Sunday 13 December 2009, 22:59

Type 1 diabetes versus type 2 diabetes

The main differences between type 1 and type 2 diabetes

Type 1 diabetes versus type 2 diabetes

Although diabetes is a popular topic nowadays, there is still a widespread misunderstanding about it and about the difference between type 1 and type 2 diabetes.


Diabetes is a chronic metabolic disease characterized by persistent high blood glucose levels (hyperglycaemia) as a consequence of the body's inability to produce and secrete adequate amounts of insulin or to respond properly to its action.


Insulin - produced by the beta-cells in the pancreas - is the hormone responsible for regulating the metabolism of glucose and keeping blood sugar levels within normal ranges. It allows glucose into cells, where it can be utilized as fuel, and inhibits the breakdown of glycogen into glucose and the conversion of amino acids or fatty acids to glucose. Without insulin or without the ability to use it, cells are deprived of glucose, despite the high increase in blood glucose levels.


In type 1 diabetes (insulin-dependent diabetes), usually affecting children and adolescents, the body is not able to produce insulin. Type 1 diabetes onset is usually rapid, occurring over days or weeks, with serious symptoms that require immediate medical attention. Type 1 diabetes pathogenesis is "autoimmune" and the disease is caused by the destruction of the pancreatic beta-cells mediated by T-lymphocytes. Therefore patients affected by type 1 diabetes need an exogenous source of insulin to survive.


In type 2 diabetes (insulin-independent diabetes), the body produces enough amounts of insulin, at least in the first stages of the disease. For not well understood reasons, the body's cells become resistant or insensitive to it and they no longer absorb glucose properly (insulin resistance). As a consequence blood glucose starts increasing and the pancreas starts secreting more and more insulin to compensate. Over the years, the resulting overload of the beta-cells leads to their exhaustion and dysfunction and the pancreas' ability to produce insulin declines. Therefore patients affected by type 2 diabetes become insulin-dependent only in the late stages of the disease.


The causes of type 2 diabetes are not completely understood. Genetic factors, overweighting or obesity and physical inactivity have been implicated in the pathogenesis of type 2 diabetes, but their role and importance still have to be defined more accurately.


If not treated, both type 1 and type 2 diabetes have devasting consequences. The inability to use glucose by the cells and the high increase in blood glucose lead to metabolic dysfunctions affecting all body systems and organs. Blood vassels, hearth, liver, kidneys, eyes and nerves are the most susceptible to serious complications.


By Chiara De Carli

Category: Diabetes

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