Living with Type 2

Key differences between Type 1 and Type 2 diabetes

Many people have misconceptions about type 1 versus type 2 diabetes and common myths add confusion

Many of my patients have misconceptions about type 1 versus type 2 diabetes. I often hear comments such as, “my type 2 diabetes turned into type 1 diabetes” or “thin people get diagnosed with type 1 and overweight people get diagnosed with type 2” or “only children develop type 1.” These myths are perpetuated by a number of factors:

  • Misdiagnosis of type 1 in adults. Patients may be initially diagnosed as type 2 and it may not be until a few months or years later that antibody tests are run to confirm type 1 or Latent Autoimmune Diabetes in Adults (LADA). Up to a third of people diagnosed with Type 2 as an adult actually have LADA, and will eventually go on to have beta-cell destruction and need insulin
  • Media and health news linking obesity and type 2 risk. While this is the majority of cases of type 2 diabetes, it’s not impossible for a normal weight individual to have type 2 diabetes.
  • Type 1 diabetes used to be called juvenile diabetes, and this verbiage still exists even though it’s not as common to hear anymore.
  • There are 6 different types of diabetes
    1. Type 1
    2. Type 2
    3. Latent Autoimmune Diabetes in Adults (LADA) – considered a sub-type of Type 1
    4. Maturity Onset Diabetes of the Young (MODY)
    5. Gestational Diabetes
    6. Neonatal Diabetes

Part of the misconception comes from people not understanding the differences between type 1 and type 2.  You can use this table to decipher the differences between these two conditions.

Type 1 Type 2
Age Diagnosis can occur at any age (but more commonly before the age of 30) Diagnosis typically occurs in adults, but in countries with obesity epidemics we are seeing younger and younger diagnoses occur (teenagers and even younger)
Diagnosis Typically will be able to be differentiated from Type 2 by a positive antibody test Not an autoimmune condition so antibodies are negative
Type of condition An auto-immune condition that involves the destruction of insulin-producing beta cells Typically this condition is slow to develop. It begins with insulin resistance and in many can eventually reduce insulin production over time
Insulin Requires exogenous (external) insulin to be taken May or may not require exogenous (external) insulin to be taken. If insulin is needed it will usually develop after someone has had diabetes for many years or as a result of having poorly controlled diabetes
Urgent issues Could develop diabetic ketoacidosis (DKA) if there is an insulin deficiency – i.e., a person not taking enough insulin, which could occur from a number of reasons Rarely is diabetic ketoacidosis (DKA) seen
Long-term complications Retinopathy, neuropathy, nephropathy, cardiovascular disease, and depression  Retinopathy, neuropathy, nephropathy, cardiovascular disease, and depression

 

Nicole Rubenstein is a Registered Dietitian, Board Certified Sports Dietitian and Certified Diabetes Educator. She owns Racer’s Edge Nutrition, a sports nutrition private practice specializing in athletes with diabetes. She is also the lead dietitian in the Endocrinology and Weight Management Departments at Kaiser Permanente in Denver, CO. She completed her undergraduate degree in Nutritional Science from Cornell University and her Master’s Degree in Sports Nutrition at the University of Colorado in Colorado Springs. Prior to her studies, Nicole was a competitive snowboard athlete and travelled the world competing in snowboard racing. She now enjoys snowboarding, mountain biking, scuba diving, cooking, and spending time with her husband and two dogs. Nicole has spent the last 12 years helping patients improve their health through bettering their nutrition habits. Of all the specialties that she has worked with, her primary passion is working with active individuals who have type 1 diabetes.

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