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Diabetes – differences between type 1 and type 2

People often get confused between the different types of diabetes so I have clarified below:

Type 1 Diabetes Mellitus

Type 1 Diabetes Mellitus accounts for 10% all cases. It is an auto-immune condition, where the body attacks the pancreatic islet cells which are responsible for the production and secretion of insulin, which is why people with this form of diabetes are known as insulin-dependent.

This type of diabetes is usually early-onset in children and adolescents, however an increasing number of adults are being diagnosed with type 1 diabetes. There is some genetic predisposition. Studies have shown that feeding a genetically susceptible child formula or cow’s milk too young also been linked with the development of antibodies associated with type 1 diabetes. These antibodies to the beta cells which produce insulin could also be produced in response to things like chemicals, viruses such as rotavirus and enterovirus, food allergies or environmental factors. Risk factors include gut abnormalities, omega 3 and vitamin D deficiency.

Treatment for type 1 diabetes involves maintaining a steady blood glucose level and focusing on prevention of problems that might occur in later life. Insulin is required and there are a number of different preparations such as injections which last different durations, or insulin pump therapy. It’s important to monitor blood glucose levels and you will do this yourself both before and after meals. Your doctor should also measure your glycated haemoglobin levels (HbA1c), which measures the amount of haemoglobin and the glucose attached to it over a three-month period. Diet also plays an important role with carbohydrate counting, a method of measuring carbohydrate intake in order to improve insulin dosage and response.

Type 2 Diabetes Mellitus

Type 2 Diabetes Mellitus is not an auto-immune condition. The beta cells in the pancreas have not been destroyed and rendered unable to produce insulin. For type 2 diabetics, it’s the sensitivity of the insulin receptor in the body’s cells that has been reduced as the individual has become increasingly insulin resistant.

There is a huge genetic component here but obesity is the overarching contributor as 90% of type 2 diabetes sufferers are classified as obese. Obesity plays a large role not only in insulin resistance but because there are other inflammatory factors such as leptin and tumour necrosis factor which are secreted by fat cells and interfere with the action of insulin. Other risk factors include sedentary lifestyle, endocrine disorders such as polycystic ovarian syndrome (PCOS), high blood pressure and high triglyceride levels in the blood.

Type 2 diabetes is typically also known as late onset diabetes but it must be noted that it’s becoming increasingly common in younger generations. In September of this year, a 3-year-old toddler in Texas was diagnosed with type 2 diabetes – the youngest case ever recorded. Dietary, weight and lifestyle changes are the first line treatment but in some cases, medication or insulin may be given when blood glucose targets are not met. Aerobic exercise may stimulate non-insulin dependent glucose transport into cells and improves insulin and glucose tolerance. It’s also important to manage blood sugar and cholesterol levels. Smoking should be stopped immediately!

It is worth noting that some mothers may suffer from gestational diabetes during pregnancy. This occurs in approximately 3-10% of all pregnancies and risk factors include a sedentary lifestyle and adolescent obesity. This does not have a big impact on the mother but may increase the size of the baby, which will make birth more difficult. It also increases the risk of the child suffering type 2 diabetes later in life due to exposure to a high sugar environment in the womb.
Next week I will be looking at the complications of diabetes, I hope you join me to find out more!

Want to know more about Healthy Blood Sugar Management? Carolina is running a webinar on the 12th January looking at this topic as well as how to prevent & reverse Type 2 diabetes.