New and confused

[starsign]

I'm a friend of a type 2 & seek knowledge to help him out. Pls understand my ignorance & forgive if I might ask something silly. I know some things, but I think it's better to hear from the experts. Can someone please explain the difference between the types. Many thanks in advance.

[Shanny]

We never worry about questions being silly . . . in fact we usually say the only silly questions are the ones not asked, so ask anything you want to know!

I'm not much of an expert, but I do know that type 1 is an autoimmune disorder, whereby the patient's own immune system attacks the beta cells in the pancreas, causing them to weaken and die. And since beta cells don't regenerate, the patient eventually makes no insulin at all, and is dependent on injections for life. This is the type that was long known as juvenile diabetes, because professionals believed at that time, that it was only found in youngsters/teenagers/twenty-somethings. But as medicine has advanced and the proper testing is done, more and more cases are found in older adults, up into the 50s and even beyond. Anyone presenting with significant unexplained weight loss, greatly increased thirst, and a constant urge to urinate should be tested for type 1. These symptoms may also be associated with type 2, but they are definite signs of type 1.

And speaking of proper testing, those tests would be for GAD antibodies - if the antibodies are found in the blood, it is proof of type 1. The test for c-peptide then should be done to determine how much insulin is actually being produced in the patient's pancreas.

While insulin deficiency is the basis of type 1 diabetes, the hallmark of type 2 is insulin resistance. Science has not discovered exactly what causes it, although that hasn't stopped them from making assumptions about weight gain and sedentary lifestyles. At any rate, type 2 diabetics can still make insulin, but the cells are resistant to it, meaning they can't access all the insulin flooding their bloodstreams, so the same symptoms begin to appear . . . possible weight loss, increased thirst and/or urinary urgency. Earlier symptoms can be extreme somnolence after heavy meals, sores or infections which are slow to heal, and recurring UTIs and/or yeast infections.

Other types of diabetes include LADA and MODY, and I've added links to the acronyms there which explain it much better than I am able. 

[skb]

I'm also no expert, especially with insulin types and dosage. As Shanny said, T1 is an auto immune disorder where the patient's own protective Immune system, mistakes the pancreatic beta cells as a virus & attacks it. However, my understanding is that this is an ongoing lifelong process, when the beta cells do keep regenerating and keep coming under constant attack. 

[starsign]

Thanks. Many things were not known to me. It always helps to ask.

[Tamagno]

Im a little confused myself as your original message says your friend is type 2, but for now, I'll go ahead and figure you meant type 1.

There's a great deal to learn! Gary Scheiner's book "Think Like A Pancreas" is a terrific contemporary source for type 1s and contains a wealth of detailed information.

Of course, the really (I mean really!) big deal is doing finger sticks before meals, getting as accurate a carb count as possible and bolusing the correct amount. Its much easier to limit carbs to a max of 30 per meal.

The next thing is getting an insulin pump. I've been using Omnipod for a few years now and really like it - it's the only one that's tubeless. Pumps let you easily deliver basal insulin and boluses in half unit increments that is great for refining insulin delivery.

After that, he'll be wanting a CGM (continuous glucose monitor). There are only a couple out there and the best is Dexcom. The CGM allows you to monitor glucose levels without a finger stick and is especially useful those times when glucose is dropping very rapidly. It can be a real life saver.

Last are finger sticks. Even with all the technology, I often test 10-12 times a day. The variables that affect glucose levels are many and difficult to keep track of. I have to remind myself constantly to just stop what I'm doing and test if I'm not sure where I am. It's important.

Keep asking questions!

[starsign]

Thank you for the reply. Yes, my friend is a diabetic type 2. He's not internet trained, so I joined up (thanks to skb) to learn. My question was placed here because it related to difference between the type 1 & 2. Hope that is ok.