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November is National Diabetes Month, a month set aside each year to spread awareness of this disease, which is the seventh leading cause of death in the United States. According to the CDC (Centers for Disease Control and Prevention), over 38  million people in the United States have diabetes, and nearly 98 million U.S. adults have prediabetes. Of those with prediabetes, more than 81% don’t even know they have it. 

There are three main types of diabetes: Type 1, Type 2, and gestational diabetes. Gestational diabetes starts during pregnancy and tends to be temporary.  This article will focus on the differences and similarities between Type 1 and Type 2 diabetes and the treatment approach for each type. Here’s everything you should know about Type-1 and Type-2 diabetes.

What’s the Difference Between Type 1 and Type 2 Diabetes  

What is Diabetes?

Diabetes mellitus is a chronic hormonal condition that affects how your body breaks down food into energy. Most of the food that you eat is broken down to sugar (glucose) and released into your bloodstream, where it reaches cells in the body that use it for energy. Some glucose is stored for later use. 

A natural body hormone called insulin is produced in the pancreas and regulates the amount of glucose in the blood by acting like a “key” to allow the blood sugar to enter the body’s cells for use as energy. If you have diabetes, your body doesn’t make enough insulin or is unable to efficiently use the insulin it makes. 

What is Type 1 Diabetes?  

Type 1 diabetes is also called insulin-dependent diabetes. It is an autoimmune condition in which insulin producing beta cells in the pancreas are destroyed by the body’s immune system and are unable to make insulin. 

What is Type 2 Diabetes?  

Type 2 diabetes is also called non-insulin-dependent diabetes. It is far more common than Type 1 diabetes, and about 90-95% of people with diabetes have Type 2 diabetes. In Type 2 diabetes, your body doesn’t use insulin well and can’t keep blood sugar at normal levels. 

Prevalence of Type 1 vs Type 2 Diabetes  

According to the CDC’s national diabetes statistics, approximately 5-10% of the population with diabetes have type 1, and it is commonly discovered in children, teens, and young adults. 

Type 2 diabetes is also called adult-onset diabetes since it typically develops after age 35. However, a growing number of younger people are now developing type 2 diabetes.

What Is The Main Difference Between Type 1 And Type 2 Diabetes?

The main difference between type 1 diabetes and type 2 diabetes is:

• Type 1 diabetes is an autoimmune condition in which the immune system in the body attacks the cells in the pancreas that produce insulin. As a result, the pancreas makes little to no insulin. People with type 1 diabetes must, therefore, be treated with daily insulin injections.

• Type 2 diabetes is a condition in which the pancreas makes less insulin than it should and the cells in the body become resistant to insulin (this is called insulin resistance and it means that while the body has insulin, it can't use the insulin properly). People with type 2 diabetes can be treated with lifestyle changes, oral diabetes medications (tablets), and insulin injections.

Note: Gestational diabetes is diabetes mellitus that is first diagnosed during pregnancy. It occurs when the pregnant woman’s body cannot make enough insulin to meet the increased demands during pregnancy, resulting in high blood sugar. Gestational diabetes can cause problems for both mother and baby, but early diagnosis and proper management can reduce the risks. Gestational diabetes usually goes away after pregnancy.

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Symptoms of Diabetes Mellitus

Common Type 1 Diabetes Symptoms

Common symptoms and warning signs of type 1 diabetes include: 

• Polydipsia (increased thirst)

• Polyuria (increased urination)

• Polyphagia (extreme hunger)

• Rapid weight loss

• Blurred vision

• Extreme fatigue

• Nausea

• Vomiting 

• Abdominal pain

Common Type 2 Diabetes Symptoms

According to the American Diabetes Association, many of the symptoms of type 2 diabetes are similar to type 1 diabetes, but they may present in very different ways. It’s common for people with type 2 diabetes to not have symptoms for many years in the early stages or possibly ever at all. 

The lack of symptoms can be dangerous because it can leave the condition undiagnosed for so long that other diabetes complications develop, such as heart disease, kidney disease, diabetic neuropathy (nerve problems), and diabetic retinopathy (eye problems). 

Some of the symptoms and warning signs of type 2 diabetes to be aware of include: 

• Polyuria (frequent urination)

• Polydipsia (extreme thirst)

• Polyphagia (increased hunger)

• Numbness and tingling or nerve pain in hands and feet

• Slow healing wounds

• Frequent infections

• Blurred vision

• Unintended weight loss

• Dark skin patches in the neck and armpits

Risk Factors for Diabetes Mellitus

Risk Factors For Type 1 Diabetes Mellitus 

• Family history: Having a close family member (parent, sibling) with type 1 diabetes can slightly increase the risk of developing this condition.

