Differences Between Type I and Type II Diabetes

I hit my reader yesterday, and it suggested a post I might be interested in. It was from a diabetic guy, talking about his diabetes. The first thing he said was I am Type 1, so I can only really speak for myself. I can’t really speak for Type II diabetes. It’s funny because on my journey, one of my first questions was what’s the difference? I don’t know the full story but here is what I do know:

Diabetes (any type) is high blood sugar. Beyond that, there are several forms of diabetes. Type II is by far the most common, covering 80-90% of cases. Then comes Type I, covering about 10% of cases. There are other forms of diabetes too, but they are rare in comparison to the two biggies. These different types cover not the raised blood sugar itself, but the causes. Once your sugar is raised, you can look forward to the same lovely benefits, whatever type you have.

Type I is where your body attacks itself – it’s an auto-immune thing, resulting in no insulin being produced. Insulin counteracts glucose (sugar). If T1 is detected, it is often detected early, although in some people it can come on as an adult. The tratment is clear – insulin. There is empirical evidence to suggest a familial link, but the causes ultimately are not yet known, although links with lifestyle or weight have been ruled out.

Type II is where you don’t produce enough insulin, or where the insulin you do produce doesn’t work. It usually gets detected when you’re a bit older. In my case, I think of things degrading over time. There are various treatments which do various jobs – reducing sugar directly, or poking various organs to work harder. Ultimately, there is the same treatment as T1, insulin. T2 is often associated with lifestyle, although in my case the familial link is very strong, though the lifestyle link pretty much non-existent.

There is no cure for either T1 or T2, although with T2 things like what we eat and how much we exercise play a part, so some people can go into remission by changing their lifestyle. I didn’t, so this rule does not apply to everybody. I guess one of the reasons that there are more options with T2 than with T1 is research – I suspect that T1’s cause being as yet unknown is largely down to funding.

Either way, your body has an intolerance to carbohydrates. Many T1s will religiously carb-count, for the simple reason that it guides their insulin dose. I don’t carb-count, although possibly I should. My dose instead is guided by the less specific what did I eat (good/bad)?, or how much did I eat (big/small)? If I ate a lot of carbs, say, I take a 10% higher dose, but again this is empirical, not scientific.

Note that I am using the word carb above. Not sugar. Although sugar is a carb, so there is a link. But a bowl of pasta will do as much damage as a packet of candy.

The insulin that I take is pre-mixed. A fast acting insulin plus a slower-acting insulin. I did post about this ages ago here. The pen is marked just in “units”. Exactly what a unit is, I can look up, but the point here is that working out how many millilitres of a particular insulin I am getting requires a couple of calculations, plus the proportions of the two types of insulin are fixed at 3:1, so for every 3 of slower insulin, I am getting 1 of fast insulin. For these reasons, mixes tend not to be prescribed to T1 diabetics. (That one comes from my wife, who is a diabetic nurse.) The guy whose blog I was reading yesterday did, however, take the two types of insulin – they were different brands to what I take, but the same kind of thing – but took them separately, so he could vary the proportions.

As I said at the top of the post, I don’t consider myself an expert here, but this is just knowledge I have picked up along the way. In many ways it is immaterial, because regardless of the cause, we’re faced with the same problems. I chuckle, too, when I hear new stroke survivors talk about whether their stroke was due to a bleed, or due to a clot. Because that’s the language they hear from the staff. Whatever the cause, we’re all still in the same boat. But maybe that’s just me?

13 comments

  1. I have type 2. Carbs are definitely the problem..I simply can not metabolize them the way I should. And of course, all of my favorite foods are carbs……. I am only on metformin, a lovely once a day pill. I dread the day I may have to take shots of insulin but figure it is coming. I, luckily, am married to a registered nurse who understand everything I do not, and helps me deal with my issues. Hang in there.

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    • Tbh my control is far better on insulin than it was with anything else. But there are side effects such as weight gain. Metformin here is horse pills, hated it, but it is generally the first stage of medication. If you’re only taking metformin now, you’ll probably die of something else way before you get to insulin. But if you do end up on it, the needle is only, like, a quarter-inch so it only really stings if you prick yourself twice on the same spot.

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  2. Well I didn’t know a lot of things you described here. Thank you for the info! So type II isn’t per se heriditary if I understood correctly.

    But the carbs thing is difficult, so you need to watch the portion of patatoes and a lot of other things I believe?

    Are there also varieties in Type II diabetes? I know people who have to measure their levels by pricking their finger but others take ‘just’ medicine. What is the difference there?

    And when you are ‘only’ required to take the pills, do you need to watch your carbs as well or will the pills ‘take care of it’ in one swoop?
    I have a lot of questions here …. don’t feel pressured to respond to all!

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    • 1. All of my father’s family had it, so I would argue that T2 is absolutely hereditary.
      2. potatoes are a pain but something I usually avoid. Same with frites and chips. Rice is not so bad. Pasta, bread are, white bread in particular.
      3. Dunno about BE. In UK it is economics. NHS will generally not fund the strips so they need to be conscious that someone might not be able to afford to test, so often do not recommend testing if sufficiently mild. As it gets worse, they will fund some very specific strips.
      4. Yes you always need to watch carbs. It is the same as with anything – the better you look after your carbs, the less medication you need to take.

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    • most people with type 2 still need to check their blood sugar levels several times a day. the ones who do not check are basically non-compliant with their doctor’s orders. sticking a finger hurts. it is annoying to have more bandages on your fingers than actual fingers. the difference is type 1’s no longer create insulin. type 2’s still create it it just sort of hangs around and refuses to work properly. The less compliant a type 2 is with the regimen of diet, exercise, blood checks and meds, the more medications become necessary. ultimately a type 2 will end up on insulin shots too. if they dont have a stroke or heart attack first. so far as carbs..carbs convert directly to sugar in the digestive process. if you are also eating anything with natural sugars you are overdosing on them. no to low carb is the easiest way to control sugars. and the pills and shots don’t really do anything about the carbs. they assist the pancreas to create and use insulin.

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      • Thank you for your clear answer! I just have an additional question on the carbs, maybe a silly one. If I understood correctly rice is better than potatoes? Is there a difference between white rice and less processed rice, in terms of carbs they would be the same no?
        I love potatoes! But I also understand that variety is key. I’ve only learned about something called ‘the potatoe diet’ I think that that must be not good at all with the knowledge that I learned here.

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      • I usually test twice a day, to guide my insulin dose. On occasion, I have tested myself every hour, just to see some typical values thru the day. It is usually lowest when waking and highest early evening. I have recently experimented taking the same dose, but shots at breakfast and lunch, which seems to be quite effective.

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  3. Some good info there, but type 1 doesn’t cause an intolerance to carbs. I know what you’re getting at, but it’s not quite right.

    In theory, if you could bolus the right amount of insulin, you can eat all the carbs in the world.

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  4. Along with type 1 and type 2 there are a handful of others as well. This short read briefly explains the difference, how individuals are affected, how one may contract a diagnosis, and best ways to control the symptoms / affects naturally! Thanks for this read.

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