Type 1 and 2 diabetes, know their conditions and ways to treat them
There are differences between type 1 and type 2 diabetes. But eating a proper diet and watching your weight can prevent complications
Editor's note: Every day a CNNHealth medical expert answers a reader's questions. Otis Brawley is medical director of the American Cancer Society
(CNN) -- What's the difference between type 1 and type 2
diabetes, asks Steve from San Bruno, California.
And the expert answers.
First of all, the formal name for what we commonly call
diabetes is diabetes mellitus, which translates from Greek as urine with
large amounts of sugar.
Type 1 and 2 diabetes mellitus are diseases that have sugar in
the urine and increased urination (the act of urinating) in common.
When there are large amounts of sugar in the blood, the kidneys
filter it into the urine. Sugar can be measured in urine through a
laboratory test. Test strips are also used to show the amount of sugar in
urine.
Patients who develop diabetes mellitus commonly have initial
symptoms of increased thirst, urination, and blurred vision due to the large
amounts of sugar in the fluids of the eye.
Type 1 diabetes is the result of a rheumatic disease in which
the body itself attacks and destroys the beta cells of the pancreas. These
are the cells that normally produce insulin. Type 1 is a disease in which
the patient stops producing insulin in a relatively short time.
All patients with type 1 diabetes can also develop a metabolism
disorder called ketoacidosis, when their blood sugar level is high and there
is not enough insulin in their body. Ketoacidosis can be fatal unless
treated as an emergency with hydration and insulin.
Type 1 was once called juvenile diabetes mellitus, because most
diagnoses were in children. But there are already occasional diagnoses even
in adults older than 60 years.
One should think of it as a disease in which high blood sugar
is due to deficiency in insulin production. Treatment should be by
administration of insulin. This is given at least once or twice a day, but
can be given up to four times a day for type 1 diabetes.
Type 2 diabetes is the result of the muscles and other body
tissues becoming resistant to the insulin produced by the beta cells of the
pancreas. It first tries to overcome this insulin resistance and produces
more insulin. Blood sugar rises as the patient's body is no longer able to
produce enough insulin.
Most patients with type 2 diabetes mellitus are overweight or
obese. For most people, but not everyone, maintaining a normal weight and
eating a good diet prevents the development of type 2 diabetes.
Most type 2 diabetes diagnoses occur after the age of 40. For
this reason, many refer to this type as adult-onset diabetes mellitus. This
name lost its meaning when the obesity epidemic caused a large number of
people diagnosed with type 2 to be between 10 and 11 years old.
Type 2 can usually be treated by modifying the diet, and
significant improvements can be made with weight loss and exercise. Some
patients can be treated effectively with drugs such as metformin that
increase the peripheral sensitivity of the organs to insulin.
However, in a more severe stage, you will need oral medications
that stimulate the pancreas to produce more insulin, such as glyburide or
glipizide. Some patients with even more severe cases of type 2 disease are
treated with subcutaneous injections of insulin.
The higher the level of insulin in the body, the peripheral
resistance to it is overcome and the blood sugar level returns to a normal
range. In some cases of patients with type 2 diabetes, years of
overproduction of insulin cause the beta cells to become exhausted and stop
producing it. These patients can develop ketoacidosis, in the same way as
patients with type 1 diabetes, and should be treated with insulin
injections.
The long-term result of types 1 and 2 diabetes mellitus is
organ damage. Patients can develop blindness, kidney failure and vascular
disease.
The blindness is due to diabetic retinopathy where extra blood
vessels grow on the retina of the eye. Vascular disease can manifest as
decreased blood flow to the feet, leading to sores, ulcers, and infections
that in severe cases require leg amputation. Vascular disease can alsocause
heart attacks and strokes.
All of these complications can be delayed with good blood sugar
control.
Do you have any questions for our experts? You can ask
it in the comments section.