How to tell the difference between type 1 and type 2 diabetes in adults

A lot of times, I come across patients who have to use insulin and aren’t quite sure whether they have Type 1 or type 2 diabetes.

I hope to be able to clarify the difference between the two, especially in an adult.

Type 1 diabetes

Type 1 diabetes is commonly called ‘juvenile onset diabetes.’ Type 1 diabetes is usually diagnosed in young children, often under the age of 5 years. Type 1 diabetes is an auto-immune disease. An auto-immune disease is when the body forms antibodies against itself.

In the case of type 1 diabetes, the body develops antibodies against the cells in the pancreas responsible for producing insulin. These are called the beta cells. When the beta cells are attacked and destroyed, the result is a rise in blood sugars. Someone with type 1 diabetes requires insulin.

During community talks as well and media appearances, I take the time to emphasize the difference between type 1 and type 2 diabetes.

It is fairly common for people to flippantly state that “Diabetes is a disease of lifestyle” without differentiating between the two.

Type 1 diabetes is not a disease of lifestyle.

Type 2 diabetes

Type 2 diabetes is different. It is not caused by a lack of insulin; instead, it is caused by a condition called insulin resistance. With insulin resistance, the cells of the body do not respond to insulin efficiently. In my book, I compare insulin resistance to the landlord changing the locks on the door to your apartment so that the key no longer works. The beta cells have to put out more insulin to overcome the resistant cells.

When someone with type 2 diabetes starts using insulin, does that mean they now have type 1 diabetes?

No. It is possible that with the ‘natural progression’ of type 2 diabetes, some people may need to start using insulin. They may also have a condition called late auto-immune diabetes of adulthood (LADA).

Individuals with LADA have a slower progression toward needing insulin than someone with type 1 diabetes.

There are also other scenarios where someone newly diagnosed with type 2 diabetes needs to be started on insulin right away. This still does not make them a type 1 diabetic.

What can happen with type 2 diabetes is that with time, the beta cells (the cells that produce insulin in the pancreas) may begin to degenerate and so cannot keep up with the production of insulin. It may be necessary to start insulin to keep blood glucose levels within the normal range and reduce the complications of diabetes.

How can you tell the difference between LADA, and Type 2 diabetes?

There are several blood tests that your healthcare provider can perform to help tell the difference between LADA and type 2 diabetes. This is particularly important as the treatments are different.

So it’s important to be pro-active when it comes to your overall health and wellbeing. Do not be afraid to ask questions.

I’ll be sharing more details in my upcoming online course, “What your doctor does not tell you about type 2 diabetes’. For more information about Type 2 diabetes, you can download a free copy of the first three chapters of my award-winning book, “Dr. Eno’s A-to-Z Guide to Thriving with Type 2 Diabetes”, by clicking here.

To your health and wellbeing,