Which is Worse, Type 1 or Type 2 Diabetes?

Diabetes is a metabolic condition in which blood sugar levels are higher than usual. The pancreas makes insulin, a hormone that breaks down glucose into energy.
In diabetes, the body either does not produce insulin or cannot utilise it.

In diabetes, the body cannot convert this blood sugar into energy. Instead, the sugar keeps getting accumulated in the bloodstream.

Diabetes may be of various types. The main ones can be:

1. Type 1 diabetes

2. Type 2 diabetes

3. Prediabetes

4. Gestational diabetes

5. Type 3c diabetes

6. Latent Autoimmune Diabetes or LADA

7. Maturity Onset Diabetes of the Young or MODY

8. Neonatal diabetes

9. Brittle diabetes

Before we discuss which is worse between type 1 and type 2 diabetes, we must understand what the two kinds are.

1. Type 1 Diabetes: An autoimmune condition in which the immune system attacks and destroys the cells of the pancreas that produce insulin.
   The exact reason behind type 1 diabetes is unknown. About 10% of the people who have diabetes have this type, which is more common in children and young adults.

2. Type 2 Diabetes: In this condition, the body does not produce adequate insulin, and/or the body cannot respond normally to the insulin and has developed insulin resistance.
   This is the most common type of diabetes and mostly affects adults.

Though both types of diabetes can wreak havoc with your health, many doctors will say that type 1 diabetes is more severe than type 2 diabetes. Type 1 diabetes is an autoimmune disease that cannot be reversed.

Even managing type 1 diabetes is more challenging than type 2 diabetes. People with type 1 diabetes have higher chances of developing hypoglycaemia than those with type 2 diabetes.

When we talk about symptoms, diabetes type 1 and 2 differences are not many. There are some common and some varying symptoms. All have been discussed below:

Common Symptoms of Type 1 and Type 2 Diabetes

1. Frequent Thirst: There is a frequent need to drink water due to dehydration because of diabetes. This condition is also known as polydipsia.

2. Dry Mouth: The mouth often feels dry.

3. Increased Hunger: As diabetics do not get energy from the food they eat, they feel hungry irrespective of how frequently they eat.

4. Frequent Urination: This sudden urge to urinate, particularly at night, happens in diabetes.

5. Fatigue: Feeling tired and lacking the energy to perform daily activities is common in diabetics.

6. Unexplained Weight Loss: Due to the body’s inability to use the glucose present in the blood, the body starts burning the fat and muscles rapidly to generate energy. This leads to sudden weight loss.

7. Blurry Vision: Problems with seeing things clearly is also a possible symptom of diabetes.

8. Slow Wound Healing: In people with diabetes, wounds generally heal at a slower rate when compared to non-diabetics.

Different Symptoms in Type 1 and Type 2 Diabetes

Although the symptoms of both types of diabetes are generally similar, there may be a difference in the timelines of these symptoms.

The main difference between type 1 and type 2 diabetes symptoms is that:

1. In type 1 diabetes, the symptoms may show in just a couple of weeks, meaning it's very quick.

2. Meanwhile, in type 2 diabetes, the symptoms develop gradually over months or even years.
   Sometimes, there may be no symptoms for years until a complication occurs.

Irrespective of the type, diabetes appears as a condition with excessive sugar in the bloodstream. However, the cause of diabetes depends on the type of diabetes. To know more, read the following:

1. Causes of type 1 diabetes:

1. Autoimmune Response: Type 1 diabetes is an autoimmune response in which the immune system attacks the insulin-producing cells (beta cells) in the pancreas. The exact reason behind this autoimmune response is unknown.

2. Causes of type 2 diabetes:

1. Insulin Resistance: The most common cause of type 2 diabetes is insulin resistance which occurs when the body does not react to the insulin.

2. Medication: Long-term usage of some medications like corticosteroids or HIV medication can cause type 2 diabetes.

Type 1 and Type 2 Diabetes Risk Factors

Diabetes type 1 and 2 differences are based on the risk factors as well. It includes the factors that can increase the chances of developing diabetes.

Known risk factors for type 1 diabetes are:

1. Age: Type 1 diabetes is more common in children and young adults, although it can develop at any age.

2. Family History: If your parent or a sibling has type 1 diabetes, the chances of you developing type 1 diabetes become higher.

Known risk factors for type 2 diabetes are:

1. Family History: If a parent or a sibling has this kind of diabetes, the chances of developing it increase.

2. Over 45 years of age: Although children can develop type 2 diabetes, the risk increases as a person gets older.

3. Prediabetes: When blood sugar levels are already high, if left untreated, it may lead to type 2 diabetes.

4. Obesity: The accumulation of excessive body fat can cause insulin resistance increasing the risk of developing type 2 diabetes.

