Type 1 And Type 2 Diabetes Compare And Contrast Essays

Diabetes, or diabetes mellitus (DM), is a metabolic disorder in which the body cannot properly store and use sugar.

It affects the body's ability to use glucose, a type of sugar found in the blood, as fuel. This happens because the body does not produce enough insulin, or the cells do not correctly respond to insulin to use glucose as energy.

Insulin is a type of hormone produced by the pancreas to regulate how blood sugar becomes energy. An imbalance of insulin or resistance to insulin causes diabetes.

Diabetes is linked to a higher risk of cardiovascular disease, kidney disease, vision loss, neurological conditions, and damage to blood vessels and organs.

There is type 1, type 2, and gestational diabetes. They have different causes and risk factors, and different lines of treatment.

This article will compare the similarities and differences of types 1 and 2 diabetes.

Gestational diabetes occurs in pregnancy and typically resolves after childbirth.

However, having gestational diabetes also increases the risk of developing type 2 diabetes after pregnancy, so patients are often screened for type 2 diabetes at a later date.

According to the Centers for Disease Control and Prevention (CDC), 29.1 million people in the United States (U.S.) have diabetes.

Fast facts on diabetes
  • Type 1 diabetes is often hereditary and unpreventable.
  • Type 2 diabetes is much more common than type 1. For every person with type 1 diabetes, 20 will have type 2.
  • Type 2 can be hereditary, but excess weight, a lack of exercise and an unhealthy diet increase
  • At least a third of people in the U.S. will develop type 2 diabetes in their lifetime.
  • Both types can lead to heart attack, stroke, nerve damage, kidney damage, and possible amputation of limbs.

Causes


People with type 1 diabetes will require supplemental insulin on an ongoing basis. People with type 2 will likely only need this for the later stages of the condition.

In type 1 diabetes, the immune system mistakenly attacks the insulin-producing pancreatic beta cells.

These cells are destroyed, reducing the body's ability to produce sufficient insulin and regulate blood glucose levels.

The body does not produce insulin, so the person needs supplemental insulin from the time they are diagnosed.

It often affects children and young adults, and it can start suddenly.

When type 2 diabetes starts, cells become resistant to the effects of insulin. In time, the body stops producing enough insulin, and the body can no longer use glucose effectively.

This means the cells cannot take up glucose, and glucose builds up in the blood.

This is called insulin resistance. If blood glucose is always high, the cells will be overexposed to insulin. They become less responsive or unresponsive to insulin.

Symptoms may take years to appear, and people can often use medications, diet, and exercise from in the early stages to reduce the risk or slow the disease.

People in the early stage of type 2 diabetes do not need supplemental insulin, but as the disease progresses, this may be necessary to control blood glucose control and to survive.

Type 2 often results from obesity and lifestyle and dietary factors, as well as medications and other issues.

Risk factors

Both types of diabetes may involve genetic factors.

In type 1, scientists have discovered a number of genes that are linked to the condition, developing the condition, but not everyone with these genetic factors develops it.

In type 2 diabetes, family history plays a key role.

Type 1 can emerge after a viral infection, such as mumps, or rubella cytomegalovirus.

Type 2 appears to be related to aging, an inactive lifestyle, diet, genetic influence, and obesity.

Both types 1 and type 2 appear to be more common in people with low levels of vitamin D, which is synthesized from sunlight.

Vitamin D supports immune function and insulin sensitivity, so those living at more northerly latitudes may face a higher risk of diabetes. Supplemental vitamin D may lower the risk of developing diabetes.

Diet

Diet has been linked to type 2 diabetes, but early diet may also have an impact on type 1.

Type 1 has sometimes been found to be more common in those who were introduced to cow's milk at an earlier stage. This suggests that breast-feeding for longer may reduce the risk. However, more research is needed.

Type 2 tends to be common in families where obesity is also a family trait. There may be a genetic link, or this may be because families have similar eating and exercise habits.

Diets high in simple sugars and low in fiber and vital nutrients have been linked to diabetes.

Symptoms

The consequences of persistently high levels of blood glucose can differ between types 1 and 2, but some symptoms and warning signs are common to both types.

The most serious complications involve kidney failure, eye problems and vision loss, neurological damage and increased risk of cardiovascular problems, including heart attack and stroke.

The table below shows some signs and symptoms of possible complications.

Diabetes type 1

Diabetes type 2

Common physical attributes

BMI is mostly within the normal range or low.

BMI is in the overweight or obese range.

