Type 1 and Type 2 Diabetes Toe-to-Toe

Patient Expert

We've passed the mid-way point in National Diabetes Month, which calls for awareness and education of diabetes to the general public and fostering a sense of community for all who have diabetes.   Diabetes is affecting more and more people and their families and friends every year - to the tune of 23.6 million in the U.S. alone, hence this push for outreach and education are both necessary and noble.

I hope that this sense of unified community begins from within the Diabetes Community itself, where I've found a fracture between those with Type 1 and those with Type 2. There have been times when I've been privy to comparisons, comments and banter (sometimes none to friendly) that have been tossed between the two D camps. The division between the two conditions can be likened to some of the other schisms that have occurred in cultures or religions, creating two distinct factions, like the Protestants v. the Catholics, or the Orange Irish v. the Green Irish, or Working Moms v. Stay at Home Moms.

Spend a little time in the lives of either - or both - D types, and one can see why the division may occur. Type 1s become frustrated by the assumption that their condition is something they can control, and it was their lifestyle that has resulted in their diabetes. Just look at the most recent Presidential Proclamation for National Diabetes Month which states that: "Preventive care is the best way to avoid diabetes ...." Frustration understood.   Too, I suspect that underlying the surface is resentment that Type 1 Diabetes never has the possibility of going away like it can with Type 2. Once Type 1 is diagnosed, it's yours always.

Type 2s, understandably, loath the labels that have been put upon them: the condition is avoidable, or their fault, or if they simply managed their lives better they wouldn't have diabetes- again, let's consider that proclamation by President Obama, and the finger points back at the one managing the diabetes. There is the more insidious insinuation that Type 2s are a cause of our spiraling healthcare costs.

So What Really Is The Difference?
Unfortunately, not all members of the overall "D" community know or understand the difference between Type 1 and Type 2. Diabetes, no matter what the type, is such a demanding condition, it is understandable why we don't make time to research further the differences between the two types. Below summarizes, in brief, the two conditions, with links for more research if desired.

  • Type 1 Diabetes, also know as juvenile diabetes or Diabetes Mellitus. It most commonly affects children and young adults and is an auto immune disease, which means the body attacks and destroys insulin cells produced by the pancreas. Type 1s are insulin dependent, and must test their blood and inject insulin several times daily. Only about 12% of those managing Diabetes are Type 1. As an auto immune disease, Type 1 Diabetes is not preventable.
  • Type 2 Diabetes: is the most common form of diabetes, with million in the U.S. being affected. With Type 2, the body either ignores the insulin the body produces or the body does not produce enough insulin to convert food eaten into energy. Large levels of glucose subsequently builds up in the blood, which can lead to diabetes-related complications. Being overweight or inactive can lead to Type 2.

It's difficult to get exact numbers on the number of diabetics in America, owing to unreported but suspected cases and since they is no central registry for this data, but the best I could piece together is as follows:

And, So "Can We All Get Along?"

As a collective, the diabetes community can accomplish much more for itself together as a whole than if separate. Here are some areas that a large group can accomplish more via sheer numbers than if we are individual voices, all with slightly separate messages:

  • _Increased Awareness: _ The more people are aware of diabetes in general, the more likely they are to want understand and educate themselves on the condition (see the next bullet). Awareness is done in myriad ways, from fundraising (like the JDRF Walk To Cure Diabetes) to National Diabetes Days and Months, from events like the Quilt for Life to well known spokespeople managing the condition (like Associate Justice Sonia Sotomayor and the entertainment guru Dick Clark), to name a few.

  • _Public Education: _ Much of this information and education can be done via the awareness events discussed above. Increased education on diabetes, its symptoms and management, should be made available in the schools, starting in preschool through university level for the teaching staff and administration as well as students;   to public servants including those in law enforcement and other services, and to all who interact with people who may manage diabetes.

  • Advocacy: A long list exists of the advocacy efforts that support the funding of diabetes research, and the rights of those managing diabetes. These efforts help to ensure that those with diabetes have the chance to lead healthy and productive lives and that more dollars are set aside to improve the medicines and devices available for diabetes management.

  • _Affordable diabetes medicine and medical devices: _ It's a simple principle of economics: the larger the community of buyers demanding a product, the more impact they will have on price of a product. Just think: if all those with diabetes formed a consortium to purchase test strips for BG monitors, imagine what an impact we'd have on the price (and not to mention its transparency)

Putting Differences Aside, One Small Step At A Time
My family directly is affected by both Types: my son was diagnosed with Type 1 nearly a year ago, and my father has had Type 2 for nearly 25 years. My father manages his diabetes with nearly the same insulin regime that my son does: Lantus serves as basal insulin and Humalog acting as carb corrections.

During one of my dad's recent visits to our home, I witnessed, first hand, the solidarity that occurs between those with diabetes, no matter what type they have: It was 10 pm and time for grandson and grandfather go through their evening routine of testing and then getting a snack. Each lined up, side-by-side, along our kitchen countertop, ready to test. My father bummed some test strops off of my son, having forgotten his. Both tested and compared readings, seeing whose was lower. They then "shot" themselves twice, correcting for their agreed upon bedtime snack - which was a unanimous vote for low carb ice cream.

And a unanimous vote for Diabetes Solidarity, no matter what the type.