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?

What are my chances?

Okay, take a look at the lovely christmas treat above.

What a lovely looking treat. My wife’s surgery had them in the office the other day. Let’s take a look inside:

That’s it. Full of delicious-looking chocolates. What a festive treat! Those little chocolate squares are maybe a cat’s whisker shy of 2″ x 2″ x ¼” each.

Now, bear in mind that my wife works in a doctor’s surgery. Also bear in mind that my wife liked them so much, we went and bought some today. We tried one each when we got home. Very enjoyable. I love a tiny bit of Turkish Delight.

Then I looked at Asda’s web site (Asda is a UK supermarket).

Wow! 47kcal per chocolate. Given that I’m diabetic and have to ration myself, how long do you you reckon these bad boys will last? Done by next christmas? Maybe I’ll just keep ’em for when I have a hypo?

Obsession

One of my friends posted the other day an informative article about OCD. It’s interesting, because there is something similar with stroke. As far as I am concerned, there is not a hint of disorder about it, but it is definitely a little obsessive.

Let me tell you about the kettle. I drink lots of tea, for which I boil a kettle. My rule? after the kettle boils, I pour my tea. If, after that, there is not enough water for another cup, I have a task to fill the kettle once again. Once full, I turn the kettle on, but don’t bother waiting for it to boil, as I’ve already poured my cuppa. I head to the lounge to drink it in my armchair.

Meantime, the kettle boils.

The reason I boil the water is because in the kettle will stay quite hot. When I want the next cup, it won’t take as long to boil, which means that I’ll spend less time standing, waiting for it. That’s the key here, the second-highest consideration behind just making the tea itself.

In fact I apply this rule all day, unless this is my last cup of the evening. If it is the last cup of the evening, I’ll fill the kettle but won’t boil it. There’s no point because it’ll be well and truly cooled by morning. Lastly, I have a nifty little gadget which will allow me to trigger the kettle from the comfort of my bed next morning.

Okay, right now, you should be thinking this is all perfectly logical, but why on earth has he gone into so much detail?

What I just did was to give you an example of how stroke affects me. I’m limited physically (in this instance, how long I can stand at a worktop before having to rest), so I think things through to work out the most efficient pathway to getting the job done.

I bet you never thought that there was an efficient way to making a cup of tea, did you? But there is. And with the fatigue I have experienced since the stroke, my choice of pathway can make the difference between enjoying my cuppa or having to postpone the exercise until later, until after I’ve rested.

Even my able-bodied wife, who is a nurse, does not realise that any level of planning is involved. I never did myself, before…. She makes a drink, and leaves the kettle empty. I grrrr, but what can I say? For anybody else, this stuff is trivial.

Of course, I have become stronger over the last few years, but in many ways this is very much like being a toddler all over again, except that I am now able to process the thoughts which go with the experience.

For exactly the same reason, my getting up routine. I can at least trigger the kettle from bed, but as the water nears its boiling point I need to be busy.

First stop is the toilet, because which of us can begin the day without having a pee? Next stop is the lounge, where I turn on the computer and retrieve last night’s teacup. I’ll take that and leave it by the kettle, which is by now well on its way. Plus, there are two hollow-legged cats who need their breakfast! No gadgets to placate them, unfortunately. I get that done as quickly as possible, before I head to the bathroom to prick my finger. A glucometer test, provided there aren’t any mishaps, is a two-minute affair, and a measurement before I’ve drunk or eaten anything provides a baseline which guides my insulin dose. By the time I am finished, the kettle will have boiled. My duties over, I can make my cuppa and return to the lounge, where the computer should have started by now and should be ready to do something useful.

This is a set pathway, the shortest path between the rooms, which I follow every morning. It gets my fasting blood sugar, my first cuppa, and my computer up-and-running, without my usually having to wait for anything.

But in both of these cases, please look past the detail. What I actually do, the order in which I do it, is irrelevant. That I have contrived a set order of ceremonies at all, is what is relevant.

You wouldn’t think somebody might need a rest while just preparing a drink, would you? But that is one of the ways in which fatigue hits, and 70% of stroke survivors experience some degree of fatigue. I don’t really expect people to be able to empathise with me – until I had the stroke myself, it isn’t something I could have grasped, but if it is something which interests you, I hope my examples give you some insight. What might be trivial for some will be a marathon for others.