Onset

Rapid, often presenting acutely with ketoacidosis

Slow, sometimes taking years and often presenting without early symptoms

Warning signs

  • Extreme thirst and hunger
  • Extreme thirst and hunger
  • Extreme weakness and fatigue
  • Pins and needles or numbness in feet

Complications

  • Diabetic coma or ketoacidosis
  • Nephropathy, or kidney disease
  • Diabetic coma or ketoacidosis, due to high blood sugar
  • Hypoglycemia, or low blood sugar

Diagnosis


A healthcare specialist will be able to test a patient for diabetes, even if type 2 diabetes shows no symptoms.

The onset of type 1 diabetes tends to be sudden. If symptoms are present, the person should see a doctor as soon as possible.

A person with prediabetes and the early stages of type 2 will have no symptoms.

If a routine blood test shows that blood sugar levels are high, action can be taken to delay or prevent diabetes and its complications.

Any of the following tests can be used for diagnosis of type 1 or type 2 diabetes, but they are not all recommended for diagnosing both types:

  • A1C test, also called the hemoglobin A1c, HbA1c, or glycohemoglobin test
  • Fasting plasma glucose (FPG) test
  • Oral glucose tolerance test (OGTT)

Another blood test, the random plasma glucose (RPG) test, is sometimes used to diagnose diabetes during a regular health check.

If the RPG measures 200 micrograms per deciliter (d/L) or above, and the individual also shows symptoms, the person may receive a diagnosis of diabetes.

Blood test levels for diagnosis of diabetes and prediabetes are outlined below.

A1C test (percent)

Fasting Plasma Glucose test (Milligrams per decilitre - mg/dL)

Oral Glucose Tolerance test (mg/dL)

Diabetes

6.5 or above

126 or above

200 or above

Prediabetes

5.7 to 6.4

100 to 125

140 to 199

Normal

Approximately 5

99 or below

139 or below

Treatment and prevention

There is no cure for diabetes, but medications can help manage it.

Insulin can regulate blood glucose, preventing hyperglycemic emergencies and protecting against some long-term complications.

Below is a list of the current methods known to treat and prevent diabetes type 1 and type 2.

Diabetes type 1

Diabetes type 2

Cure

None.

Some researchers are currently looking at the potential benefits of a combination of immunosuppressant drugs, and drugs that increase gastrin production to encourage pancreatic regeneration, that may allow people with type 1 diabetes to live insulin-free.

There is no cure for type 2 diabetes, although gastric bypass surgery, lifestyle, and medication treatment can result in remission. An active lifestyle, healthy loss of weight, and diet control is advised.

Prevention

No known way to prevent the autoimmune attack on pancreatic, insulin-producing cells.

Preventable and can be delayed with a healthy diet and active lifestyle.

Treatment

  • Regular check-up of blood sugar levels and A1C
  • Sometimes insulin injections
  • Self-Monitoring of Blood Glucose (SMBG)
  • Controlling blood pressure
  • Treating high cholesterol levels

Will there ever be a cure?

There is no cure for diabetes, but gastric bypass surgery, lifestyle, and medication treatment can result in remission in people with type 2.

For people with diabetes, some researchers are currently considering combining immunosuppressant drugs and drugs that increase gastrin production to encourage pancreatic regeneration.

This could one day mean that people with type 1 diabetes will no longer need to use insulin.

1. Persson M, Norman M, Hanson U. Obstetric and perinatal outcomes in type 1 diabetic pregnancies: A large, population-based study. Diabetes Care. 2009;32(11):2005. doi: 10.2337/dc09-0656.[PMC free article][PubMed][Cross Ref]

2. Dunne FP, Avalos G, Durkan M, Mitchell Y, Gallacher T, Keenan M, et al. “ATLANTIC DIP: pregnancy outcome for women with pregestational diabetes along the Irish Atlantic seaboard” Diabetes Care. 2009;32(7):1205–6. doi: 10.2337/dc09-1118.[PMC free article][PubMed][Cross Ref]

3. Hillman N, Herranz L, Vaquero PM, Villarroel A, Fernandez A, Pallardo LF. Is Pregnancy Outcome Worse in Type 2 Than in Type 1 Diabetic Women? Diabetes Care. 2006;29(11):2557–8. doi: 10.2337/dc06-0680.[PubMed][Cross Ref]

4. Knight KM, Pressman EK, Hackney DN, Thornburg LL. Perinatal outcomes in type 2 diabetic patients compared with non-diabetic patients matched by body mass index. J Matern fetal Neonatal Med. 2012;25(6):611–5. doi: 10.3109/14767058.2011.587059.[PubMed][Cross Ref]