• Genetics: Certain genes have been linked to a higher risk of developing type 1 diabetes.

• Age: Diagnosis of type 1 diabetes peaks in two specific age windows: between 4 and 7 years of age and between 10 and 14 years of age.

• Geographical location: The prevalence of type 1 diabetes is higher in places located further away from the equator.

Risk Factors For Type 2 Diabetes Mellitus 

• Excess body weight or weight gain: being overweight or obese.

• Belly fat or abdominal obesity: waist circumference above 40 inches in men and above 35 inches in women. 

• Lack of physical activity. 

• Family history of type 2 diabetes in a close relative (parent or sibling).

• Race: People of Black, Hispanic, Asian, Pacific Islander, and Native American races and ethnicities are at a higher risk. 

• Abnormal blood cholesterol levels: low high-density lipoprotein (HDL) which is the “good” cholesterol and high triglycerides. 

• Age above 35 years. 

• Prediabetes: a condition in which there is high blood sugar but it does not qualify as diabetes; left untreated, prediabetes can progress to Type 2 diabetes). 

• Gestational diabetes: those who had high blood sugar during pregnancy are at a higher risk of developing type 2 diabetes mellitus. 

• Polycystic ovary syndrome (PCOS) is linked to a higher risk of type 2 diabetes.

Causes of Diabetes  

Causes of Type 1 Diabetes  

Type 1 diabetes is an autoimmune disorder that occurs when the body’s immune system attacks insulin-producing cells in the pancreas. The exact reason why this happens is unclear. Both genetic and environmental factors, such as exposure to viruses, are believed to play a role. 

Causes of Type 2 Diabetes  

Type 2 diabetes occurs because the pancreas does not make enough insulin and because cells in the body (liver, fat, and muscle cells) become less responsive to insulin (this is called insulin resistance). As a result, more glucose stays in the bloodstream, leading to hyperglycemia or high blood sugar levels. The exact reason why this occurs is unknown, but obesity and a sedentary lifestyle are key risk factors. 

Prevention Strategies

There is no way to prevent type 1 diabetes, but it can be well-managed, thus increasing the quality of life for people with Type 1 diabetes. 

Research suggests that a Diabetes Prevention Program can delay/reduce the risk of developing type 2 diabetes by losing weight, eating healthy, and being active. 

Taking your prescription medicines, including insulin regimens, as prescribed and keeping up with healthcare appointments can also help reduce the impact of diabetes on daily life and diabetes-related long-term complications. Learn more about preventing diabetes through healthy habits.

Treatment and Management  

Lifestyle and Dietary Recommendations

Your healthcare provider will recommend making healthy lifestyle modifications to keep blood sugar levels in a healthy range. The key components of diabetes treatment are:

• Healthy eating: Eat a healthy, balanced, low-calorie diet that includes fruits and vegetables, whole grains, low-fat dairy, healthy fats, lean proteins, and other nutrients. Avoid high-fat, high-sugar foods.

• Regular exercise: Aim for at least 150 minutes of moderate-intensity aerobic activity and one or two sessions of weight training each week.

• Weight loss: If you are overweight or obese, take steps to maintain a healthy weight.

• Sleep: Get enough sleep (the recommendation is for 7 to 8 hours each night).

• Stress management: Manage stress by spending time in nature, exercising, deep breathing, and relaxation techniques.

• Blood sugar monitoring: It is important to follow your doctor’s advice and check blood sugar levels regularly. This can help your doctor decide when to prescribe medications and adjust the doses.

• Taking insulin or oral diabetes medication: If lifestyle changes don’t control blood glucose, your doctor will prescribe medications to treat diabetes.

Insulin Therapy for Type 1 Diabetes  

Type 1 diabetes is treated with insulin, which must be taken by injection, although some needle-free devices are now available. As mentioned above, insulin acts as the “key” to bring glucose into the cells. 

The process of managing blood sugar levels can be challenging, as you don’t always know how much insulin your body needs. The amount is based on many factors, including food, exercise, stress, and overall health. If you take too little insulin, your body can go into hypoglycemia, which is an extreme drop in blood sugar. If you take too much insulin, your body can go into hyperglycemia, raising your blood sugar to a dangerously high level. 

Today, there are a wide range of devices, such as an insulin pump or insulin pen, to help people taking insulin better manage their blood sugar levels, many being needle-free.

There are also different types of insulin available that vary in terms of how quickly they start working and how long their effects last. Your healthcare provider and diabetes care team will develop a diabetes treatment plan that includes both short-acting and long-acting insulin to maintain blood glucose control at mealtimes, throughout the day, and overnight. Your insulin types, doses, and schedule will change based on blood sugar control.

