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You’ve likely heard of diabetes, a common category of disease that affects millions of people across the globe. Yet, many may not realize that there are two different forms of diabetes: Type 1 and Type 2.

Both types of diabetes cause similar symptoms and need lifelong management after diagnosis. But the two diseases have different causes. It’s an important distinction that leads to different treatment approaches for these two diseases.

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Differing Causes

The first difference between type 1 and type 2 diabetes is the cause of the disease. Type 1 diabetes, for example, is an autoimmune condition. In Type 1 diabetes, the immune system attacks the beta cells in the pancreas that make insulin.

Insulin is a hormone that helps your body use the sugars in your blood. If insulin levels aren’t right, you may end up with blood sugar levels that are too high or too low.

The body can’t make enough insulin if too many beta cells have died. When the body does not make enough insulin, cells can’t take up the glucose they need to produce energy. Consequently, glucose builds up in the blood leading to high blood glucose (or blood sugar) levels.

Over time, high blood glucose can lead to complications like heart problems, kidney issues, vision loss, and even nerve damage. According to the Centers for Disease Control and Prevention (CDC), approximately 1.3 million Americans live with Type 1 diabetes.

Doctors have long referred to Type 1 diabetes as “juvenile” diabetes because most diagnoses occur during childhood or teen years. And while researchers don’t know exactly what causes Type 1 diabetes, they know that it increases family members risk of having an autoimmune disease, including Type 1 diabetes or others.

On the other hand, Type 2 diabetes develops much later in life, usually in middle age. It is a condition caused by a breakdown in the metabolic pathways that regulate insulin and blood sugar levels. The body becomes resistant to insulin, making it harder for your cells to take up glucose and convert it to energy.

This disease affects far more people than Type 1 diabetes. According to the CDC, more than 20 million Americans live with Type 2 diabetes.

Genetics plays a role in if you may develop Type 2 diabetes. It is more common in some families — especially those of Black and Hispanic ethnicities. But environmental factors like an unhealthy diet and lack of exercise also play a role in whether or not someone develops this disease.

Overlapping Symptoms

The basic symptoms of Type 1 and Type 2 diabetes are similar: excessive thirst, increased urination, and extreme fatigue. That’s often what leads them to make an appointment with their doctor.

But how these symptoms appear differs between the two types of diabetes. In people with Type 1 diabetes, symptoms have a quick onset, while Type 2 diabetes symptoms have a slower progression.

Elevated blood glucose levels can lead to weight loss in either Type 1 or Type 2 diabetics. Often patients with Type 1 diabetes do not notice weight loss before they get a diagnosis.

Also, Type 2 tends to develop slower than Type 1. That gradual progression means some people may get a diagnosis of prediabetes (higher-than-normal blood sugars). They can then change their diet or exercise regimen to prevent Type 2 diabetes.

Varying Approaches to Management

Whether you’re diagnosed with Type 1 or Type 2 diabetes, you’re in for a lifetime of management. But how you manage diabetes also depends on which type you have.

People living with Type 1 diabetes have permanently lost their insulin-producing cells and must inject insulin to compensate for it. They check their blood sugar levels several times a day or use a continuous glucose monitor. Their glucose numbers help to determine how much insulin to take.

Some individuals diagnosed with Type 2 diabetes may also require insulin therapy, but most can manage their condition in other ways. A healthy diet and regular aerobic exercise can improve Type 2 diabetes for some, reducing the need for medicine. For others, non-insulin medications like repaglinide (Prandin) or metformin (Fortamet) can regulate blood sugar without insulin.

If you think you have diabetes, talk to your doctor. They’ll review your medical history and current symptoms and come up with the best plan of action. Your healthcare practitioner will help you manage your condition.

World Health Organization. Diabetes. Link.

Juvenile Diabetes Research Fund. Diabetes Basics. T1D Basics - JDRF. Link.

Juvenile Diabetes Research Fund. What is the Cause of Diabetes Type 1? - JDRF. Link.

American Diabetes Association. The path to understanding diabetes starts here. Link.

American Diabetes Association. Type 2 Diabetes - Symptoms, Causes, Treatment | ADA Link.

Juvenile Diabetes Research Fund. Diabetes Symptoms: Early Warning Symptoms & Signs of Diabetes Link.

American Diabetes Association. Prediabetes | ADA. Link.

Juvenile Diabetes Research Fund. Treatments - JDRF Link.

About Endocrinology

The UPMC Department of Endocrinology stands as a national leader in research of diabetes and endocrine conditions. We partner with the University of Pittsburgh Division of Endocrinology and Metabolism for research and clinical trials. We treat diabetes, obesity, osteoporosis, hormonal disorders, and thyroid disorders at several locations across our communities. We also have specialized Diabetes Centers to help you manage your disease. Find an expert near you.