How Do You Know If You Have Type 1 or Type 2 Diabetes?

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Welcome back.

So excited to have you tuning into another episode of the Diabetes Digital Podcast.

Today we are addressing a question that we get all of the time and is how do you tell the difference between type one and type 2 diabetes?

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Yes.

And it’s interesting because since starting Diabetes Digital, I have joined a bunch of different diabetes support groups just to hear kind of the conversation, what people are talking about.

And this is a question that I also saw coming up in the Group a lot, where people were diagnosed and they didn’t know which type of diabetes that they had, which I was surprised that doctors didn’t tell them or that they weren’t understanding it clearly.

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So we figured it would be great to talk about the differences between type 1 and type 2 diabetes today on the Diabetes Digital Podcast, ’cause I know a lot of people are confused.

Welcome to the Diabetes Digital Podcast.

I’m Wendy.

And I’m Jess, and we’re best friends, registered dietitians and diabetes educators.

Through our telehealth platform, Diabetes digital.co, we offer accessible and personalized virtual nutrition counseling for people with diabetes and pre diabetes.

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Visit diabetesdigital.co That’s Co to book your first appointment.

We accept insurance and offer affordable self pay options.

Now let’s get into today’s episode.

So let’s start with the basics when it comes to the main differences between type one and type 2 diabetes.

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So just an overview, what do they have in common?

Well, type one and type 2 diabetes are both chronic conditions that affect the way your body regulates blood sugar.

But the thing is they have different causes and different treatments.

So type one diabetes is an autoimmune disease where the immune system attacks and destroys the insulin producing cells in the pancreas.

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And as you’ll remember from other podcast episodes, insulin is a hormone that helps glucose, also known as sugar, get into your cells.

So what happens is this attack on those insulin producing cells known as beta cells.

They result in little to no insulin production and they require individuals with type one diabetes to take insulin injections or you can also use an insulin pump to manage their blood sugar levels.

2:12
So type one typically gets diagnosed in childhood, but it’s also possible to develop this later in life.

Now, on the other hand, type 2 diabetes is characterized by insulin resistance, where the body cells don’t respond properly to insulin or the pancreas doesn’t produce enough insulin to maintain normal blood glucose levels.

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Type 2 is often linked to lifestyle factors such as physical inactivity, but there’s also a huge genetic component, so we don’t want to have people feel stigma or shame if they get diagnosed with type 2 diabetes.

Because there’s so many factors that are outside of your control that can lead to you getting type 2 diabetes as well.

2:52
Yeah, and if you’re unsure about what symptoms you should be looking out for, for type one and for type 2, they can be pretty similar, but then there are differences that you want to look out for.

For type one, diabetes symptoms usually come on really quickly and so they might include going to the bathroom really often in terms of urination, being really thirsty because your blood sugars are running super high.

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You might be losing a lot of weight because your cells are not taking in and utilizing energy and so it’s just circulating around the blood.

You might feel really tired, your vision might be blurry.

These are all side effects of having really, really high blood sugar and they might come on suddenly.

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If you have type one diabetes, you might also get vomiting, nausea, stomach pain, whereas for type 2, typically for most people it’s more of a gradual progression of symptoms.

And so you might get all of the same things.

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Like you’re urinating a lot, especially like if you’re having numbness or tingling on your extremities, like your feet and your hands.

You’re losing that sensation.

That can also be, you know, a sign that your sugars are running really high and you might be at risk of type one or type 2 dark patches on the skin, especially, like around the neck and the armpits.

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If you’re noticing that your wounds are taking really long to heal, let’s say you got a cut and you’re noticing that it’s been weeks and you know it’s still not scarring properly, then you know, that might be a sign too, that your blood sugars are running really high.

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But again, the the biggest difference between type 1 and type 2 diabetes in my opinion is that for type 2 it’s more of a gradual progression of symptoms or for type one, they typically come on very quickly and it’s really important that you recognize these symptoms, You seek medical attention as soon as you notice that something might be off, so that you can get testing done to confirm you know whether this is something that you have.

4:52
Yeah, we also have a really great episode with one of our dietitians.

Her name is Jenny Fernandez.

Shout out to Jenny, she has type one and in that episode we can include it in the show notes.

