Type 1 vs. Type 2 Diabetes: What’s the Difference?
Diabetes is a serious health condition stemming from the body’s ability to produce and effectively use insulin. Insulin is a hormone produced by the pancreas to maintain stable blood sugar levels. Diabetes as a condition has roots in both genetics and lifestyle, and while there is no cure for the disease, it is possible to manage diabetes and have a high quality of life.
The rates of incidence of prevalence of diabetes are growing in the United States. According to the Centers for Disease Control and Prevention, more than 34 million Americans, or one in every 10 people, have diabetes (1). There are two primary forms of diabetes – type 1 diabetes (T1D) and type 2 diabetes (T2D). Of the total number of people with diabetes, about 5% have T1D and 95% have T2D.
CDC data also reveal that as many as 88 million Americans – or one-third of the population – are considered to have prediabetes. People with prediabetes have consistently high blood sugar levels, but those levels are not high enough for a formal T2D diagnosis. The overall risk of developing T2D is significantly higher among prediabetics, but this risk can be managed.
Clinically speaking, T1D and T2D have many similarities, but there are clinical distinctions between the two. Understanding these distinctions can provide a clearer picture for overall diabetes management.
Here’s a breakdown of the key similarities and differences between T1D and T2D:
Symptoms: T1D vs T2D
The symptoms associated with both T1D and T2D include (2):
- Having to urinate very frequently
- Feeling very thirsty despite drinking a lot of water
- Extreme fatigue
- Cuts or sores that do not heal properly
- Blurry vision
- Unexplained weight loss
- Unexplained mood changes including irritability
- Numbness or tingling in the feet or hands
Although many of the symptoms of T1D and T2D are shared, the presentation of these symptoms is often different. The symptoms are often more pronounced in T1D as is usually sudden – symptoms can develop quickly and worsen over just a few weeks. Conversely, people with T2D may experience symptoms slowly over time as the condition develops gradually.
It is not uncommon for people with T2D to only find out they have the condition only after complications arise. Because of this, it is extremely important to keep up with regular routine healthcare and to speak with your doctor if you are experiencing any of the above symptoms.
Causes and Risk Factors: T1D vs. T2D
The causes and risk factors for T1D and T2D can vary. The differences are primarily based on the origin of the condition.
While the exact cause of T1D is not exactly known, the incidence has a strong association with genetics and family history (3). Conversely, T2D is more causally linked to environmental and lifestyle factors. Onset typically occurs slowly over time.
Risk factors associated with T1D include:
- Family history. People who have an immediate family member with T1D are more likely to develop the condition.
- Age. Onset of T1D can occur at any age, but onset is most common during the childhood and adolescent years.
- Genetic profile. Certain genes are linked to an increased likelihood of T1D.
Risk factors associated with T2D include:
- Having a family member with T2D
- Long-term poor dietary habits
- Being overweight or obese – including carrying a lot of belly fat
- Physical inactivity
- Gestational diabetes (a form of diabetes that occurs during pregnancy) or giving birth to a baby weighing more than 9 pounds
- Race or origin, including being of Hispanic, Black, American Indian or Alaskan Native descent
Prevention: T1D vs. T2D
T1D cannot be prevented. Genetic components are involved, and onset is inevitable. The risks associated with T1D can be managed with proper treatment and working closely with a healthcare team.
T2D also has a genetic component, but prevention is possible by making certain lifestyle changes as recommended by a healthcare provider. These lifestyle changes include:
- Maintaining a healthy weight or, for people who are already overweight or obese, working with a doctor to develop a healthy weight-loss plan
- Increasing activity levels to meet the minimum preventive exercise recommendations
- Eating a diet low in sugary, processed foods and high on healthy foods like vegetables, lean proteins and grains.
Careful monitoring of lifestyle can go a long way in preventing serious complications associated with both T1D and T2D.
Dietary Management: T1D vs. T2D
Managing nutritional intake is a critical part of life for everyone with diabetes, but the exact recommendations may vary based on the clinical differences between T1D and T2D(4).
People with T1D need to carefully balance their food intake with the amount of insulin needed to account for the effects of certain foods. For example, carbohydrates cause a quick spike in blood sugar, so insulin must be taken immediately following to control for the spike. People with T1D can work with their doctor to determine how much insulin is needed as individual needs do vary.
People with T2D, however, have additional considerations beyond insulin when it comes to their diet – and depending on the extent of T2D taking additional insulin at mealtime may not be needed at all. The greater focus in T2D is healthy eating in general. Weight loss and management is typically an important part of the treatment plan for people with T2D, so doctors may recommend a low-calorie meal plan in support of this effort.
In sum, while people with T1D must consider mealtime insulin corrections for the food they eat, people with T2D may have additional considerations to keep in mind when selecting the right foods to eat.
Treatment Options: T1D vs. T2D
Treatment strategies for T1D and T2D are different in a few significant ways.
There is no known cure for T1D, and because the condition is characterized by the body’s inability to produce insulin, proper and regular use of insulin is the cornerstone of successful T1D treatment (5).
Insulin administration can be managed through injections several times a day. People can inject insulin into soft tissue areas, including the stomach, arm or buttocks. Another administration option is to use an insulin pump – a device external to the body that pumps a steady and predetermined amount of insulin into the body throughout the day.
For T2D, the first-line treatment is lifestyle modification.6 People can often manage their condition successfully from just lifestyle modifications. In some cases, adherence to these modifications can even reverse the effects of T2D. Medications are usually only introduced if lifestyle changes are not enough. Oral forms of insulin are available to help treat and manage T2D – injections are not necessarily required.
Blood sugar monitoring is important in both T1D and T2D, but there are differences in frequency recommendations. People with T1D need to check their blood sugar several times throughout the day as their levels can rise and fall quickly based on several factors – including food intake, activity levels and stress. People with T2D, on the other hand, do not have to monitor their blood sugar as frequently because they do not tend to experience the same highs and lows.
T1D and T2D Management Both Require a Thoughtful Strategy
While T1D and T2D have many clinical similarities, it is important to understand the differences as they do influence overall management strategies. Your doctor is a critical partner in managing your diabetes and can help you work with treatment options and lifestyle modifications to help you live a relatively normal, healthy life.
- The U.S. Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2020. Last reviewed February 11, 2020.
- Mayo Clinic. Diabetes Overview: Symptoms & Causes. Last reviewed October 30, 2020.
- American Diabetes Association. Type 1 Diabetes: Symptoms, Causes and Treatment. Accessed November 16, 2020.
- American Diabetes Association. Nutrition Recommendations and Interventions for Diabetes. Diabetes Care. 2008 Jan
- 31(Suppl 1):S61-S78.
- National Institute of Diabetes and Digestive and Kidney Diseases. Insulin, Medicines, & Other Diabetes Treatments. December 2016.
- American Diabetes Association. 5. Lifestyle Management: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2019 Jan
- 42(Suppl 1):S46-S60.