It all comes down to insulin production.
Type 1 and type 2 diabetes can certainly have similar symptoms and complications, but it’s a mistake to conflate them. Yet, conversations about diabetes on your Twitter feed or the evening news often fail to specify, referring simply to “diabetes” and ignoring the uniqueness of the two types.
“In type 1 diabetes, your body cannot produce any insulin,” says Sonal Chaudhry, MD, an endocrinologist at NYU Langone Health in New York City. “In type 2 diabetes, your body produces insulin, but may not be enough to produce enough to overcome the peripheral insulin resistance.”
Insulin is a hormone secreted by the pancreas that helps move blood glucose from the bloodstream to cells for energy, according to Dr. Chaudhry. When the body does not have enough insulin, excess glucose remains in the bloodstream, leading to high blood sugar, known as hyperglycemia. (Learn more about how insulin works here.) Over time, this can damage critical organs like your heart, kidneys, and brain.
In type 1 diabetes, previously known as “juvenile diabetes,” the immune system attacks the pancreas and prevents it from making insulin. “There’s usually a genetic predisposition,” says Minisha Sood, MD, an endocrinologist in New York City, “and then some inciting event—some precipitating factor—that set off the immune system.” As a result, the immune system attacks the pancreas.
Patients with type 2 diabetes, on the other hand, do make insulin, but their livers and muscles do not respond to the insulin as they should, which is known as insulin resistance.
After eating a meal, they may see a blood sugar spike because the insulin is not moving glucose out of the bloodstream. “Their body will produce insulin, and produce a lot of it,” says Dr. Chaudhry, “but they may not be able to overcome that insulin resistance.”
Over time, the pancreas may lose its ability to produce insulin with type 2 diabetes, and patients may need to take insulin injections to manage blood sugar, according to Dr. Sood. On the other hand, patients with type 1 diabetes need insulin immediately.
Previously, experts often distinguished between type 1 and type 2 diabetes based on the age of diagnosis, which is why type 1 diabetes used to be called “juvenile diabetes.” That’s changed: Adult-onset type 1 diabetes has become more common than it used to be, just as young children are now being diagnosed with type 2 diabetes due to an increase in childhood obesity and sedentary lifestyles.
Regardless of the type of diabetes, patients with either type 1 diabetes or type 2 diabetes need to manage their blood sugar levels. Here are the worst foods for diabetes and lifestyle habits for better blood sugar management.
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In type 1 diabetes,
your body cannot produce any insulin.
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In type 2 diabetes, your body produces
insulin, but may not be able to produce
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enough to overcome the peripheral
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Insulin is a hormone secreted by the
pancreas, and insulin is needed to move
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blood glucose from the bloodstream into
the peripheral cells to be used for
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Type 1 diabetes is characterized by
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a lack of insulin production.
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There's usually a genetic predisposition
and then some inciting event,
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some precipitating factor that
set off the immune system, so
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the immune system then
attacks the pancreas.
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There are antibodies that are formed
to different parts of the pancreas,
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specifically cells called the beta cells,
that make insulin, and
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over time, the pancreas loses
the ability to make insulin.
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Patients with type 2 diabetes still make
insulin, but they don't use it very well.
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That's called insulin resistance.
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Their liver doesn't respond to
insulin as well as it should,
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neither do their muscles.
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And because of that, blood glucose, blood
sugar can't get into the cells where it
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needs to be.
When you eat a meal, your blood sugar
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is gonna rise, your pancreas will
sense that blood sugar rise and
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secrete appropriate amounts of insulin to
deliver that glucose to your cells and
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maintain a normal blood sugar.
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In somebody with type 2 diabetes,
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their blood sugar will rise after a meal,
their body will produce insulin, and
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produce a lot of it, but they may not be
able to overcome that insulin resistance.
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And in that setting,
the blood sugar may stay elevated.
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And then over time, many years,
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there's loss of the pancreatic ability
to make insulin in type 2 diabetes.
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So later on in type 2, patients may
require insulin, but people with type 1
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require insulin right away.
Type 1 diabetes was called juvenile
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diabetes because historically, patients
were younger when they were diagnosed.
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But we now know that you can develop type
1 diabetes later in life, and that type 2
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diabetes is being increasingly diagnosed
in young and adolescent patients as well.
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Type 2 diabetes is occurring earlier
because many more younger patients
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are obese and sedentary or
don't have healthy lifestyles.
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