5. Gestational Diabetes: A type of diabetes during pregnancy may turn into type 2 diabetes if not managed well during and after pregnancy.

6. PCOS: Women with PCOS (polycystic ovarian syndrome) usually have insulin resistance, making them susceptible to developing type 2 diabetes.

The best way to diagnose diabetes is by blood tests that measure the levels of sugar in the bloodstream. These tests can be done at any diagnostic centre by a blood sample collection at your home.
Some of these tests are:

1. A1C: The A1C is known as the glycated haemoglobin test or HbA1C and checks the average blood sugar levels for the last three months.
   A1C levels are indicated in percentages.
   A level of 6.5% or high is indicative of diabetes. 

2. Random Blood Sugar Test: This blood test may be performed at any time of the day and checks blood sugar levels.
   The levels are expressed in mg/dL. If the reading is over 200 mg/dL, you have diabetes.

3. Fasting Blood Sugar Test: In this blood test, blood sugar levels are checked after a fasting period of over 8 hours. Before the test, you are not supposed to eat or drink anything overnight.
   The test is usually done early in the morning, before breakfast.

4. Oral Glucose Tolerance Test: This test to check for diabetes is usually done during pregnancy. You are required to fast overnight, and at the time of the test, you will be asked to drink a sugary liquid.
   The blood sugar levels are then tested 2 hours later.

5. Autoantibody Testing: An autoantibody test is done to check for type 1 diabetes. Autoantibodies are antibodies that attack healthy cells and tissues.
   The presence of these antibodies is indicative of type 1 diabetes.

Type 1 diabetes is caused due to an autoimmune response, and hence it may not be possible to prevent it. However, some steps can be taken to prevent type 2 diabetes. These are:

1. Healthy Diet: Consumption of a healthy diet that is rich in protein and low in carbs can control the sugar levels in the bloodstream.

2. Regular Exercise: Exercising regularly for at least 30 minutes five days every week helps to stay active and reduce the risk of developing diabetes and other health complications.

3. Healthy Body Weight: Maintaining a healthy body weight can help reduce insulin resistance, keeping blood sugar levels in control.

4. Stress Reduction: Studies show that high levels of stress affect the pancreas’ ability to produce the required quantity of insulin.

5. Avoid Smoking and Alcohol Consumption: Control alcohol consumption as it affects blood sugar levels. Quit smoking as nicotine causes insulin resistance, causing blood sugar levels to rise.

6. Get Enough Sleep: Sleep properly for about 7-9 hours every night.

7. Manage Other Risk Factors: Take medications to control other risk factors like heart disease.

Prevention of diabetes due to some risk factors like age, family history and race can’t be changed. The only thing that can be done is to manage the modifiable factors.

Depending on the type of diabetes, there are several management and treatment plans available. Also, diabetes has a different effect on different people, so the treatment plans are also customised:

Treatment for Type 1 Diabetes

1. Insulin: Type 1 diabetes requires synthetic insulin, as the pancreas does not produce any insulin. Various types of synthetic insulin are available, including injectable insulin with a syringe, insulin pen, insulin pump and rapid-acting inhaled insulin.

2. Diet: Managing the diet is an important aspect of managing diabetes. The food we eat impacts blood sugar levels.
   Management of carbohydrates is important as it determines how much insulin is needed.

3. Exercise: Physical activity helps the body respond to insulin, thereby decreasing insulin resistance. For people with type 1 diabetes, exercise is an important part of managing the condition.

Treatment for Type 2 Diabetes

1. Oral Diabetes Medications: Some medications are available that can be used to manage blood sugar levels effectively. These medications are common in people with type 2 diabetes and prediabetes.
   Metformin is the most common oral medication to treat diabetes.

2. Diet: A well-balanced diet that is low in calories, fats, starch and carbohydrates and rich in vitamins, minerals, protein, and fibre can help regulate blood sugar levels and prevent post-meal sugar spikes.

3. Exercise: Regular physical activity is a crucial aspect of managing diabetes effectively, as it helps the body respond more to insulin.

4. Insulin: In some diabetics with type 2 diabetes, insulin may be required as a treatment option.

Irrespective of which diabetes is worse, both can lead to many long-term complications. Some complications are common to both type 1 and type 2, while some of them are different.

Complications of Type 1 Diabetes

Diabetes Ketoacidosis (DKA): A complication that usually affects people with type 1 diabetes and occurs when there is a lack of insulin in the body.
Due to this lack of insulin, the body can’t break down glucose for energy and starts to break down fat instead.

When fats are broken down, substances called ketones are released that turn the blood acidic. Ketones cause vomiting, laboured breathing and loss of consciousness, requiring immediate medical attention.

Complications of Type 2 Diabetes

Hyperosmolar Hyperglycaemic State (HHS): A complication that usually affects people with type 2 diabetes, HHS is a condition in which blood sugar levels are extremely high, over 600 mg/dL.

