Hack #8: Type 1 vs. Type 2 Diabetes for Dummies (like me)

Okay, first of all, there are dozens of places a person can go to on the web to understand the technical difference between T1D and T2D, and explain it much more thoroughly than I can. I'm writing this blog because, after contracting diabetes, I read about it several times, and it was explained to me several times by various articles, books, doctors, endocrinologists, nurses, etc. But even with an above-average IQ, it took awhile for it to sink in. 
       So, the purpose of this article is to try and cut through all the technical stuff and focus on what I think matters on the topic for those who are curious about the topic but don't want to get lost in the mire.
       On the surface, T1D and T2D share these commonalities:

• Both relate to the body's inability to break down sugar (glucose) in the body and convert it to energy (or fat), and so both are often treated with insulin injections.
  
• Both types can cause people to have high glucose levels in their bloodstream (which can lead to eye, heart, and other issues in the long-term, if left untreated) and low-glucose levels (which can quickly lead to loss of consciousness, coma and even death if not treated immediately).
  
• Both can also cause unexpected weight loss, thirst, cramping, and lack of appetite when untreated for a period of time (as was the case with me. See Hack 4), when glucose levels stay elevated. Typically, T2 diabetics are overweight and inactive, but this isn't always the case. There's such a thing as "skinny diabetics." 
  
• Both types can be mitigated by careful dietary choices and exercise. And this is very important to realize, especially for Type 1 diabetics. Even though T1D requires insulin for life (unlike T2D, where they can lose their insulin dependence), T1 diabetics can reduce the amount of daily "units" they require of both long-acting and fast-acting insulin to keep their glucose in a safe range, if they chose to be careful about the quantity of carbohydrates they eat at their meals (see other Hacks on diets and supplements for glucose management), and rigorous exercise, which can instantly lower glucose levels.  

But here are some important differences that are good to know about: 

• T1D occurs when the body's pancreas can't produce any / enough insulin to convert sugar in the bloodstream into energy in the body. People with T2D typically have a functioning pancreas, but their body has developed "resistance" to the insulin it produces, and so more insulin (from injections) is often needed to help that process.
• T1D is not curable (yet at least). People with T2D, however, can usually make their diabetes "go away" if they lose weight and exercise, which can reduce or at least temporarily eliminate their body's resistance to the insulin it produces. And I've read that many of the symptoms that they experience, like eye/retina issues and foot/neuropathy issues, can also go away or be significantly improved. 
  

The challenge in diagnosing T1D vs. T2D is that, according to my endocrinologist I consulted at the Mayo Clinic in Rochester (see Hack on this, too), the only way to be conclusive about which type one has, is to do an antibodies test (a c-peptide test can help as well, which determines at what level the pancreas is functioning), AND that test is very expensive (nearly $2000). But for me, this was very important to confirm, because although my endocrinologist was pretty sure I had T1D based on my symptoms and his examination, without this test, frankly, most other doctors I consulted with would assume that, because I contracted the disease in my 50s, I should have T2D, and so they would hammer away at the diet and exercise part and I would believe, incorrectly, that I could someday stop using insulin in the hopes the disease would go away.