She talks about her story and when she was diagnosed as a kid and she went to Disney World and she was having all these symptoms and her parents were like, OK, something’s off.

5:12
So when you’re feeling like something’s off, definitely go and get things checked out.

So what exactly do you get checked out, what test you have done?

We’re going to talk about that next.

So for type 2 diabetes, there is a blood test which you’ll hear us talk about all the time, and it’s called hemoglobin A1C, also known as A1C.

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Now what is A1C?

This measures your average blood sugar levels over the past two or three months.

And it’s often used to diagnose diabetes.

So typically somebody who has an A1C of 6.5% or higher is diagnosed with diabetes.

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And as you’ll know from previous episodes, people with an A1C of 5.7 to 6.4 are diagnosed with pre diabetes or impaired fasting glucose.

Which means you don’t have diabetes yet and you may never get diabetes but your body is having a little bit of trouble kind of regulating blood glucose.

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Now in addition to the A1C, they will often also check a fasting plasma glucose test and that essentially means they’re checking your glucose at one period in time and they want to make sure that you also have had nothing to eat for the past eight hours to just see where you’re kind of landing with your fasting.

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So typically for people who have diabetes that fasting plasma glucose will be over 125 or more and for folks with pre diabetes, it’s typically 100 to 124.

Another test that they may do and this is also very common for gestational diabetes.

6:46
It’s an oral glucose tolerance test also known as OGTT.

Sounds like, I don’t know, a band or something.

OGTT is another test that can also help to confirm the diagnosis.

Now if you are diagnosed with type 2, it’s also really important to do some additional lipid tests like a lipid profile and kidney function test, just to assess your overall health and risk factors.

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So make sure that if you have been diagnosed, you’re getting those tests as well.

And if you’re not sure, you can always meet with one of our dietitians and they’ll kind of see what you’ve have had done and give you some recommendations for what tests to get in the future.

So let’s talk about type one diabetes.

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So for type 1, the same tests are used for diagnosis.

However, your doctor may add additional autoimmune testing.

So you might be wondering why do I need this?

What is the deal?

And the deal is that type one is an autoimmune disease, which means that your body is attacking your pancreas.

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The reason why they might do autoimmune testing is so that they can detect specific auto antibodies that target components of the pancreas.

So just FYI, an auto antibody is an antibody produced by the immune system that is directed against one or more of a person’s own protein.

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So in this case, the antibodies produced by your immune system and it is directly attacking the pancreas.

Now what tests do you need to have happen?

So here’s a couple of the antibody tests.

We’re also going to include them in the show notes just in case you, you know you haven’t had this testing and you’re curious and you don’t know which type of diabetes you’ve had, this usually will help to give you an answer.

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So these tests are, one is cytoplasmic auto antibodies and it’s called ICA.

The other one is glutamic acid decarboxylase auto antibodies.

The acronyms for that one are gada.

There’s also insulinoma associated to auto antibodies and that’s IA dash 2A and then there’s insulin auto antibodies, IAA.

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So elevated levels of these antibodies will suggest a higher likelihood of type one diabetes.

Again, don’t expect you to remember all these.

We’re going to include them in the show notes.

Now alongside these antibody tests in this antibody panel, your healthcare provider may also order additional tests like C peptide or an insulin assay test to kind of further evaluate your diabetes status.

9:22
And these tests along with the diabetes antibody panel will help to provide a comprehensive assessment of your condition.

And like I said before, positive results that indicate the presence of antibodies may suggest type one diabetes or an increased risk of developing type one diabetes even if you don’t have it now.

9:41
Yeah.

And something that I have seen happen quite a few times is that people that have type one diabetes are actually diagnosed as having type 2 because they’re diagnosed at a later age and they’re really not taking well to any of the oral medications or the non insulin injectable medications like Ozempic for example.

10:00
So they’re trying all these different medications.

Their A1C is wildly high in the 91011 twelves and there’s just no explanation.

They’re making dietary changes.

Their blood sugar is still not coming down.

That’s kind of a red flag that maybe you have type one, maybe there’s some autoimmune stuff going on and that you should really advocate for testing.

10:22
And I’ve seen this happen especially in black and brown communities.

I don’t know what it is.