Treatment Options for Type 2 Diabetes  

• Metformin (Glumetza, Fortamet) is usually the first medicine prescribed for type 2 diabetes mellitus. Metformin is an oral medicine that improves insulin sensitivity.

• Sulfonylureas such as glipizide (Glucotrol XL), glyburide (Glynase, DiaBeta), and glimepiride (Amaryl) help the pancreas make more insulin. 

• Glinides such as repaglinide and nateglinide stimulate the pancreas to release more insulin. 

• Thiazolidinediones such as pioglitazone (Actos) increase insulin sensitivity. 

• DPP-4 (dipeptidyl peptidase-4) inhibitors such as saxagliptin (Onglyza), sitagliptin (Januvia), alogliptin (Nesina), and linagliptin (Tradjenta) lower blood sugar levels.

• SGLT2 (sodium-glucose cotransporter-2) inhibitors such as dapagliflozin (Farxiga), canagliflozin (Invokana), and empagliflozin (Jardiance) help the body eliminate glucose in urine. 

• GLP-1(glucagon-like peptide-1) receptor agonists such as liraglutide (Saxenda, Victoza), exenatide (Byetta, Bydureon Bcise), semaglutide (Rybelsus, Ozempic, Wegovy), dulaglutide (Trulicity) regulate blood sugar levels and slow digestion. Some of these medications are FDA-approved for chronic weight management.  

• Dual GIP/GLP-1 (glucose-dependent insulinotropic) polypeptide/glucagon-like peptide-1) receptor agonist: tirzepatide (Mounjaro, Zepbound) 

• Insulin therapy: People with type 2 diabetes who don’t respond to lifestyle changes and oral medications may need to take insulin.

• Other medications: People with type 2 diabetes may need to take medications for high blood pressure and high cholesterol, as well as low-dose aspirin to lower the risk of heart disease.

Emotional and Psychological Impact  

Emotional Challenges for Type 1 Diabetics  

People with type 1 diabetes can experience a range of emotional challenges, including: 

• Depression (feelings of sadness and hopelessness) related to the diagnosis of a chronic health condition. 

• Anxiety (due to fears and worries about the health implications of the diagnosis and life-threatening diabetes complications like hypoglycemia (low blood sugar) and diabetic ketoacidosis or DKA).

• Stress (due to the constant need to monitor blood glucose levels and manage the condition). 

• Social isolation and poor self-esteem.

These mental health issues can make diabetes worse and vice versa. Some strategies that can help in managing mental health problems related to a type 1 diabetes diagnosis include cognitive behavioral therapy (CBT) and support groups.

Coping with Type 2 Diabetes  

Some of the measures that can help you cope with a diagnosis of type 2 diabetes and control blood glucose levels: 

• Use technology: You can use continuous glucose monitors, insulin pumps, smart watches, and smartphone apps to help you manage your diabetes. 

• Talk with others: You can talk with your healthcare team, family, friends, or other people with diabetes to learn about the condition and how to manage it. 

• Join support groups: You can connect with people who also have type 2 diabetes to feel less alone and learn coping skills. 

Support Systems and Resources

There are many resources and support groups for diabetes, including: 

• Online communities, support groups, and forums on social media platforms like Facebook, Instagram, Twitter, and TikTok. You can also find online forums on sites like Diabetes Daily, Smart Patients, Type2Diabetes.com, DiabetesForum.com, DiabetesSisters, Beyond Type 1, Beyond Type 2, and TuDiabetes. 

• Health organizations such as the American Diabetes Association (ADA) and Centers for Disease Control and Prevention (CDC) have online educational materials and support communities. 

• Other health organizations that offer support services for people with diabetes include the Association of Diabetes Care & Education Specialists (ADCES), the College Diabetes Network, the Endocrine Society, and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Frequently Asked Questions  

Can You Reverse Type 2 Diabetes?

Yes, you can reverse type 2 diabetes and pre-diabetes with a healthy lifestyle, such as eating a healthy diet, getting regular exercise, and losing weight if you are overweight or obese. 

Do Type 1 Diabetics Take Insulin?

Yes, people with type 1 diabetes must take insulin injections every day to control their blood sugar levels. Type 1 diabetes occurs because of an autoimmune reaction where the immune system destroys cells in the pancreas that make insulin hormone. 

Does Type 2 Diabetes Require Insulin?

People with type 2 diabetes may require insulin if other treatments like lifestyle changes and oral diabetes medications (tablets) are not enough to control blood glucose levels.