HHS causes extreme dehydration and confusion and requires immediate medical attention.

Common Complications in Type 1 and Type 2 Diabetes

Hypoglycaemia: Sometimes, due to insulin, the blood sugar levels may drop below the healthy range, causing hypoglycaemia.
Symptoms of this complication include blurred vision, clumsiness, disorientation and seizures.

The treatment for hypoglycaemia is emergency glucagon or medical attention. In addition to hypoglycaemia, elevated blood sugar levels also damage the organs and tissues.

Some of the most common complications of diabetes include:

1. Cardiovascular conditions (Heart attacks, Coronary artery disease, Strokes, Atherosclerosis)

2. Diabetic Neuropathy: Nerve damage

3. Diabetic Nephropathy: causing kidney failure or dialysis 

4. Diabetic Retinopathy: causing blindness 

5. Diabetes-related foot issues

6. Skin infections

7. Amputations

8. Sexual dysfunctions

9. Gastroparesis

10. Hearing loss

11. Periodontal disease

Diet plays a key role in the management of diabetes. Nutritional management helps to control blood sugar levels.

For people with type 1 diabetes, it is important to know how much insulin is required after consumption of certain types of food, mostly carbohydrates.
Meanwhile, irrespective of the type of diabetes, people should focus on healthy eating.

Irrespective of the type of diabetes, there are food items that are good and others that must be avoided.

Foods to Eat in Diabetes

People should focus on eating high-protein and low-sugar food items. Some have been discussed below:

1. Green Leafy Vegetables: Green leafy vegetables, such as spinach, kale, cabbage, etc., have essential nutrients like vitamins, fibres and minerals and have lesser calories.
   The fibre helps to regulate blood sugar levels.

2. Whole Grains: Whole grains have more fibre and nutrients in comparison to refined white grains. Consumption of a diet with fibre is important as it helps to slow down the digestion process, which helps the blood sugar remain stable.
   This includes brown rice, whole-grain pasta, quinoa, etc.

3. Beans: Beans are a good food item to include in the diet as they have protein and help achieve satiety.
   Therefore, they cause fewer spikes in blood sugar levels.

4. Nuts and Seeds: Nuts are rich in essential nutrients and promote satiety. Including nuts, such as walnuts, almonds, etc. in your regular diet can help you reduce the consumption of unhealthy snacks.

5. Fatty Fish: Fish is high in protein, healthy fats and vitamin D. Diabetics often have a deficiency of vitamin D, and fatty fish helps to control this.
   Omega-3 is essential in reducing inflammation that is caused due to diabetes.

Foods to Avoid in Diabetes

Some foods and drinks can increase blood sugar levels. In addition to diabetic complications, you also become susceptible to other chronic conditions like heart diseases, kidney diseases, and eye disorders.

Food and drinks to be avoided are:

1. Sugary Food Items: Avoid food items that contain added sugar, like table sugar, honey, molasses and corn syrup.
   While sugar improves the taste and flavour of food, consumption of large amounts of sugar increases the risks of diabetic complications, heart conditions and obesity. 

2. Food with Trans Fats: Trans fats are naturally present in dairy products and meat.
   While trans fats do not directly influence blood sugar levels, they can cause insulin resistance, inflammation and belly fat – conditions that can worsen diabetes. 

3. Alcohol: Alcohol intake should be limited or avoided in diabetes. Alcohol influences the liver’s ability to release glucose and can also negatively interact with diabetes medication.
   Additionally, when alcohol is consumed, the blood sugar levels become lower. This becomes worse when alcohol is consumed on an empty stomach.

4. White Carbohydrates: Foods such as white bread, white rice and pasta have no nutritional value.
   These food items cause a spike in blood sugar levels and contribute to not only weight gain but also increased levels of LDL, or bad cholesterol.

   Instead of white carbohydrates, consume whole grain carbohydrates like brown rice, whole grain bread, quinoa and whole grain pasta. 

5. Dried Fruits: Though good to curb the appetite and satisfy sweet cravings, dried fruits have a lot of sugar.
   Studies show that 43 grams of raisins contain approximately 25 grams of sugar, and 50 grams of dates contain 25 grams of sugar.
   To satisfy cravings, it is better to replace dried fruits with fresh fruits.
   Apples, bananas, berries and citrus fruits are good options. 

Diabetes can be controlled and managed with an effective nutrition plan. A healthy and balanced diet is effective in regulating blood sugar levels, managing inflammation, reducing the risks of heart diseases and kidney diseases, and acting as antioxidants.

When it comes to which is worse, type 1 or 2 diabetes, there is no concrete answer. However, we at HexaHealth can help you understand and manage both types of diabetes. Book an appointment with a doctor at HexaHealth and get the best treatment available.

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