Where like I don’t know, maybe they think that black and brown people aren’t as affected by type one.

But this testing doesn’t happen as often in communities that have less resources.

10:38
So you really have to advocate and say, hey, can I get tested for those antibodies?

Because, you know, sometimes people go years and years with uncontrolled diabetes being diagnosed as type 2 when they are in fact type one.

And then there’s also something known as diabetes type 1.5, and this is known as Latta.

10:56
So latent autoimmune diabetes in adults and it’s a very interesting subtype within the spectrum of diabetes.

Typically for type one, you get diagnosed in childhood, but you know, like I said, you could also get diagnosed later in age.

And this type 1.5 is kind of challenging that notion that it’s it doesn’t just affect children for people that have an autoimmune manifestation of diabetes and it’s kind of like in the middle, there’s some characteristics from type one and type 2.

11:26
So unlike the rapid progression of type one, type 1 1/2 typically presents when you’re an adult.

It is a slower progression, but the diagnosing is challenging because it kind of overlaps with type 2 diabetes and you know providers might assume that that’s just what you have.

11:46
So again, as I mentioned earlier, it’s really important that you’re clear with your provider about what symptoms you’re having, what you’re trying to do to get your blood sugars within range and what you feel is working and what you feel is not working so that they can get you the right diagnosis.

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Now in terms of treatment, there are different approaches for type one and type 2, but the goal for both of them is to get your blood sugars within range.

So for type one diabetes, insulin therapy is going to be of the utmost importance because your body is not producing the insulin that it needs.

12:19
So you’re likely going to need different types of insulin.

There’s basal and bolus basal acts throughout the day.

It’s like a slow acting insulin and bolus insulin is the kind of insulin that you inject with each meal.

So you want to make sure that you have enough coverage throughout the day to keep your numbers within range.

12:38
And in addition to that, that you’re also eating regularly, you’re having consistent meals because especially when you’re requiring external insulin, you really need that consistency to gauge what dose you’re going to require.

Because if you’re, you know, one day you’re eating one thing, one day you’re having another thing and the carb amounts are just like varying drastically, it’s going to be hard to predict how much insulin you’re going to need.

13:02
And it just becomes really tricky with, you know, just kind of planning dosing and things like that.

So that’s something to keep in mind and you know, similar to the recommendations that we would get for Type 2, in addition to eating balanced meals, also trying to stay active.

13:18
So doing whatever activity you think is enjoyable for you, trying to keep stress low, getting a good night’s sleep, that is all going to help with keeping your blood sugar within range.

Yeah.

And for type 2, the treatment may also include lifestyle changes.

13:36
Typically that is where people start.

Depending upon your A1C, the higher the A1C, you might need to start with some oral medications or even injectable medications like insulin to help lower your blood sugar levels.

Treatment may include lifestyle changes such as adopting a healthy diet, increasing physical activity and also stress reduction because stress can have a huge impact on our blood sugar levels.

14:01
So treatment strategies for type 1.5 require a tailored approach just like any type of diabetes and it will encompass lifestyle modifications and potentially specific medications, right.

14:16
So research efforts are ongoing to continue to understand type 1.5.

It is a type that we’re still learning about and trying to understand.

So efforts are ongoing, but overall it’s going to be a combination of the treatment for type one and type 2.

Now if you are somebody who has been diagnosed with diabetes or even pre diabetes and you’re looking for some help and some guidance especially on those diet and lifestyle changes, we have dietitians who are experts in diabetes and pre diabetes with our company Diabetes Digital.

14:50
So to sign up, all you have to do is head on over to our website diabetesdigital.co slash patient, and you can fill out our whole intake form and we will do a complimentary insurance vacation.

We’re a network with most insurance companies and we’ll let you know if you’re a network and what to do next and get you scheduled with the dietitian.

15:09
So with that, thank you so much for listening to our podcast and we’ll catch you next Wednesday.

Bye.

Thanks for joining us for today’s episode.

If you’re interested in nutrition counseling with one of our expert dietitians to help improve your pre diabetes or diabetes, visit us at diabetesdigital.co.

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Dot Co and TuneIn every Wednesday for practical, inclusive and culturally humble diabetes insights.

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We’ll catch you later.

Bye.