Type 1 type 2 difference.

[FredT]

What are the causes, symptoms and treatments of type 1 compared to type 2 . I’m curious about how much the 2 types have in common. Could you have a combination of both?

 

[SB2015]

Good morning Fred

Type 1 and Type 2 are completely different diseases, but both can lead to high blood Glucose levels, so the long term effects of poor control are the same.

So in a very numerical description (apologies to HCPs)

In Type 1 the body releases antibodies which destroy the beta cells in the pancreas. These are responsible for making insulin, so gradually you are able to make less and less insulin, and unltimately without treatment will go into a coma and die. That is why you need insulin from the start. People are usually diagnosed when the number of beta cells have got so low that the body goes into crisis which happens very quickly. I lost a stone and a half in a week (Thinner) was extremely thirsty, going to the toilet all the time and felt extremely tired. The four Ts.

In Type 2 the body is not able to make enough insulin for the amount of glucose that is in their blood stream,or the insulin that is made is not working well. This can be managed by reducing the amount of insulin needed (through a change in diet and increase in exercise), taking tablets to make the pancreas release more insulin or that make the insulin they make work better. The symptoms here are similar with tiredness, thirst and frequently going to the toilet, but the wieght loss is not common. This can go undiagnosed for a long and may cause a lot of damage before it is picked up.

With both types, and all the other variations, high blood glucose levels cause damage to the smaller blood vessels, leading to the same collection of conditions such as retinopathy, kidney failure, neuropathy stroke and heart attack.

BUT these conditions are manageable. So well worth taking control of ourselves and managing this as best we can.

 

[Deleted member 21371]

In Type 2, the main problem is the insulin produced isn't being used efficiently.
So more insulin is produced.
This can eventually lead to a burn out of beta cells.
Or fat can cover the pancreas, and stop the beta cells working.

The inefficiency can be addressed in several ways.
Medication.
Exercise (to help the muscles use the glucose for energy)

Or if the beta cells are affected, loss of weight will reduce fat surrounding the pancreas, and the beta cells can be made to work again.

A change in diet will help, either short term until the above is addressed, or long term to try to control actual BG levels.

 

[ukjohn]

SB2015 and traveller have given reasonable theories to the question except they both suggest that diet and exercise together with tablets is the answer to control for Type2. I find it interesting that neither of them suggests insulin has to be the treatment for various reasons for Type2 as well as type1. I was admitted to hospital 13 years ago in a semi conscious state and put on insulin, tablets had no effect and I have been on MDI since that first day. I could not be given Metformin because I only had 50% kidney function. So once again it's a case of we are all different .

John.

 

[DaveB]

I would comment on all the posts so far to add the following. Most T2s have some insulin resistance due usually to some excess weight. This means insulin can't be used effectively so the body produces more and more. A C-peptide test will show a lot of insulin in the blood. T1s will have few beta cells and a C-peptide test will show low insulin production. This test appears to be the most useful to distinguish the two types. Mis-diagnosis is common i.e. T1s being mis-diagnosed as T2 as T1 diagnosed later in life can come on slowly and with out testing ends up classed as T2. (ukjohn may be you are one of those mis-diagnosed like me?). I would also add that viruses can cause beta cell death as well as anti-bodies.

 

[Mark T]

It is possible to have both T1 and T2.

T1 is fairly narrowly defined as a specific antibody reaction where your body attacks itself.

In the NHS, T2 is often used as a catch all for anything that isn't T1. Some are Insulin resistant, others don't produce enough insulin, others both.

 

[Matt Cycle]

It is possible to have both T1 and T2.

Double diabetes. Often found in overweight T1's and they're usually put on metformin as well as insulin.

Do beta cells in a T2 wear out from over production? Presumably a C-peptide would then indicate T1 with a low insulin production even though it's not from an autoimmune attack. I guess these beta cells be restarted? Although rarer than T1's diagnosed as T2's there's also T2's diagnosed as T1's later in life before being reclassified. We've had some on the forum.

 

[Deleted member 21371]

Double diabetes. Often found in overweight T1's and they're usually put on metformin as well as insulin.

Do beta cells in a T2 wear out from over production? Presumably a C-peptide would then indicate T1 with a low insulin production even though it's not from an autoimmune attack. I guess these beta cells be restarted? Although rarer than T1's diagnosed as T2's there's also T2's diagnosed as T1's later in life before being reclassified. We've had some on the forum.

Now, that is a good question.
It was thought that type 2 was irreversible.
The theory being that a type 2 used up their beta cells over producing insulin, to combat the insulin resistant, until they wore out.
So they progressed to injecting.

Now, it seems that insulin cells can recover.
Internal fat is a major issue, not only does it affect insulin resistance, as double diabetes seems to show, it also affects the beta cells on type 2's.
If a type 2 can lose weight, they seem to certainly improve their diabetes in the majority of cases, some even totally reverse it.

As with all things though, there are always going to be exceptions to this.

 

[mikeyB]

Insulin resistance in T1’s doesn’t make them T2, unless your definition of T2 includes anybody taking Metformin. It can happen in normal weight T1s as well.

 

[Deleted member 21371]

This thread seems to be expanding to be an interesting discussion as well on type 2's beta cells, overweight, insulin responses...

But to answer...
Me?
I simply ate my way to being diabetic.
I'm not going to argue on that.
I put on a lot over many years, simply by overeating.
Medical advice was to lose weight.
I didn't.

However, I accepted diabetes, when it eventually caught up with me, because I was too fat, was a wake up call.
I decided I would accept the advice.
I lost weight, and reversed my diabetes.
I lost weight still eating carbs, just counting the calories.

I suspect the "majority" of type 2's may be the same, if the results of the Newcastle diet trials are to be believed.

If you were often low carbing, what was the event that triggered your eventual diabetes, if it wasn't excessive carbs?
As I said, mine was morbid obesity.

 

[Drummer]

I have always had problems with being told not to low carb. I was seriously ill a couple of times during gestation of my second child, after following high carb diet sheets - I was threatened with being taken into hospital and 'fed properly' - but I became so ill on the starchy foods I started to lie to the HCPs and they were so smug about being right all along.
I was on a cholesterol lowering diet for almost 2 years before diagnosis - starch starch and more starch, porridge potato wholemeal bread - the day after diagnosis I went out in the garden and burnt all the diet sheets and information on my lack of progress with weightloss.
the diagnosis was due to the thyroid check being requested wrongly - it is now no longer done automatically each year as it used to be.
I was always told to lose weight, but I have been on so many low calorie diets that if I go more than a few hours over my usual time for eating I go deathly pale and start to shut down.