Type 1 Vs. Type 2 Diabetes

Diabetes is more than just blood glucose. It can involve a lot of balancing. And each type can look different. Here’s what to know.

What is diabetes?

Diabetes is a condition that impacts how your body uses food and turns it into energy.

“When you eat, your body breaks down your food into a type of sugar known as glucose,” says Aparna Baburaj, MD, endocrinologist at Geisinger. Then it releases it into your bloodstream. As your blood glucose rises, it tells your pancreas to release a hormone known as insulin. Insulin is a compound that allows blood glucose to enter your body’s cells for energy.

“When you have diabetes, your body either doesn’t make enough insulin, doesn’t make any insulin or can’t use insulin effectively. As a result, glucose builds up in the bloodstream instead of entering cells to provide energy,” Dr. Baburaj says.

There are 2 main types of diabetes: Type 1 and Type 2. While both can cause similar symptoms, they are different conditions.

The difference between Type 1 and Type 2 diabetes? The cause.

Type 1 diabetes

This type is typically diagnosed in children or young adults. But it can occur at any age.

“Type 1 is an autoimmune condition where the body mistakenly destroys the cells that make insulin,” says Dr. Baburaj.

Without enough insulin, glucose cannot efficiently enter cells and instead accumulates in the bloodstream. Over time, that increase in glucose can damage healthy tissue.

With Type 1 diabetes, the onset of symptoms tends to be fast. Symptoms may include:

Being very thirsty
Fatigue
Frequent urination
Unintended weight loss
Bed wetting in children
Blurry vision

Type 2 diabetes

Type 2 diabetes is commonly diagnosed later in life, after age 35, but it can happen at any age.

“Unlike Type 1, Type 2 isn’t an autoimmune condition,” Dr. Baburaj notes.

Type 2 diabetes develops due to insulin resistance and a gradual decline in insulin production. Several factors increase the risk, including:

Family history
Excess body weight
Physical inactivity
Older age
History of gestational diabetes
Certain ethnic backgrounds

Both types share symptoms. But with Type 2, symptoms tend to progress more slowly than they do with Type 1. In early stages, you may not notice any symptoms.

“Type 2 diabetes can go undiagnosed for years,” says Dr. Baburaj. But as the condition progresses, you may notice symptoms like:

Frequent infections
Numbness or tingling in your hands or feet (also known as neuropathy)
Slow-healing wounds

Similarities between the two

Despite different causes, Dr. Baburaj notes Type 1 and Type 2 diabetes share key features. They both:

Result in chronic hyperglycemia because insulin is absent, insufficient or doesn’t work effectively
Carry the risk of the same long-term complications
Are diagnosed using the same laboratory criteria, which generally require confirmation on a repeat test unless blood glucose is markedly elevated with classic symptoms
Require lifelong management, including blood glucose monitoring, attention to diet and physical activity and regular screening for complications
Involve genetic and environmental factors

Managing diabetes

Type 1 diabetes requires lifelong insulin replacement — there is no alternative.

Most of the time, insulin can be delivered through a pump instead of injections. Pumps are commonly paired with continuous glucose monitors (CGM) to measure blood glucose without having to prick your finger.

Unlike Type 1, Type 2 diabetes can often be managed through lifestyle modifications, including diet and exercise.

“Some people with Type 2 diabetes can achieve remission through significant weight loss and sustained lifestyle changes, although ongoing monitoring remains important,” says Dr. Baburaj.

If lifestyle changes don’t help control symptoms, medications can be used to help lower glucose levels. Regular insulin may be needed if diabetes isn’t well controlled with other treatments.

No matter which type you have, careful management and treatment are key to feeling your best. Untreated or uncontrolled diabetes can lead to serious complications, like:

Heart or kidney disease
Damage to small blood vessels that can lead to vision loss
Nerve damage
Foot ulcers and infections
Amputations

Untreated diabetes can also raise your risk of heart attack or stroke.

What to do if you have symptoms

Many conditions can cause symptoms similar to diabetes. However, if you notice increased thirst, frequent urination, unexplained weight loss or other symptoms, start by talking to your healthcare provider.

Based on your symptoms, they may order testing to measure blood glucose levels as well as other tests. The sooner you’re diagnosed, the sooner you can start treatment, so you can get back to feeling like yourself again.