From the Guidelines
The main difference between type 1 and type 2 diabetes is their underlying cause and onset, with type 1 being an autoimmune condition and type 2 developing from insulin resistance and inadequate insulin production, as noted in the most recent guidelines 1.
Key Differences
- Type 1 diabetes is characterized by an absolute deficiency of insulin secretion due to autoimmune destruction of pancreatic beta cells, typically developing in childhood or adolescence, and requiring lifelong insulin therapy 1.
- Type 2 diabetes, on the other hand, results from a combination of resistance to insulin action and an inadequate compensatory insulin secretory response, often associated with lifestyle factors like obesity, poor diet, and physical inactivity, and typically developing gradually in adults 1.
Management and Prevention
- Type 1 diabetes management involves intensive glucose monitoring and insulin titration to maintain optimal plasma glucose and HbA1c levels, as recommended by an expert panel 1.
- Type 2 diabetes management often begins with lifestyle modifications and oral medications like metformin, sulfonylureas, DPP-4 inhibitors, SGLT2 inhibitors, or GLP-1 receptor agonists, with insulin therapy added if necessary, and recent guidelines emphasize the importance of glucagon-like peptide-1 receptor agonists and sodium glucose cotransporter 2 inhibitors in reducing cardiorenal events in high-risk patients 1.
- While type 1 diabetes cannot be prevented, type 2 diabetes risk can be significantly reduced through maintaining a healthy weight, regular physical activity, and a balanced diet, as supported by recent studies 1.
Complications and Monitoring
- Both types of diabetes require regular monitoring of blood glucose levels and can lead to similar complications if poorly managed, including cardiovascular disease, nerve damage, kidney disease, and vision problems, highlighting the importance of early detection and treatment 1.
- Recent guidelines and studies emphasize the need for integrated care and the application of evidence-based recommendations to clinical practice to improve patient outcomes 1.
From the Research
Difference between Type 1 and Type 2 Diabetes Mellitus
- Type 1 Diabetes Mellitus (T1DM) is a chronic autoimmune disease where beta cell destruction may occur over a number of years before clinical diabetes is diagnosed 2.
- Type 2 Diabetes Mellitus (T2DM) is the result of an interplay of relative insulin deficiency or a defect in insulin release together with insulin resistance 2.
- T1DM has a weaker genetic link, with an association with HLA antigens, while T2DM has a stronger genetic association but the exact gene or genes responsible are unknown 2.
- The environmental trigger in T1DM may be a viral infection, while urbanisation, obesity, physical inactivity, and stress may trigger the development of T2DM 2.
Pathogenesis and Characteristics
- T1DM is characterized by the destruction of beta cells, leading to a lack of insulin production, while T2DM is characterized by insulin resistance and a relative insulin deficiency 3, 4.
- T1DM is typically managed with lifelong insulin therapy, while T2DM is often associated with obesity, sedentary lifestyle, and/or genetic factors, and is managed with lifestyle changes and oral medications 3.
- Hyperglycemia perpetuates the problem of beta cell defect and insulin resistance in T2DM 2.
Clinical Presentations and Diagnosis
- Type 1 and type 2 diabetes have different clinical presentations in their common forms, but the absence of biological tests for diagnosis of type 2 diabetes and the limited sensitivity of antibody tests in type 1 diabetes can make classification difficult 4.
- T1DM is primarily the result of autoimmune destruction of beta cells, while T2DM is found in those with resistance to the action of insulin, usually as a result of obesity, and deficient insulin secretion 5.