Information in the Differences and Similarities in T1 and T2 Diabetes

Hello everyone,
I am in college and I am writing an essay for my communications class and I have chosen to write about the differences and similarities of T1 and T2 diabetes. I would like to find out more information and learn about other diabetics life experiences. I feel that knowing what people with Diabetes has experienced in their life will help me write my essay. I would really enjoy hearing about your life experiences if you would like to share. Diabetes runs in my family. My mom was telling me today that she first found out that she had diabetes at the age of 42. I find that very interesting because I found out at the same age. My Aunt June was a diabetic and she used to be on insulin shots. My grandfather was a diabetic and I seen him lose both legs due to gain green that started on the bottom of his foot. The gain green worked it's way up his leg and he lost his leg just below the knee. Then he lost the other one above the knee due to the same reason. I knew with diabetes running in my family that is was just a matter of time before I found out that I had the disease. I always tried to stay away from a lot of sugar. Hardly ever at candy bars. I lost 40 lbs since finding out in December that I had diabetes. I think that I am putting some of the weight back on, but not sure because I haven't been to the doctor since July. Learning how to adjust my diet was the biggest and still is the hardest thing to learn. I find it better to eat and steam fresh or frozen vegetables. Baking the meat instead of frying it is also better. When I am hungry and at work I try and snack on the fruits that we have. We are always changing it from grapes, apples, pineapple, watermelon, and cantaloupe. When I get a meal on my break I eat Monterrey chicken, baked potato,and a salad with water. Sometimes when at work it can be difficult because we make some yummy desserts for our dessert bar. For the last few months we have been making no-bake cookies. These are not an easy task to stay away from. The are one of my favorite cookies, but I can control that urge get when you want something. Some days are not as easy as others.

Similarities between T1 and T2: They are both conditions that cause elevated blood sugar levels.

Differences between T1 and T2: People with T1 MUST take insulin to survive. There is no other treatment option. People with T2, depending on severity, may control their condition with diet and exercise, oral medications, insulin, or any combination of these things.

I have a couple of friends who have T2 and, at least from what I observe in them, the differences in what they go through are completely different (compared to me who is a T1). One of my friends is managing his T2 with diet and exercise alone, another is using diet, exercise, and oral meds. They watch their carb intake, occasionally test their blood sugar, and go to the doctor a few times a year. They do "common sense" things like cut back on portion sizes and carbs and eat "healthier," but aren't particularly anal about eating. If they want a snack, they have one. Most of their progress is measured in their A1C.

As a T1, my experience is completely different. All my waking and sleeping moments are consumed by my blood sugar levels and diabetes management. My blood sugar levels and tasks around taking care of myself sometimes seem to consume my day. I count carbs, change infusion sets, weigh my food, set temp basals on my pump, check my blood sugar, etc. My blood sugar levels determine whether it's safe to drive, exercise, or leave the house. I am constantly worried if I counted the carbs in my meal correctly, if my infusion set is working properly, if my pump is going to die on me, if I'm developing too much scar tissue from my pump. Because I need insulin to survive, I am constantly worried about whether I have all the stuff I need when I travel or whether I have enough money to pay up all the copays I have to for insulin, pump supplies, and test strips. I worry about long-term complications, but also short-term complications such as dying in my sleep (dead in bed syndrome). I worry about getting sick and going into DKA. And then I worry that I'm worrying too much, and try to relax. But all this stuff is just running through my head on some endless loop.

Sometimes I wish living with T1 was JUST about food or just involved administering insulin. The fact that it is so much more, so constant and consuming, is what makes it difficult. It's a this HUGE balancing act of trying to get just the right amount of insulin into your body while taking into account food, exercise, stress levels, other hormones, weather, and a bunch of other things.

Somebody once said to me also that living with diabetes is like trying to walk a tightrope everyday. I must admit that I know very little about type 2. I have type 1 myself and as it's been said it's like having a full time job all by itself.Somedays are easier than others, somedays my bloods run smooth, but more often than not I am constantly monitoring and adusting to maintain control. Sometimes it gets too much and I let go of my control. That is when I become ill and if I want to live I must take control again. I don't think people with type 2 have the same terror of hypos that type 1's live with. I have heard that people with type2 can develope complications of diabetes due to poor control, so they also have that worry. This isn't a comprehension reply but if you stay on the site and read through people's stories you will gain valuable information and insight into these diseases.

