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what is the difference
- Thread starter staceyc
- Start date
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Northerner
Admin (Retired)
- Relationship to Diabetes
- Type 1
Type 1 is an autoimmune disease where the cells in the pancreas that produce insulin have been killed off by the person's own immune system so the person needs to inject it. Type 2 is mainly due to insulin resistance, where the body produces insulin but can't use it efficiently - the pancreas tries to produce more insulin to overcome this, but if it can't produce enough then blood sugar levels rise and it is at this point that the person becomes diabetic.
The complications of both types are similar, since both are affected by high blood sugar levels over a period of time, but treatment can be quite different. Type 1 is always insulin, Type 2 can sometimes improve sensitivity to their own insulin by adopting diet and lifestyle changes, or sometimes take pills to aid the use of the insulin. Many Type 2s also end up on insulin when their pancreas is unable to supply sufficient, even with the help of the pills. 🙂
The complications of both types are similar, since both are affected by high blood sugar levels over a period of time, but treatment can be quite different. Type 1 is always insulin, Type 2 can sometimes improve sensitivity to their own insulin by adopting diet and lifestyle changes, or sometimes take pills to aid the use of the insulin. Many Type 2s also end up on insulin when their pancreas is unable to supply sufficient, even with the help of the pills. 🙂
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mcdonagh47
Banned
- Relationship to Diabetes
- Type 2
There is also a strong connection between Gestational Diabetes and Type 2 Diabetes .
One study found 50% of women who suffered Gestational Diabetes had Type 2 within 6 years of the birth. The figure rises if the woman had to be treated with insulin. The child is also at increased risk of childhood obesity and Type 2 Diabetes later in life.
that is interesting thanks i got gd quite early on and have gone on to inslin 4 times a day at the min but its still not going down much my dose is chaning once /twice a week still on quite a low dose 6 slow relese 6 rapid at brekfast 5 at lunch and 2 at tea , noone has really said much about after the baby is here
Northerner
Admin (Retired)
- Relationship to Diabetes
- Type 1
Monica
Well-Known Member
- Relationship to Diabetes
- Parent of person with diabetes
Gestational Diabetes is supposed to be just that. You have it while pregnant and as soon as you have your baby, it is supposed to go away. You notice I wrote "supposed". I did that, because my friend had gestational diabetes 12 years ago, but it never went away. Only just recently the docs have decided to do a test to see if she's actually type1 or 2😱 or even 1 1/2. It actually made me wonder whether she ever had "gestational" or she just happed to get type1 or2 diabetes while pregnant.
I aso disagree a bit with Alan, all cases of T1 are not autoimmune,
So T 1 involves autoimmune destruction, but also destruction of beta cells for an unknown reason. T1 is prone to DKA.
TIa is definitely autoimmune,
T1b is we dont' really know why, maybe an antibody we haven't found, maybe something else but they've lost their beta cells and will go into DKA without insulin.
Some people have beta cell destruction for another reason ie a disease or a genetic defect or a physical destruction of the pancreas. These people are neither T1 or T2: they are officially 'other types'.
So what do you classify a person who is insulin resistant, gets diagnosed in DKA, need insulin but is found to be very insulin resistant and then after a few months seems to get better. They then stay Ok, maybe for years and then it happens all over again. What type are they?
(answer: ketosis prone type 2 or type 1b, or atypical diabetes dependent upon who's writing)
As posted already the definition for T2 is also very wide
The categories are just boxes designed by a commitee and we don' all fit into them easily. The more they find, the less well the boxes fit. (and it's probably about time for a revision but some doctors still haven't got used to this one as its only 12 years old)
http://www.staff.ncl.ac.uk/philip.home/who_dmc.htm
So T 1 involves autoimmune destruction, but also destruction of beta cells for an unknown reason. T1 is prone to DKA.
TIa is definitely autoimmune,
T1b is we dont' really know why, maybe an antibody we haven't found, maybe something else but they've lost their beta cells and will go into DKA without insulin.
Some people have beta cell destruction for another reason ie a disease or a genetic defect or a physical destruction of the pancreas. These people are neither T1 or T2: they are officially 'other types'.
So what do you classify a person who is insulin resistant, gets diagnosed in DKA, need insulin but is found to be very insulin resistant and then after a few months seems to get better. They then stay Ok, maybe for years and then it happens all over again. What type are they?
