What Should Diabetes Patients Know About Type 1 vs Type 2?
More Programs and Publications Featuring Dr. Kyle Riding
In this program:
What are the key differences between type 1 diabetes versus type 2 diabetes? Medical laboratory scientist Dr. Kyle Riding explains what occurs in the body with type 1 versus type 2.
Transcript
Interviewer:
So I'm glad that we're discussing microalbumin, because I feel like a lot of patients, when they go do their annual physicals, it all revolves around blood sugar and A1C, and those are the magic numbers that everyone only ever considers when it comes to diabetes or even pre-diabetes. So I'm glad that we actually got a chance to discuss that as something important to also look into. But speaking of diabetes, can you give us a breakdown of the differences between type 1 and type 2, and what are the key differences at what influences disease progression for both of these types?
Dr. Kyle Riding:
So you're actually going to be insulin deficient in type 1 diabetes. That is why type 1 diabetics are the ones having to continually monitor their glucose, often have the glucometers at their side or the implants with them at all times, and are injecting themselves with insulin from diagnosis. Okay? Type 2 diabetes, on the other hand, is not an immune-mediated issue. In fact, it has nothing really to do with destruction of insulin-producing cells. It has to do with the fact that we make insulin, your body just doesn't know what to do with it anymore. We actually produce what's like a resistance to the insulin. So all of the cells that rely on insulin end up saying, "Yeah, okay, I know you're there. I see you, insulin, but I'm going to take in the glucose when I feel like taking it in right now." And so what happens is the glucose builds up in the blood and causes damage.
So here's the issue between the two of them. The type 1 diabetics, we get very concerned about a real emergent condition called diabetic ketoacidosis. Okay? That's what we worry about with type 1 diabetics. If their insulin is not regulated appropriately, their cells start to starve. And when cells starve, they produce a ton of acids and other byproducts and waste materials that are damaging to the body and can cause really quick and lethal harm to a patient very rapidly.
Type 2 diabetics, on the other hand, their cells aren't starving. Their glucose shoots up because their cells are indifferent to the insulin, but they still work with the insulin. And so the cells themselves are not starving, so they don't develop ketoacidosis, but their glucose levels get much higher typically before any major systemic consequences are seen. And all of that elevated circulating glucose is damaging to the cells of the body, particularly the kidneys and the eyes. That's why they get nephropathies. So that's really the difference between type 1 and type 2 diabetes.
Interviewer:
And what can patients do to prevent disease progression if they have either of these types?
Dr. Kyle Riding:
Absolutely. So just like any other disease, you will hear me say this about that, you want to follow up with all screens that your physician is recommending, all laboratory tests. Because they're diagnostic algorithms that are really, really, really validated in the literature and in practice around monitoring both type 1 and type 2 diabetics to make sure that we are able to keep them under control, which means we're able to protect their kidneys, protect their eyes, and protect their nervous system. And so really just follow through with those tests that your physician is recommending. I can't stress that enough. I know it can be a time drain or a money drain, but it's meant to prevent any adverse consequences for you.
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