MBP sums it up nicely. I rarely go an hour without thinking about T1. It is 24/7/365 relentless. More than just food but also about activity level and unreliable action of injected insulin. Physical and emotional hardship is a daily challenge not to mention the financial.

Wow, I am T1 pumper diagnosed a year ago after a 3 day DKA coma at the age of 44..Never had any Diabetes in the family and was a very active person with an A1C 4.9 8 mons prior to the coma. My hubby is a T2- oral hypoglycemic control. When first diagnosed, people actually thought I caught it from him..LOL ...I used to say the difference was he had the easy one-take a pill and eat whatever you want (he's done that for yrs) Now, over a year later,my A1C is 6.4 and my hubby's is 6.9..So, now he says--"You have the easy one. You eat all of the right stuff, exercise without a thgt and let a machine do all the work for you" Wish it was that easy but I guess the similarity would be---EVERYONE should be conscientous of their diet, exercise and lifestyle.. The difference is one person's nightmare can be someone else's dream!

MBP - Excellent summary of all the things that T1s pay attention to, in addition to all of the other issues that life throws at us. You hit the nail squarely on the head with this:

Sometimes I wish living with T1 was JUST about food or just involved administering insulin. The fact that it is so much more, so constant and consuming, is what makes it difficult.

I'm T1 and I'd like to add that eating and taking insulin to cover what I just ate is not as simple as it sounds. There is absolutely no way to know the EXACT amount of carbs eaten to match the amount of insulin needed. It's all a guessing game! AND, that game changes constantly. We have to consider things like the weather (hot or cold affects our insulin rates), stress, hormones, food, exercise, etc. And, right when you think you've tweeked your insulin rates, it changes again.

Laura - Type 1 diabetics produce little to no native insulin. They must take insulin, by a shot or infusion pump, or they will die.

Type 2 diabetics do produce insulin but their body is resistant to using it. Even this impaired insulin metabolic function tends to give T2s a bit easier time controlling their blood glucose and many T2s, with focused effort, can reasonably achieve A1c's under 6.0%.

It is much more difficult for a T1 to bring their A1c under 6.0%. That being said, there are many T1s in this community that sport sub 6% A1c's. Participation in this diabetes online community is a good indication of people willing to make a good effort to control their blood glucose level.

T2s over time lose the ability to produce insulin and then must take insulin, like T1s. T1s often gain weight due to using insulin and start to become insulin resistant. It's a complicated disease and it resists simple T1/T2 comparisons!

Please keep in mind that the A1c test is simply an average blood glucose over approximately the last three months. It tells nothing of blood glucose variability, an important influence on the quality of life.

All T1s and some T2s (from memory, about 25%) use insulin. Insulin, a very effective tool for controlling blood sugar, can be very tricky to use well.

There is a great deal written in the TuDiabetes archives. I recommend that you spend some time reading what many others have written over time. Good luck with your paper!

Ugh, exactly! There are so many unknowns when it comes to functioning as a pancreas. And maybe that's the real difference conceptually - T1s have to function as their own pancreas, which I refer to as the most under-appreciated organ in the human body. We marvel at the brain and our heart, but the pancreas? No one gives it a second thought until it no longer works.

Also, T1s who develop the condition as the result of an autoimmune attack on the beta cells (the majority of T1s) also lose the ability to produce other hormones that, while not necessary for sustaining life, may play a role in the development of complications in the long run.

Good point about the financial aspect of it. Because our needs are so immediate (must have insulin to survive and require external insulin all our lives), the financial aspect can take a huge toll. I spend far more than I would like to on pump supplies, insulin, and test strips. I am fortunate to have good insurance, but the cost of these things even with insurance adds up. When a T1 loses insurance, it is an immediate disaster, one that is very stressful.

We also have to constantly deal with insurance companies, whether it's obtaining the appropriate approvals for pumps or CGMs or just making sure that our bills are getting paid.

