What's the Difference Between Type 1 and Type 2 Diabetes?
Why would anybody bother to post an article on the difference between type 1 diabetes and type 2 diabetes? Well, there are some distinctions that are easy to miss, and that aren't being repeated in post after post after post. Knowing them just might point you in the direction of better treatment or even avoiding the disease. Here's my take after 25 years as a diabetic and 20 years in doctor-friendly but natural healthcare for diabetics.
Diabetes (more technically, diabetes mellitus, literally “sugar diabetes”) is a failure of the proper metabolism of sugar. Diabetes causes glucose to remain in the bloodstream rather than to be transported inside cells where it can be used as a source of energy. In full-blown diabetes, cells may be starved for energy and forced to burn fat and protein for fuel. The byproducts of protein breakdown accumulate with sugar in the bloodstream and increase the urgency of both urination and thirst. Even before the disease is fully developed, there can be blurred vision and slow healing of cuts, scrapes, and infections.
There are two major types of diabetes mellitus. Type 1 diabetes involves a complete or nearly complete failure of the cells in the pancreas to produce insulin. This form of diabetes usually strikes in childhood or early adulthood, although in rare cases older adults can develop type 1 diabetes after viral infections or as a complication of treatment for cancer or HIV. Children and young adults who develop type 1 diabetes carry genes that predispose them to the disease, but only about 40 percent of the carriers of these genes actually develop the disease. At one time researchers believed that the actual development of the disease involved an allergy to cow’s milk or exposure to immune factors in the breast milk of diabetic mothers, but the current thinking is that viral infections, especially viral diarrhea, trigger the disease. To the extent type 1 diabetes can be “caught” from breast milk from a diabetic mother, it can be prevented if the mother takes insulin to control blood sugars.
Type 1 diabetes comes on suddenly. It typically is diagnosed in an emergency room. This form of diabetes must be treated with insulin. No existing therapy, conventional or alternative, can replace the need for taking 3–5 injections of insulin each and every day. Natural treatments for type 1 diabetes, however, can help the body use insulin more efficiently and help prevent complications.
Type 2 diabetes does not always require insulin injections, but this form of the disease is more insidious. Type 2 diabetes is sometimes only diagnosed after it causes a serious complication, such as loss of sight or ulceration of a foot or leg.
Like type 1 diabetes, type 2 diabetes has both a genetic component and an environmental trigger. Some people are born with a genetic defect—actually a genetic characteristic that confers greater likelihood of survival between conception and birth—that causes every cell in their bodies to react to insulin in an unusual way. The outer membrane of every cell in the body holds proteins that act as a lock for which insulin is the key. These receptors grasp insulin and take it inside the cell. In people who are prone to type 2 diabetes, cells reduce the number of receptor sites for insulin if the amount of insulin in the bloodstream increases. That is, if the body makes more insulin, cells change so that they are less, rather than more, able to respond to it.
When people with this genetic characteristic gain weight or become physically inactive, at least two vicious cycles set in. Increased body fat, especially over the abdomen, physically blocks the flow of blood to the fat cells that ordinarily store and convert sugar. Since glucose cannot reach fatty tissues, it remains in the bloodstream. The pancreas senses the additional sugar and makes more insulin. The additional insulin, however, causes fat cells to lose insulin receptor sites. Both sugar and insulin stay in the bloodstream, and cells lose still more insulin receptor sites, so the pancreas produces still more insulin. A second vicious cycle involves insulin resistance. When blood sugar levels pass about 170 mg/dl (9.4 mmol/L) liver and muscle cells protect themselves by disabling insulin receptor ports for sugar. (They still receive fatty acids.) Glucose stays in the bloodstream and blood sugar levels go up. The pancreas releases more insulin, at least in the early stages of diabetes to get blood sugar levels back down, but cells shut down still more insulin receptor sites for sugar. The pancreas releases still more insulin, cells become even more insulin resistant, and eventually the ability of the pancreas to make insulin is greatly reduced or destroyed.
Even when people have a genetic tendency toward type 2 diabetes and become overweight, however, diabetes is not necessarily inevitable. I'll talk more about that in my next post.