I don't know how many times I've explained the difference between Type 1 and Type 2 diabetes -— to family, friends, colleagues, teachers, other mothers, you name it! I never really intended to write about it here, figuring I was addressing a primarily diabetic audience that'd be quite familiar with the distinction. But I've been implored to do so, and there's also been some hot blog discussion on the topic of late.
So for those who aren't familiar: Type 1 and Type 2 diabetes are essentially two different diseases. What they share is the central feature of elevated blood sugar (glucose) levels due to absolute or relative insufficiencies of insulin, a hormone produced by the pancreas. Insulin is a key regulator of the body's metabolism.
To paraphrase author and blogger Martha O'Connor:
Type 1 Diabetes, traditionally referred to as juvenile-onset diabetes as well as insulin-dependent diabetes mellitus (IDDM), is a genetic autoimmune disorder. The body's T-cells recognize the insulin-producing cells of the pancreas (islet cells) as foreign invaders and begin to destroy them. Eventually, all the islet cells are destroyed, and the patient must take insulin shots several times daily in order to sustain life.
Just because you're an adult, you can be diagnosed with type 1, too -- it's known as LADA (Latent Autoimmune Diabetes of Adults).
Type 1 Diabetes is NEVER caused by unhealthy lifestyle or simply by eating too many sweets. Never.
Type 2 Diabetes, which most often hits adults but has been on the rise in children since the mid-2000s, is a disorder in which the body is no longer able to properly use the insulin being produced. Type 2 can be brought on by poor diet and sedentary lifestyle, but that does not mean it always is and it's not accurate to feed that stereotype (pun, sorry). Essentially, overloading the body with carbohydrates over time causes the system to "break down" such that insulin can no longer be absorbed. Type 2 can often be controlled with diet and exercise, and/or with oral medications, though often they can find better management with insulin too.
Note that Type 1 diabetes can never be controlled with just diet and requires frequent blood glucose monitoring and insulin shots to preserve the patient's life. Type 2 diabetes may be preventable if a pre-diabetic condition is caught early. Sadly, once the autoimmune reaction of Type 1 diabetes has begun, it cannot be reversed. There is no known way to prevent Type 1 diabetes, although researchers are working on it.
Paul Chaney of The Diabetes Blog poses the question whether a rift exists between the two diabetic "camps."
I like to stick to the mantra, "we're all in this together." Because we are!! But... there is also the aspect that many Type 1s can't help feeling resentful of healthy people (i.e. carrying no genetic defects) who "brought the disease on themselves" through overeating and sluggishness.
As Scott Reynen comments on The Diabetes Blog:
"I've had negative feelings about Type 2s for a while now. But I think it's sort of like watching rich people waste money. I'd probably do the same if I were rich, but as I'm not, it's annoying to see them waste something I'd love to have. In the case of Type 2s, that something is the opportunity to not be diabetic, which to me is more valuable than money..." (I added the italics, btw)
Also many Type 1s and parents of Type 1 diabetic children are offended by the fact that much of the world lumps all diabetics together -— typically assuming that we all brought the disease upon ourselves in some way.
Martha writes: "It's very demoralizing and disheartening for a child with a chronic, life-threatening and uncurable illness to be told he did something to cause this illness, when he did NOT."
Again, Type 1 is a genetic weakness that usually strikes thin people, who then characteristically become ultra-health-conscious.
BUT THEN AGAIN, there are also many Type 2s who apparently have a natural propensity for insulin resistance, and some who cross the line, like Kathleen Weaver, a Type 2 who is on insulin therapy and therefore lives like a Type 1.
So from my perspective, once you've got diabetes -— whichever type -- what it boils down to is what you're going to do about it. I am very bothered by people who do little or nothing, and let themselves slip away. My own father died FAR TOO YOUNG from the effects of neglected Type 2 diabetes. If you've gotten to a bad place by taking poor care of yourself, then stand up and act, before it's too late!
Remember, no matter what type of diabetes someone lives with, they didn't ask for this. No one should be blamed or stigmatized as a result of diabetes, and there is no "bad" kind that worse than another. We are all part of this same diabetes community, working VERY HARD 24 hours a day and doing what we can to best manage and stay healthy.