According to the American Diabetes Association, 23.6 million adults and children are diagnosed with diabetes, and that number continues to increase daily. November is American Diabetes Month, which is a good time to answer a common question about the diagnosis of diabetes: "How did my doctor know if I had type 1 or type 2 diabetes?"
It depends on whether or not the pancreas is producing insulin. Type 1 or type 2 diabetes can occur at any age, although it is more common for type 2 diabetes to occur in those over the age of 40, and type 1 to occur in children and young adults.
With type 1 diabetes, the patient’s pancreas makes little or no insulin; therefore the patient must be treated with insulin throughout his or her lifetime, which is commonly referred to as having IDDM or Insulin Dependent Diabetes Mellitus. If a patient with type 1 diabetes does not take insulin, blood sugar levels will continue to be extremely elevated and could rise to dangerous levels. Since type 1 typically occurs in children and young adults, it is commonly referred to as "juvenile onset of diabetes." Approximately 5-10 percent of Americans with diabetes have type 1; the other 90-95 percent have type 2.
Type 1 diabetes typically develops due to an autoimmune disorder, meaning that the body’s immune system attacks its own tissues. It is unknown as to why the autoimmune disease develops. Most often the diagnosis of type 1 diabetes follows a viral infection such as mumps, rubella, measles or influenza. A lot of people feel like having type 1 diabetes is worse than having type 2 because type 1 requires insulin injections for the rest of their life. Type 1 diabetes is not necessarily worse than type 2 - it depends on how well you control it. Controlling diabetes, whether you have type 1 or type 2, is a combination of diet, exercise, taking medication as prescribed by a doctor and stress management.
With type 2 diabetes, the pancreas continues to produce some insulin, just not quite as much as the body needs. Since there is some insulin production, people with type 2 diabetes can control their blood sugar levels either through diet and exercise, oral diabetes medications or insulin injections. With type 2 diabetes, taking diabetes medication does not necessarily mean a patient will always be on medication to control his or her sugar levels. One commonly asked question we hear from our patients is: “ If I have type 2 diabetes and I begin taking insulin injections, does that make me a type 1?” Once you are diagnosed with type 2 diabetes, you always have type 2. It just depends on how you control it. Some individuals can control their sugar levels through diet and exercise, while others may need oral medications or insulin injections.
There are several risk factors associated with type 2 diabetes such as family history, weight gain (central obesity, which is carrying excess weight in the abdominal area), high blood pressure, high cholesterol, high triglycerides, ages 40 and older, certain ethnicities such as African American, Hispanic, Native American or Pacific Islander, and women with a history of gestational diabetes or having delivered a baby weighing greater than 9 pounds.
For more information on diabetes related programs, call the Blount Memorial Diabetes Management Center at 865-977-5767.
Dawn Hollaway is a registered nurse, certified diabetes educator and program coordinator for the Blount Memorial Diabetes Management Center.