T1 and T2 are the same, but different. Autoimmune T1 is a narrow condition, you basically are insulin deficient. But T2 is a complex condition with a great deal of variation. The respected researcher Ralph DeFronzo suggests that there are eight different defects associated with T2, of which one is insulin resistance.

I am T2, but never fit the classic stereotype of an overweight T2 who could just "fix" things with eating less. I could never gain good control with diet and exercise and escalated throught medications, eventually up to triple medication. These days, I use insulin and have achieved good control.

These days, my life is very similar to a T1. I continue to be very strict about my diet, far more limited than you describe. But I test often and I inject insulin every time I eat. And I also test my blood sugar and just shake my head in disgust at readings that are just wacko. But, I am fortunate that I don't suffer the extremee fluctuations that many of my T1 friends here suffer. In compensation, I struggle with insulin resistance and carb intolerance.

I long ago decided that the things that made T1 and T2 different were largely irrelevant. All that matters to any of us is that we are able to properly take care of ourselves and live a long happy and healthy life.

I'm an insulin dependant T2 and now a days my treatment is more like that of a T1 than the average T2. It took me 20 years to get to a full insulin regime. During that time I have been on diet and exercise, then an oral med was added, then multiple oral meds and after a while injectables such Byetta was added then finally I was started on insulin.

Treatment of T2 medicine wise is a constantly changing affair. It has been said that no two diabetics are alike, that's even more true for T2.

Being on oral meds is frustrating thing because you have no real control. Oral med can leave you frequently with high blood sugars with no remedy except wait. Even though I took on most of the issues that T1's have I felt kind of relieved when I started insulin because I have a powerful tool I can now use.

As an insulin dependant T2 on MDI I must still deal with the insulin resistance that almost always comes with T2. That makes my insulin needs higher than the average T1.

T2 is a progressive disease that gets worse as time goes by. T1 is full blown bad and ugly almost from the start. T2 treatment leaves a lot to be desired since it's main focus is to prevent high sugar sometimes with poor results. T1 treatment is a never ending thing that requires constant attention.

Since I faced all the challenges of T2 and now face the challenges of insulin use faced by T1's I feel qualified to say that neither form of the disease is a picnic and I would not wish either type of diabetes on even my worst enemy.

Gary S

One observation I want to make is that Type 2's are presented with such a disservice by the medical profession that tells them they don't need to test more than a couple times a day. While that's not a good thing even on diet and exercise and oral meds, when Type 2's are eventually put on insulin, so many carry over those beliefs. I know Type 2's who are now on insulin after many years. One is on older types of insulin, rarely tests, and has made no diet changes; the other is on a sliding scale and tests a bit more often but not really enough for someone on MDI. This is, in my opinion, in large point due to doctors (mis)information.

and on the other sad side of the coin it may very well be that " the older age types " have no desire to be more pro active "

...complexity abound and difficult to pinpoint the reasons .

One difference between T1 and a T2 who isn't on insulin is that a T1 gets immediate feedback all the time which is the positive side of the all consuming nature that MBP described so well. If I make a mistake, I know it within a couple of hours and can use insulin or glucose tabs to correct and perhaps learn something in the process. For those not on insulin, the process doesn't seem nearly as direct.

Good point there! I can only speak from a Type 1 prespestive but it runs in both sides of my familty and my daughter is aa Type 1 herself. If u need anything for ur paper just ask me. I've been a Type 1 for 39 years now. My daughter is 24 years old and was diagnosed at 11 herself

To piggyback on what Zoe and a few others have said, I think the upside of being a T1 is that you're rarely seen to be "at fault" by the medical community. Whereas, T2s are often blamed for "causing" their condition through being overweight and lazy and consuming bad foods. I've learned from being on this site that T2 diabetes is much more complicated. I know that one of my friends who was diagnosed as a T2 recently has never been overweight and has always been a generally healthy eater (certainly no worse than the average American). He was quite shocked to learn that had developed the condition. So, in that respect, being T1 is easier. There aren't really many treatments to choose from - it's insulin or bust!