5. O’Sullivan EP, Avalos G, O’Reilly M, Dennedy MC, Gaffney G, Dunne F, et al. Atlantic Diabetes in Pregnancy (DIP): the prevalence and outcomes of gestational diabetes mellitus using new diagnostic criteria. Diabetologia. 2011;54(7):1670–5. doi: 10.1007/s00125-011-2150-4.[PubMed][Cross Ref]

6. International Association of Diabetes. Pregnancy Study Groups Consensus Panel. Metzger BE, Gabbe SG, Persson B, Buchanan TA, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676. doi: 10.2337/dc09-1848.[PMC free article][PubMed][Cross Ref]

7. Macintosh MC, Fleming KM, Bailey JA, Doyle P, Modder J, Acolet D, et al. Perinatal mortality and congenital anomalies in babies of women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland: population based study. BMJ. 2006;333:177. doi: 10.1136/bmj.38856.692986.AE.[PMC free article][PubMed][Cross Ref]

8. Sibai BM, Caritis S, Hauth J, Lindheimer M, VanDorsten JP, MacPherson C, et al. Risks of preeclampsia and adverse neonatal outcomes among women with pregestational diabetes mellitus. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. Am J Obstet Gynecol. 2000;182(2):364. doi: 10.1016/S0002-9378(00)70225-0.[PubMed][Cross Ref]

9. Miller E, Hare JW, Cloherty JP, Dunn PJ, Gleason RE, Soeldner JS, et al. Elevated maternal hemoglobin A1c in early pregnancy and major congenital anomalies in infants of diabetic mothers. N Engl J Med. 1981;304(22):1331. doi: 10.1056/NEJM198105283042204.[PubMed][Cross Ref]

10. Sibai BM, Caritis SN, Hauth JC, MacPherson C, VanDorsten JP, Klebanoff M, et al. Preterm delivery in women with pregestational diabetes mellitus or chronic hypertension relative to women with uncomplicated pregnancies. The National institute of Child health and Human Development Maternal-Fetal Medicine Units Network. Am J Obstet Gynecol. 2000;183(6):1520. doi: 10.1067/mob.2000.107621.[PubMed][Cross Ref]

11. Lawrence JM, Contreras R, Chen W, Sacks DA. Trends in the prevalence of preexisting diabetes and gestational diabetes mellitus among a racially/ethnically diverse population of pregnant women, 1999–2005. Diabetes Care. 2008;31(5):899. doi: 10.2337/dc07-2345.[PubMed][Cross Ref]

12. Owens LA, Avalos G, Kirwan B, Carmody L, Dunne F. ATLANTIC DIP: closing the loop: a change in clinical practice can improve outcomes for women with pregestational diabetes. Diabetes Care. 2012;35(8):1669–71. doi: 10.2337/dc12-0120.[PMC free article][PubMed][Cross Ref]

13. Tennant PW, Glinianaia SV, Bilous RW, Rankin J, Bell R. Pre-existing diabetes, maternal glycated haemoglobin, and the risks of fetal and infant death: a population-based study. Diabetologia. 2014;57(2):285–94. doi: 10.1007/s00125-013-3108-5.[PubMed][Cross Ref]

14. Feig DS1, Hwee J, Shah BR, Booth GL, Bierman AS, Lipscombe LL. Trends in Incidence of Diabetes in Pregnancy and Serious Perinatal Outcomes: A Large, Population-Based Study in Ontario, Canada, 1996–2010. Diabetes Care. 2014 Apr 4. [Epub ahead of print] [PubMed]

15. Committee ACOG. on Practice Bulletins. ACOG Practice Bulletin. Clinical Management Guidelines for Obstetrician-Gynecologists. Number 60, March 2005. Pregestational diabetes mellitus. Obstet Gynecol. 2005;105:675–85. doi: 10.1097/00006250-200503000-00049.[PubMed][Cross Ref]

16. Clausen TD, Mathiesen E, Ekbom P, Hellmuth E, Mandrup-Poulsen T, Damm P. Poor Pregnancy Outcome in Women With Type 2 Diabetes. Diabetes Care. 2005;28(2):323–8. doi: 10.2337/diacare.28.2.323.[PubMed][Cross Ref]

17. Diabetes and pregnancy group, France French Multicentric Survey of Outcome of Pregnancy in Women With Pregestational Diabetes. Diabetes Care. 2003;26:2990–3. doi: 10.2337/diacare.26.11.2990.[PubMed][Cross Ref]

