Type 1 Diabetes vs. Type 2 Diabetes

Until my son was diagnosed, I never gave much thought to the different types of diabetes. I knew a little bit about Type 1 diabetes because a good friend in high school had it. She was the only person I knew with Type 1. That was a long time ago, and management was much different. I remember spending time at her house, talking with her mom to learn about diabetes, and encouraging her to take care of herself. In the late 90s, I actually interviewed with two companies making diabetes products and spent time talking with a Certified Diabetes Educator (CDE) and endocrinologist about the technologies. The most common form is Type 2 diabetes, so when people hear the word diabetes that is what they associate it with. And while I was pregnant, I had gestational diabetes - and unfortunately wound up on insulin. My blood sugar was never actually very high (I don't remember any readings over 180!), but my body didn't absorb insulin as predicted. As a result, they had me check my blood sugar every three hours around the clock. Talk about being exhausted before having a newborn!!! Gestational Diabetes (GDM) predisposes me to Type 2: about 50% of people with GDM develop Type 2 within 10 years. I remember saying, repeatedly, that I couldn't imagine having to check my blood sugar and take insulin for the rest of my life. It was actually my greatest fear.

So I guess life thought it would be funny to make me face my fears. I'm still at risk for Type 2 and work with an endocrinologist to attempt to stave it off. But what I envisioned living with Type 2 to be like is a far cry from the complexities of managing Type 1.

All forms of diabetes involve the hormone insulin that is produced by the beta cells within the pancreas. The simplest way to understand the role of insulin is to think of the bloodstream as a long hallway with doors running along it. Sugar in the bloodstream needs to get through those doors into the cells to give them energy. Insulin acts as a key to those doors. Without enough insulin, sugar builds up in the bloodstream and you wind up with high blood sugar. With too much insulin, too much sugar goes into the cells and you wind up with low blood sugar (hypoglycemia). In someone without diabetes, this process occurs naturally. When you eat, the pancreas releases the right amount of insulin to regulate blood sugar and keep the cells adequately fueled.

Type 1 diabetes is a chronic, autoimmune condition in which the body attacks the beta cells within the pancreas. The cells stop producing insulin. A person with Type 1 is considered an insulin-dependent diabetic, and must have insulin on a regular basis to live.

Type 2 diabetes is a condition in which the body doesn’t respond to insulin correctly. In other words, the body loses it’s insulin sensitivity and sugar levels in the blood remain high. Type 2 diabetes can often be controlled with oral medications, and diet and lifestyle changes can also be beneficial in reducing blood sugar. In Type 2, over time, the body can also stop producing sufficient insulin and insulin injections then become necessary.