Many people are confused about many things when they first get diabetes. One of the main questions is, “Do I have type 1 or type 2 diabetes? What medications should I use to treat these two types of diabetes? Which one is less severe? Here, let’s learn the difference between these two types of diabetes.
Type 1 diabetes
The number of people with type 1 diabetes is relatively small, less than 5% of the overall diabetes population. In general, type 1 diabetes is younger, has a more rapid onset, has three distinct symptoms of polyuria (i.e., excessive urination, thirst, drinking, eating, and weight loss), and in severe cases, ketoacidosis.
The pathogenesis of type 1 diabetes is an absolute deficit of insulin secretion, where the patient’s immune system dysfunction injures their own islet beta cells, causing severe damage to their insulin secretion function, and only a small amount of insulin is secreted into the bloodstream, which is far from adequate to meet the body’s needs.
At the time of diagnosis of type 1 diabetes, most patients have high blood glucose, low insulin and C-peptide levels, and positive islet β-cell autoantibodies. In terms of treatment, most people with type 1 diabetes require multiple daily subcutaneous injections of insulin to control blood glucose and keep them alive.
Type 2 diabetes
China has the highest number of adults with diabetes in the world, and the vast majority of these patients have type 2 diabetes, between 90% and 95%. In recent years, the increase in the incidence of diabetes is mainly due to the increase in the number of people with type 2 diabetes.
The reasons for the increased incidence of type 2 diabetes include, on the one hand, with the development and progress of society, people’s lifestyles have changed greatly, and people’s diets have improved under modern lifestyles, with more calories eaten but less physical activity, leading to overnutrition and obesity, which is an important reason for the increased incidence; on the other hand, as human life expectancy increases and the number of elderly people increases, the number of type 2 diabetes The number of patients has also increased accordingly.
In general, most type 2 diabetes develops in adults, but in recent years there have been cases of type 2 diabetes in adolescents due to obesity. Type 2 diabetes is slow to develop and early symptoms are not obvious; patients do not have symptoms of excessive drinking, thirst, or polyuria, they eat a lot, and they are fat. Many people find it by chance during a physical exam, or incidentally during a visit for another condition.
The pathogenesis of type 2 diabetes is complex and influenced by both genetic and environmental factors, with the main pathogenesis being insulin resistance and relative insulin deficiency. Usually, obesity leads to insulin resistance, which means that the body is insensitive to insulin and requires more insulin to control blood glucose. And the pancreatic β-cells are burdened with secreting more insulin into the bloodstream (more insulin than normal) in order to control blood sugar. When time goes by, the pancreatic β cells are so fatigued that they can’t produce enough insulin to control blood sugar (i.e., there is a relative lack of insulin), and in this way the patient’s blood sugar begins to rise.
At the time of diagnosis of type 2 diabetes, most patients have mildly elevated blood glucose, some insulin production, and negative islet β-cell autoantibodies. People with type 2 diabetes do not usually develop ketoacidosis, except in those who have been untreated for years and have severely elevated blood glucose.
In terms of treatment, patients with type 2 diabetes can control their blood glucose with lifestyle changes and oral hypoglycemic agents for a significant period of time after diagnosis, without the need for subcutaneous insulin injections. However, in later stages of the disease when patients have poorer islet β-cell function, insulin injections are often needed to control blood glucose as well.
In summary, the difference between type 1 and type 2 diabetes is multifaceted and is based on the clinical features of the patient and the course of the disease, in terms of age at onset, urgency of onset, severity of symptoms, weight, tendency to ketoacidosis, and the need for insulin to maintain life, combined with islet β-cell autoantibodies and β-cell function tests.
However, from these factors, the difference between type 1 and type 2 is relative, and some patients have difficulty determining whether it is type 1 or type 2, and can be temporarily staged and treated accordingly, and later reevaluated and staged according to changes in their condition.