- family history of type 2 diabetes
- being overweight or obese, especially with excess weight around the waist
- a low level of exercise
- poor diet
- being over 55 years of age — the risk of type 2 diabetes increases as we get older
- being over 45 years with high blood pressure
- are over 35 years of age and are from an Aboriginal or Torres Strait Islander background
- are over 35 years of age and are from Pacific Island, Indian subcontinent or Chinese cultural background
- are a woman who has given birth to a child over 4.5kgs, or had gestational diabetes when pregnant, or had a condition known as Polycystic Ovarian Syndrome.
What are the treatments for type 2 diabetes?
Symptoms can sometimes take years to appear. And whilst there is currently no cure for the condition, type 2 diabetes can be managed through lifestyle changes and, if required, diabetes medication, to help control blood sugar levels.
If your doctor thinks you might be diabetic, you will need to have various blood tests to measure your glucose levels, much the same as type 1 diabetes.
In the early stages, a person with type 2 diabetes does not need supplemental insulin. Instead, doctors will advise patients to make drastic changes in their lifestyle, such as exercising regularly, eating a healthy, balanced diet, as well as monitoring your blood glucose levels.
To help manage your diabetes symptoms and control your blood sugar levels, you should:
- eat a healthy diet — eat low GI food to help optimise your blood sugars, such as wholegrain breads, oats, legumes, fruit, pasta and dairy. Avoid high-carbohydrate, low-nutrient foods like cakes, sweets, and soft drinks, and eat a diet low in saturated fat.
- exercise regularly
- lose weight if you are overweight or obese
- quit smoking
- limit alcohol consumption
People may use a combination of medications, diet, and exercise from the early stages to reduce the risk or slow the disease. Although, as the illness progresses, they may need insulin therapy to manage their blood glucose levels in order to stay healthy.
What are the risks associated with type 2 diabetes?
Much like type 1 diabetes, type 2 diabetes can cause a number of chronic, long-term health complications, if the condition is not managed properly. If they go left untreated, they can become life-threatening.
Hypoglycaemia is one of the most common short-term effects of type 2 diabetes, when blood sugar levels are too low, as well as hyperglycaemia, when your blood sugars are way too high. This can cause diabetic ketoacidosis (DKA) and requires urgent medical attention.
Long-term complications can include heart disease, stroke, high blood pressure, high cholesterol, kidney disease, eye damage, foot infections, and nerve damage. It can also have serious effects on your mental health.
Diabetes is a difficult and challenging illness to live with. In fact, research shows that having diabetes more than doubles the risk of developing depression. If you do experience any feelings of depression, visit your GP who will be able to give you further advice, or provide a referral for counselling.
The best way to reduce your risk of developing any long- or short-term health complications, is to effectively manage your blood glucose levels, get regular check ups with your specialist — they will be able to give you all the help and advice you need to help mange your symptoms — and maintain a healthy lifestyle.
For further advice, you can visit diabetesaustralia.com.au
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