(answer: ketosis prone type 2 or type 1b, or atypical diabetes dependent upon who's writing)
As posted already the definition for T2 is also very wide
The categories are just boxes designed by a commitee and we don' all fit into them easily. The more they find, the less well the boxes fit. (and it's probably about time for a revision but some doctors still haven't got used to this one as its only 12 years old)
Northerner
Admin (Retired)
- Relationship to Diabetes
- Type 1
Thanks Helen, I'll get me coat...😉
Actually, this might be something that Deepss is interested in, I'll add the link to their thread.
Actually, this might be something that Deepss is interested in, I'll add the link to their thread.
mcdonagh47
Banned
- Relationship to Diabetes
- Type 2
And of course some recent research ( will have to find the link) has suggested that there is an auto-immune element in T2 as well.
Vicsetter
Well-Known Member
- Relationship to Diabetes
- Type 2
T1s get test strips, a lot of T2s don't🙄
Seriously, the definition of the two type seems to be difficult. Are Type1 always dependant on insulin whereas Type 2's are sometimes treated with insulin, but are not dependant? or is that too simple. I have often wondered that as a T2 progresses there must come a stage when they no longer produce insulin and are thus effectively Type 1.
Seriously, the definition of the two type seems to be difficult. Are Type1 always dependant on insulin whereas Type 2's are sometimes treated with insulin, but are not dependant? or is that too simple. I have often wondered that as a T2 progresses there must come a stage when they no longer produce insulin and are thus effectively Type 1.
trophywench
Well-Known Member
- Relationship to Diabetes
- Type 1
A T2 can never become T1 Vic even though they may look the same from the outside when reliant on insulin jabs. They will most likely still need to take Metformin alongside their insulin whereas I probably won't - unless I for some reason put on boatloads of weight and thus bestow upon myself insulin resistance. If I try and counterract that with insuin alone, then I will put on even more weight because insulin is a growth hormone. So I then get prescribed metformin too - but that doesn't make me a T2 !!
T2's carry much more 'baggage' than a straightforward T1 in terms of insulin resistance for starters, and their tolerance to carbohydrates, it's a rare T2 who could eat as much carb as a T1 could (if they wanted to) and merely 'kill it' with insulin. Usually because of other factors, T2's will need one heck of a lot more insulin to do the same job, even though they are skinny and run marathons.
Whereas I might need say 15 units of basal a day, a T2 might easily need 75 units to achieve the same result. Likewise they will typically need eg 5 units of fast-acting insulin for every 10g of carbs whereas I need 1 unit per 10g.
This is a bummer; see comments re insulin being a growth hormone.
There is also the broken mechanism in the T2 body where the Phase 1 insulin release doesn't happen but the Phase 2 does (ie the insulin that should be released as soon as you take your first bite and the message goes to the brain, carbs arriving on Platform 3, send insulin. The phase 2 insulin response doesn't get going until 20 mins is it? later when the brain considers if you've finished unloading your luggage and finding you have, and that the porter has already moved some of your bags to your waiting taxi (ie the Phase 1 took care of it) then sends enough extra insulin along to see the remainder of your baggage into the car. Then discovers the Phase 1 hasn't really moved you first few bags to the taxi, it only moved them into the ticket office, so it has to send along some more Phase 2 insulin to get rid of that, but before it does another train has arrived and has started disgorging its suitcases. It just can't keep up with the amount of luggage all over the platform ..... T1's don't have this problem whatsoever. Their beta cells are completely dead. They inject their insulin; it does its job because nothings trying to hinder it - and there's an end to it.
Ish.
T2's carry much more 'baggage' than a straightforward T1 in terms of insulin resistance for starters, and their tolerance to carbohydrates, it's a rare T2 who could eat as much carb as a T1 could (if they wanted to) and merely 'kill it' with insulin. Usually because of other factors, T2's will need one heck of a lot more insulin to do the same job, even though they are skinny and run marathons.
Whereas I might need say 15 units of basal a day, a T2 might easily need 75 units to achieve the same result. Likewise they will typically need eg 5 units of fast-acting insulin for every 10g of carbs whereas I need 1 unit per 10g.
This is a bummer; see comments re insulin being a growth hormone.
There is also the broken mechanism in the T2 body where the Phase 1 insulin release doesn't happen but the Phase 2 does (ie the insulin that should be released as soon as you take your first bite and the message goes to the brain, carbs arriving on Platform 3, send insulin. The phase 2 insulin response doesn't get going until 20 mins is it? later when the brain considers if you've finished unloading your luggage and finding you have, and that the porter has already moved some of your bags to your waiting taxi (ie the Phase 1 took care of it) then sends enough extra insulin along to see the remainder of your baggage into the car. Then discovers the Phase 1 hasn't really moved you first few bags to the taxi, it only moved them into the ticket office, so it has to send along some more Phase 2 insulin to get rid of that, but before it does another train has arrived and has started disgorging its suitcases. It just can't keep up with the amount of luggage all over the platform ..... T1's don't have this problem whatsoever. Their beta cells are completely dead. They inject their insulin; it does its job because nothings trying to hinder it - and there's an end to it.
