By Parveen Verma, DO, Endocrinologist, Virtua Endocrinology – Cherry Hill

Type 1 and type 2 diabetes affect millions of people, increasing their risk of heart attack, stroke, kidney disease, and more.

Understanding the roles of glucose and insulin are key to unlocking the difference between the two conditions, and the special treatment each requires.

How Glucose Keeps Us Running
Glucose, or blood sugar, is the body’s main source of energy.

Glucose comes from foods rich in carbohydrates, like bread, pasta, fruit, oatmeal, and lentils. When we eat, food travels down the esophagus to the stomach, where enzymes and acids break it into small pieces to release glucose and other nutrients. From there, it passes into the intestines and is absorbed into the bloodstream.

Our body works to keep the level of glucose in our blood constant. When we eat and there’s an influx of glucose, beta cells in the pancreas release insulin. Insulin acts as a key, unlocking cells so the glucose can enter.

For someone with diabetes, the insulin key is either missing or doesn’t fit the lock, leading to blood sugar levels that are too high.

Type 1 Diabetes
Type 1 diabetes, previously called juvenile-onset or insulin-dependent diabetes, is an autoimmune disease that can occur in children and adults at any age.

For reasons that are not yet entirely understood, the immune system, the body’s defense against infection, mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. Scientists believe that both genetics and environmental factors, such as a virus, are involved in triggering the disease. Its onset, which can be sudden, is not related to diet or lifestyle.

As a result, the body produces little to no insulin to regulate blood sugar and get energy from food. Glucose is locked out of the cells, leading to high levels in the bloodstream.

If you have type 1 diabetes, you will need to take daily insulin shots, or wear an insulin pump, to manage your glucose levels and ensure your body gets the energy it needs. You can’t take insulin as a pill because the acid in the stomach would destroy it.

You will need to check your blood sugar often, even overnight, and closely watch what you eat to avoid potentially dangerous spikes and lows.

Type 2 Diabetes
Type 2 is the most common form of diabetes, accounting for 90 to 95% of people diagnosed.

Type 2 diabetes can result when the pancreas is producing insulin, but the cells are not responding to it the way they should. As opposed to type 1 diabetes, where there’s no insulin key to open the cells, with type 2 diabetes, the locks on the cells are damaged.

Less glucose is able to enter the cells, leading to high levels in the bloodstream. This is called insulin resistance. In response, the pancreas works harder to make more insulin to force the cells open. Over time, this can damage the pancreas and it may not be able to produce any insulin.

As the disease progresses and the beta cells in your pancreas cease insulin production, you will need to begin insulin injections. (This does not mean you now have type 1 diabetes, as the two conditions have different causes.)

Because your body is not getting the energy it needs, constant hunger and excessive thirst often are among the first symptoms of type 1 and type 2 diabetes. Other early signs include:

• Lack of energy and fatigue
• Frequent urination
• Blurry vision
• Unintended weight loss
• Cuts and bruises that are slow to heal
• Tingling, pain, or numbness in the hands and feet (type 2)

While the onset of type 1 diabetes can be sudden, with type 2 the symptoms can come on gradually, and may be easy to dismiss. Over time, however, symptoms become more severe and lead to complications like loss of feeling in your extremities (neuropathy), kidney disease, vision loss, heart attack, and stroke.

Type 2 diabetes may run in families, but you are more likely to develop it if you are obese or overweight, lead a sedentary lifestyle, eat high-fat, high-sugar foods, have high blood pressure, and have low HDL cholesterol and/or high triglycerides. In women, diabetes during pregnancy and having polycystic ovary syndrome also are risk factors.

Type 2 diabetes is more likely to occur in people over 40. However, with increased rates of obesity, younger people are developing it as well.

Unlike type 1 diabetes, you can control, and even prevent, type 2 diabetes with diet and exercise. Losing 7 to 10% of your body weight can help your body use insulin more efficiently. A number of medications also are available to help manage type 2 diabetes. Bariatric weight-loss surgery also has been shown to eliminate type 2 diabetes in some people.

With the right tools and support, you can manage your condition and live your life to the fullest.

Certified Diabetes Education
Virtua’s certified diabetes educators help people manage their health, while significantly lowering their risk for long-term complications. They teach diabetes self-management and insulin management skills, and advise on proper diet and exercise.

Virtua's diabetes self-management education program has been recognized for its high-quality education efforts from the American Diabetes Association. Learn more about Virtua Health's diabetes services here.