18. Lapolla A, Dalfrà MG, Di Cianni G, Bonomo M, Parretti E, Mello G; Scientific Committee of the GISOGD Group. A multicenter Italian study on pregnancy outcome in women with diabetes. Nutr Metab Cardiovasc Dis. 2008 May;18(4):291–7. Epub 2007 Apr 11. [PubMed]

19. Roland JM, Murphy HR, Ball V, Northcote-Wright J, Temple RC. The pregnancies of women with Type 2 diabetes: poor outcomes but opportunities for improvement. Diabet Med. 2005;22(12):1774–7. doi: 10.1111/j.1464-5491.2005.01784.x.[PubMed][Cross Ref]

20. Balsells M, Garcia-Patterson A, Gich I, Corcoy R. Maternal and fetal outcome in women with type 2 versus type 1 diabetes mellitus: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2009;94:4284–91. doi: 10.1210/jc.2009-1231.[PubMed][Cross Ref]

21. Knight KM, Thornburg LL, Pressman EK. Pregnancy outcomes in type 2 diabetic patients as compared with type 1 diabetic patients and non diabetic controls. J Reprod Med. 2012;57(9–10):397–404.[PubMed]

22. Murphy HR, Steel SA, Roland JM, Morris D, Ball V, Campbell PJ, et al. Obstetric and perinatal outcomes in pregnancies complicated by Type 1 and Type 2 diabetes: influences of glycaemic control, obesity and social disadvantage. Diabet Med. 2011;28(9):1060–7. doi: 10.1111/j.1464-5491.2011.03333.x.[PMC free article][PubMed][Cross Ref]

23. Handisurya A, Bancher-Todesca D, Schober E, Klein K, Tobler K, Schneider B, et al. Risk Factor Profile and Pregnancy Outcome in Women with Type 1 and Type 2 Diabetes Mellitus. J Womens Health. 2011;20(2):263–71. doi: 10.1089/jwh.2010.2033.[PubMed][Cross Ref]

24. Wahabi HA, Esmaeil SA, Fayed A, Al-Shaikh G, Alzeidan RA. Pre-existing diabetes mellitus and adverse pregnancy outcomes. BMC Res Notes. 2012;5:496. doi: 10.1186/1756-0500-5-496.[PMC free article][PubMed][Cross Ref]

25. Dronge AS, Perkal MF, Kancir S, Concato J, Aslan M, Rosenthal RA. Long-term glycemic control and postoperative infectious complications. Arch Surg. 2006;141(4):375. doi: 10.1001/archsurg.141.4.375.[PubMed][Cross Ref]

26. Evagelidou EN, Kiortsis DN, Bairaktari ET, Giapros VI, Cholevas VK, Tzallas CS, et al. Lipid profile, glucose homeostasis, blood pressure, and obesityanthropometric markers in macrosomic offspring of nondiabetic mothers. Diabetes Care. 2006;29:1197. doi: 10.2337/dc05-2401.[PubMed][Cross Ref]

27. Ornoy A. Growth and neurodevelopmental outcome of children born to mothers with pregestational and gestational diabetes. Pediatr Endocrinol Rev. 2005;3:104.[PubMed]

28. Silverman BL, Rizzo TA, Cho NH, Metzger BE. Long-term effects of the intrauterine environment. The Northwestern University Diabetes in Pregnancy Center. Diabetes Care. 1998;21(Suppl 2):B142.[PubMed]

29. Greene MF. Spontaneous abortions and major malformations in women with diabetes mellitus. Semin Reprod Endocrinol. 1999;17:127. doi: 10.1055/s-2007-1016220.[PubMed][Cross Ref]

30. Gonzalez-Gonzalez NL, Ramirez O, Mozas J, Melchor J, Armas H, Garcia-Hernandez JA, et al. Factors influencing pregnancy outcome in women with type 2 versus type 1 diabetes mellitus. Acta Obstet Gynecol Scand. 2008;87(1):43. doi: 10.1080/00016340701778732.[PubMed][Cross Ref]

31. Egan AM, Dennedy MC, Al-Ramli W, Heerey A, Avalos G, Dunne F. ATLANTIC-DIP: excessive gestational weight gain and pregnancy outcomes in women with gestational or pregestational diabetes mellitus. J Clin Endocrinol Metab. 2014;99(1):212–9. doi: 10.1210/jc.2013-2684.[PubMed][Cross Ref]

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