The two types are critically different, however, overall it can be said that diabetes is a condition where people don't produce insulin or their cells don't respond properly to insulin. Insulin is important because it moves glucose, a simple sugar, into the body's cells from the blood.
The food people eat provides the body with glucose, which is used by the cells as a source of energy. If insulin isn't available or doesn't work correctly to move glucose from the blood and into cells, glucose will stay in the blood. These levels will become higher than normal. Also, cells won't get the fuel they need. These two problems cause the symptoms of diabetes.
There are two main kinds of diabetes: type 1 diabetes and type 2 diabetes. More than 90% of all people with diabetes have type 2 and fewer than 10 % have type 1. Overall, about 20 million people in North America have diabetes. Only about half are aware of it and are receiving treatment.
Type 1 diabetes used to be called "juvenile" diabetes, since it usually occurs in people under 30. Everyone with type 1 diabetes requires insulin injections. Type I diabetes is most common in people of northern European ancestry.
Type 2 diabetes used to be called "adult-onset" diabetes, because it usually occurs in people over 40. People with type 2 diabetes usually have a family history of this condition and are most often overweight. Some people with type 2 diabetes need insulin injections. This condition is most common in First Nations peoples, Hispanics, and North Americans of African descent.
Another less common form is gestational diabetes, a temporary condition that occurs in 2% to 4% of pregnancies. The problem usually clears up after delivery, but women who have had gestational diabetes have a higher risk of developing type 2 diabetes later in life.
CAUSES
Type 1 diabetes is an immune disorder.It's believed that a combination of genetic predisposition and a hidden viral infection provoke the immune system into attacking the insulin-producing cells in the pancreas, killing them.
Type 2 diabetes is mainly caused by insulin resistance.This means that no matter how much or how little insulin is made, the body can't use it. As a result, glucose can't be moved from the blood into cells. is a leading cause of insulin resistance - 80% of people with type 2 diabetes are overweight. There are probably genetic factors in type 2 diabetes as well. A family history of the disease increases your chances of getting it.
SYMPTOMS & COMPLICATIONS
People with type 1 diabetes urinate frequently and feel excessively thirsty. They usually feel very tired and experience profound weight loss despite normal or excessive food intake.
The symptoms of type 2 diabetes appear gradually. People with type 2 diabetes often have a persistent, mild thirst. They urinate frequently, and often feel mild fatigue and complain of blurred vision. Many women with the disease have recurring vaginal yeast infections.
Diabetes is a major cause of heart disease, the leading cause of death in Canada. It's also the biggest cause of blindness and kidney disease in adults. Older adults with diabetes are twice as likely to develop high blood pressure as people without diabetes. People with diabetes are also 11 times more likely to undergo foot and other "lower extremity" amputations due to circulatory problems. Between a third and a half of men with diabetes will suffer from impotence at some point.
DIAGNOSIS
Diabetes is diagnosed with simple blood tests. A doctor may diagnose diabetes if the level of glucose in the blood after 8 hours of fasting is above 7.0 mmol/L. If the fasting blood sugar is 6.1-6.9 mmol/L, then the person has impaired glucose tolerance, and may go on to develop diabetes. Diabetes is also diagnosed if a blood sugar level taken two hours after eating is greater than 11.1 mmol/L. A doctor may also examine the eyes for signs of damage to the blood vessels of the retina (back of the eye).
Another option in Canada is that a doctor will diagnose diabetes based on the results of an oral glucose tolerance test (OGTT). With this test, the patient is given some glucose and then their blood sugar is tested at various times after ingesting the glucose.
TREATMENT AND PREVENTION
Diabetes is a chronic condition, and it can last an entire life. The goal of treating diabetes is to keep blood glucose levels as close to a "normal" range as possible. This prevents the symptoms of diabetes and the long-term complications of the condition. A doctor, working with the other health-care professionals on a diabetes care team, will help someone with diabetes find their target blood glucose levels.
More than most conditions, treating diabetes requires a significant amount of real work on the patient's part. Coping with diabetes is a lifelong challenge, so people with diabetes should not be afraid to speak with a doctor or pharmacist if they feel overwhelmed.
People with type 1 diabetes need insulin every day to survive. The only way to cure this disease is by pancreas transplant, but the operation is reserved for only the most severe cases.
There are three main things a person can do to treat type 2 diabetes:
- make lifestyle changes
- use medication
- monitor blood glucose levels
Like many conditions, treatment of type 2 diabetes begins with lifestyle changes in diet and exercise. If a person has type 2 diabetes, they should speak with their doctor about an appropriate diet. The doctor may recommend seeing a dietitian. It is also a good idea to speak with a doctor before beginning an exercise program to determine what kind and how much exercise is appropriate.
If lifestyle changes don't put blood glucose levels in the target range, medications may be required. Medications for type 2 diabetes include antidiabetic pills, insulin injections, or a combination of both.
Medications are very effective at treating diabetes and reducing the symptoms and long-term effects of the condition. However, hypoglycemia, blood glucose that is too low, can occur when taking medications for diabetes. Symptoms of hypoglycemia include:
- pale skin
- sweating
- fatigue
- dizziness
- irritability
- anxiety
- confusion
- hunger
- tremors or shakiness
- visual changes
If the blood glucose level is extremely low, it is possible for a person to have a seizure or lose consciousness. A health care professional can tell people with diabetes how to recognize the warning signs of hypoglycemia. People with diabetes should carry candy, sugar or glucose tablets, to treat hypoglycemia.
Hypoglycemia is an unfortunate side effect of many medications for type 1 and 2 diabetes, but it is NEVER a reason to avoid treatment. The best way to avoid hypoglycemia is to monitor blood glucose.
Whether someone has type 1 diabetes or they are making lifestyle changes or taking medications for type 2 diabetes, frequent measurement of blood glucose levels is the best way to know whether blood glucose levels are in the target range. This is easily done at home with a blood glucose monitor.
In recent guidelines, the Canadian Diabetes Association (CDA) says that it's essential for all people with type 1 diabetes and all people with type 2 diabetes using insulin to self-monitor blood glucose levels. The CDA also recommends self-monitoring for most people using pills to control type 2 diabetes, and even for those who are managing their type 2 diabetes through diet and exercise alone.
