If you’ve ever been less than clear on the differences between type 1 and type 2 diabetes, you aren’t alone. Even some people who have diabetes struggle to understand what makes these two diseases different.

It doesn’t help that there are, indeed, quite a few similarities between the two or that they have deceivingly similar names. But T1D and T2D are actually very different diseases, with different causes, treatments, and outlooks. You can’t go from type 1 diabetes to type 2 or vice versa. But, if you are really unlucky, it is possible to have both at the same time.

So how are these two chronic illnesses different? And if they are so different, how did they end up with the same name? Let’s take a closer look at the two most common forms of diabetes.

Cause of Diabetes Type 1 vs Type 2

Over 30 million Americans have diabetes. About 95% of those people have type 2, while only 5% have type 1. T2D is the most common type of diabetes among all age groups, with the exception of children and teens. Though, the number of minors with T2D is on the rise. The number of people being diagnosed with T1D overall is also on the rise.

Scientists believe the increase in both types of diabetes could be due to overlapping factors, including diet and immunity. But what causes each disease in the first place, couldn’t be more different.

Different causes

• Type 1 diabetes is an autoimmune disease in which the person’s immune system attacks the insulin-producing cells of the pancreas. 
• Type 2 diabetes is caused by the body’s inability to use insulin effectively, either because of insulin resistance or other metabolic issues.

Insulin Production

• Once all the beta cells have been destroyed, a type 1 diabetic can no longer produce their own insulin. 
• T2Ds make their own insulin, but, due to insulin resistance, they may require more insulin than their beta cells can create.

Role of lifestyle and weight

• Type 2 diabetes is influenced by diet and a person’s body mass index. 
• Type 1 affects people of all sizes, regardless of diet and weight.

Age of diagnosis

• Type 1 is commonly diagnosed in childhood but can strike at any time throughout a person’s life. 
• Type 2 is most commonly diagnosed in older adults and the elderly, but is seen in people of all ages and is increasingly common in children.

Similarities

• While the causes of each type are very different, both result in elevated blood sugars.

Symptoms of Diabetes Type 2 vs Type 1

In Greek, the word diabetes means “to pass through”, and the Latin word Mellitus means “sweet.” Both diabetes mellitus type 1 and diabetes mellitus type 2 got their names because of the tendency for glucose to pass into the urine in both diseases. In fact, T2D and T1D share a lot of similarities in the symptoms they each cause.

Speed of onset:

• Type 1 diabetics most often see symptoms come on very quickly with blood sugar rising to dangerous levels within weeks or a couple of months. 
• Type 2 diabetics may have elevated blood sugars for months or years before a diagnosis is made.

Blood sugar levels

• The blood sugar levels of a T1D will typically reach extremely high numbers if left untreated. 
• People with type 2 diabetes, on the other hand, will typically only have mild to moderately high blood sugars if left untreated.

Weight gain/loss

• Many type 1s experience weight loss before diagnosis 
• Those with type 2 are often overweight at diagnosis.

Similarities

• Both types of diabetes cause high blood sugar.
• Frequent urination, excessive thirst and hunger, and feelings of fatigue are common symptoms in both cases.
• High blood sugar can affect the eyes, kidneys, and nerves in both T2Ds and T1Ds.
• Difficulty in healing and frequent infections are also symptoms which both types of diabetics experience before and after diagnosis.
• Medications used to treat both diseases are known to cause low blood sugars, which can cause fatigue, shaking, confusion, and, in extreme cases, loss of consciousness. 

Treatment of Type 2 Diabetes vs Type 1 Diabetes

While the symptoms of these diseases have a lot of overlap, how each is treated has more to do with the underlying causes than the symptoms they produce.

Treatment with insulin

• Type 1 diabetes can only be treated with insulin injections (either through a pump or multiple daily injections). 
• Type 2 diabetes may sometimes be treated with long-acting insulin, but multiple daily injections of insulin as treatment is rare.

Treatment with other medications

• Type 2 is most frequently treated with oral medications that help remove excess glucose from the bloodstream and increase insulin sensitivity. 
• Type 1 diabetics are almost never treated with oral medications.

Blood glucose monitoring

• Many type 1s will opt for a continuous glucose monitor (CGM) to keep tabs on their blood sugar levels throughout the day. 
• This type of ongoing minute-by-minute monitoring is usually unnecessary for type 2s.

Role of exercise

• T2Ds are often instructed to diet and exercise as part of their treatment plan. 
• No amount of dieting or exercise will cure type 1 diabetes.

Similarities

• Both types of diabetes require frequent blood sugar checks.
• Both types require diet changes and monitoring. For type 1s this is necessary in order to assure correct insulin dosage, while type 2s should use diet to reduce insulin resistance and lose weight if needed.

Prognosis of Type 1 vs Type 2 Diabetes

The prognosis of a person with either type of diabetes depends greatly on how well they follow their treatment plan. But long-term health can also depend on the type of diabetes they have.

Prospect for a cure/remission

• Type 1 diabetes is a lifelong illness with no cure at this point. 
• In many cases, type 2 diabetes can be reversed, but a person is always at risk of needing treatment for the disease again.

Risk of complications

• With proper treatment and hard work, many people with type 2 can drastically reduce their chances of suffering long-term consequences from high blood sugar. 
• Even with excellent management, most T1Ds will see some ill effects of high blood sugar as they age.

Risk of medical emergencies

• Because of the effects of insulin and the tendency of blood sugars to rise very quickly in type 1s, hospitalization for extremely low or high blood sugars is common. 
• People with T2D are less likely to experience extreme blood sugar fluctuations, especially after the correct medication doses are established.
• T2Ds are more likely to suffer from wound healing issues and amputation, but poorly managed T1Ds can end up with these problems as well.

Similarities

• Both diseases require a lifelong commitment to avoid long-term complications.
• Both T2D and T1D can cause cardiac, nerve, kidney, and eye problems over time.

All Types Know the Fight

Despite their differences, people suffering from type 1 and type 2 diabetes share a lot in common. 

They both know the shaky, uneasy feeling of low blood sugar. And the pain and fatigue brought by elevated blood sugar. 

They also know that good health is a reward that only comes with hard work, dedication, and a lot of finger pricks.