Ish.
Vicsetter
Well-Known Member
- Relationship to Diabetes
- Type 2
Really! you think! that's why I said effectively a T1.
A T2's beta cells can die off and similarly a T1's insulin resistance can increase, hence a T1 on Metformin and a T2 on rapid insulin. As Helen has already said the boundaries are blurred.
Northerner
Admin (Retired)
- Relationship to Diabetes
- Type 1
People were referred to as IDDM and NIDDM not so long ago (Insulin Dependent and Non-Insulin Dependent Diabetes Mellitus) so were classified differently anyway. The more I have learned about diabetes, chiefly from reading the stories of people here, the more I have come to accept that there are some VERY blurry edges! I think the main problems with how you are classified come when you are denied things that a different classification would seem to entitle you to. For example, a classification of Type 2 might mean you couldn't attend a course like DAFNE, even if you were on MDI.
There are children who have all the T1 symptoms but when tested don't have antibodies . (usually in research projects as quite frequently they aren't tested). They will be treated as T1.
There are also a number of people who lose beta cell function over a period , some only afew months, some a few years. They may go through the various medications comparatively rapidly because they don't work well for them. When they eventually go onto insulin they are found to be insulin sensitive.
This could be LADA but if they are then tested and have no anti bodies detected , as happens to some, then it's something else (LADA is defined by autoimmunity)
People in this subset are very likely to continue to be categorised as T2, rather than T1b and this, as Alan says, has it's consequences in the UK and elsewhere.
There is a lady on Tu diabetes that calls herself type weird. I think that applies to a lot of people.
There are also a number of people who lose beta cell function over a period , some only afew months, some a few years. They may go through the various medications comparatively rapidly because they don't work well for them. When they eventually go onto insulin they are found to be insulin sensitive.
This could be LADA but if they are then tested and have no anti bodies detected , as happens to some, then it's something else (LADA is defined by autoimmunity)
People in this subset are very likely to continue to be categorised as T2, rather than T1b and this, as Alan says, has it's consequences in the UK and elsewhere.
There is a lady on Tu diabetes that calls herself type weird. I think that applies to a lot of people.
KateXXXXXX
Well-Known Member
- Relationship to Diabetes
- Parent of person with diabetes
The more I read, the more I think that the 'classic' T1 and T2's are just either end of a whole spectrum: there are no clear divisions, just a sliding scale, with areas given a handy label. There will always be people on the boundry between the bands...
To me, as a lay person and an observer and carer, the causes are largely immaterial: a note of curiosity, no more. It's the treatment that matters: that each person is given the tools and advice to enable them to manage their condition to the best of their ability, alone or with the help of carers. To that end I will always support research into the causes and treatment of diabetes, as the more we understand it, and it's causes, the better we can treat it.
I live with two classic T1's. Their bodies just stopped producing insulin. I don't know how long this took to manifest with my husband: I was far less aware of the signs and symptoms in those days, and had a small baby to look after. Also, as far as we were concerned, Muttley was well outside the expected catchment pool, being of the correct weight for his body type and reasonably fit, and 'too old' to develop T1... With the son, I was far better educated (if rather complacent!), and we got him diagnosed as soon as it became aparant. He is within the typical age range for developing T1. Muttley's experience taught me that hard lesson that every dinosaur curve has a far end, and it wags...
To me, as a lay person and an observer and carer, the causes are largely immaterial: a note of curiosity, no more. It's the treatment that matters: that each person is given the tools and advice to enable them to manage their condition to the best of their ability, alone or with the help of carers. To that end I will always support research into the causes and treatment of diabetes, as the more we understand it, and it's causes, the better we can treat it.
I live with two classic T1's. Their bodies just stopped producing insulin. I don't know how long this took to manifest with my husband: I was far less aware of the signs and symptoms in those days, and had a small baby to look after. Also, as far as we were concerned, Muttley was well outside the expected catchment pool, being of the correct weight for his body type and reasonably fit, and 'too old' to develop T1... With the son, I was far better educated (if rather complacent!), and we got him diagnosed as soon as it became aparant. He is within the typical age range for developing T1. Muttley's experience taught me that hard lesson that every dinosaur curve has a far end, and it wags...
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