GHEF Blog
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Differences Between Type 1 and Type 2 Diabetes Mellitus (DM)
Understanding the key distinctions between these two forms of diabetes
Type 1 Diabetes
- Typical age of onset is <40 years
- Body weight is usually normal or low
- Family history is uncommon
- There is complete insulin deficiency, therefore treatment is with the use of insulin only
- It is due to T Cell mediated autoimmune disease destruction of insulin secreting beta cells of islets of Langerhans
- Progressive loss of beta cell function takes place over a prolonged period (months to years), but symptoms of DM occur only when 80-90% of the functional capacity of beta cells has been lost
- Genetic factors account for about one-third of the susceptibility to type 1 DM
- Viruses implicated in type 1 DM include Mumps, Coxsackie B4, retroviruses (e.g HIV), rubella (in utero), Cytomegalovirus and Epstein barr virus
- Bovine serum albumin, a major constituent of cow's milk, has been implicated, since children who are given cow's milk early in infancy are more likely to develop type 1 DM than those breastfed
Type 2 Diabetes
- Typical age of onset > 50 years
- Body weight is usually obese
- Family history is common
- There is relative insulin deficiency, treatment is with the use of oral anti diabetic medications
- The key feature is a relative insulin deficiency, such that there is insufficient insulin production to overcome the resistance to insulin action
- Obesity is a major cause of increased insulin resistance especially intra-abdominal central obesity
- Sedentary lifestyle or lack of physical activity also contribute to insulin resistance
- Physical activity allows for glucose to be taken up into the muscle, independent of insulin reducing the demand on the pancreatic beta cells to produce insulin
- The risk of developing type 2 DM is tenfold in people with a BMI > 30kg/m²
Type 1 Diabetes typically develops in younger individuals
Insulin therapy is essential for Type 1 Diabetes management
Type 2 Diabetes is often associated with lifestyle factors
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Other Causes of Diabetes Mellitus
Beyond Type 1 and Type 2: Understanding other factors that can lead to diabetes
Drug-Induced Diabetes
- Corticosteroids (prednisolone, hydrocortisone)
- Thiazides diuretics (hydrochlorothiazide)
- Phenytoin and other anticonvulsants
- These drugs are used cautiously or discontinued for people who are pre-diabetic (Fasting blood glucose 6.1-6.9mmol/L) or Diabetic
Pancreatic Diseases
- Pancreatitis (acute or chronic)
- Pancreatectomy (surgical removal of pancreas)
- Hemochromatosis (iron overload)
- Cystic fibrosis
Endocrine Disorders
- Acromegaly (excess growth hormone)
- Cushing syndrome (excess cortisol)
- Pheochromocytoma (adrenal gland tumor)
- Thyrotoxicosis (excess thyroid hormone)
Genetic Syndromes & Other Causes
- Down's syndrome
- Klinefelter's syndrome
- Turner's syndrome
- Gestational Diabetes (occurs during pregnancy)
Some medications can increase diabetes risk
Pancreatic diseases can affect insulin production
Gestational diabetes occurs during pregnancy
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