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November 28, 2013

Type 1 and 2 diabetes: What’s the difference?

Though both types of diabetes are often confused because they have the same symptoms, they actually have very different causes.

Diabetes was front and centre recently with actor Tom Hanks’ announcement that he’d been diagnosed with the type 2 variety. His news undoubtedly left many wondering: Just what is type 2 diabetes, and how is it different from type 1? 

Type 1: the facts

“Type 1 diabetes occurs when the body is no longer able to make insulin (the hormone that enables the body to use glucose as fuel), because the cells that make insulin have been destroyed by the immune system,” says Dr. Jan Hux, chief scientific advisor, Canadian Diabetes Association. As a result, the level of sugar in the bloodstream increases as the levels of insulin decrease.

Type 1 diabetes is not preventable and is not caused by being overweight or inactive. It’s usually diagnosed in children and teens, and sometimes (though rarely) after age 40, and accounts for 10% of all diabetes cases. It is treated with insulin injections, along with a healthy diet low in carbohydrates, and exercise. Sometimes medications are prescribed to control cholesterol and high blood pressure, two health conditions that can make diabetes worse.

Canada has the world’s sixth-highest incidence of type 1 diabetes in children aged 14 years and younger, says JDRF (formerly known as the Juvenile Diabetes Research Foundation), a global organization dedicated to diabetes research.

Type 2: the facts

Type 2 diabetes occurs when the pancreas does not produce enough insulin, or the body does not properly use the insulin it does make (a condition called insulin resistance). In either case, blood sugar levels rise.

Type 2 is linked to:

  • Genetics (some families have a history of type 2 diabetes)
  • Excess weight or obesity
  • Inactivity
  • Being a member of an ethnic group in which diabetes is more prevalent (Aboriginal, Hispanic, Asian, South Asian or African)
  • Having high cholesterol or high blood pressure
  • A diagnosis of polycystic ovarian syndrome, acanthosis nigricans (darkened patches of skin), or schizophrenia
  • Having had gestational diabetes (a form of diabetes diagnosed in pregnancy) or given birth to a baby weighing more than nine pounds.

In both types of diabetes, says the Canadian Diabetes Association, poorly managed blood sugar levels can lead to these devastating complications: heart disease and stroke, kidney disease, blindness, limb amputation, depression and premature death.

Numbers of diabetics growing

Type 2 accounts for 90% of diabetes cases and usually develops in adulthood, although higher numbers of children and young adults are being diagnosed with the condition, according to the Public Health Agency of Canada.

“Currently, more than nine million Canadians, or one in four, are living with diabetes or prediabetes (when your blood sugar is 7.0 mmol/L or higher after fasting), a number expected to rise to one in three by 2020,” says Hux. The key is to be vigilant, particularly if you have risk factors.

Symptoms of both forms of diabetes include:

  • Being thirstier than usual
  • Frequent urination
  • Sudden weight gain or loss
  • Excessive fatigue or lack of energy
  • Blurry vision
  • Frequent or recurring infections
  • Cuts and bruises that take a long time to heal
  • Tingling or numbness in the hands or feet
  • Sexual difficulties in men

Unlike type 1 diabetes, type 2 can be prevented – and managed – through proper nutrition, quitting smoking and regular exercise. “In people at elevated risk for type 2 diabetes, the rate of the condition can be cut in half by lifestyle interventions to increase physical activity and reduce obesity,” says Hux. Even when type 2 has been diagnosed, sticking to healthy habits such as eating more vegetables and fruit, staying away from fatty foods and exercising regularly can slow the disease.

And awareness is essential. “It’s important that Canadians educate themselves about diabetes to recognize if they are at risk,” says Hux.

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