Scott Hanselman

What is the difference between Type 1 and Type 2 Diabetes?

November 7, '05 Comments [11] Posted in Diabetes
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I'm asked all the time what the difference is between Type 1 and Type 2 Diabetes. I'm a Type 1 and I wear an Insulin Pump that pushes insulin into my system 24 hours a day. Sometimes folks will say, "Oh, my uncle has diabetes, he got it when he was fifty" and assume it's just like mine.

Type 1 diabetics don't produce enough insulin and need augmentation. Type 2 diabetics product too much because they are resistant to their own insulin. Both of us have high blood sugar because we're not using insulin effectively. Here's a very clear difference:

Dr. Michael Murray clearly identifies the difference between type 1 and type 2 diabetes when he states, "Healthy individuals secrete approximately 31 units of insulin daily; the obese type 2 individual secretes an average of 114 units daily.  Individuals with type 1 diabetes secrete only 4 units of insulin daily."

This is totally true, because I use about 30 units of insulin each day delivered from my pump.

UPDATE: You might also enjoy my "Diabetes: The Airplane Analogy" post from a while back.

About Scott

Scott Hanselman is a former professor, former Chief Architect in finance, now speaker, consultant, father, diabetic, and Microsoft employee. He is a failed stand-up comic, a cornrower, and a book author.

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Monday, November 07, 2005 6:27:13 PM UTC
My thought is that allot of "normal" people don't understand what diabetes is...or how it works in either case. I am type 1 and when I relay that my sugar is low, people ask "well don't you have a pump to fix that?". well...the answer is "the pump caused it...in a way, so no." They don't understand that we HAVE to give ourselves insulin in order to "fight" the carbs we intake. I think the typical response I have had is that the pump just fights against the highs and lows because insulin takes care of both...it is a lack of knowledge on the subject, so I laugh it off at this point. I get funny questions when I let people know I am diabetic and typically, I get the "my uncle has that too" response as well.

Good post.

Ernie
Monday, November 07, 2005 7:47:19 PM UTC
Good post.

Of course, as all good diabetics know -- your milage may vary.

I'm a Type 2, on an Insulin pump, and while in the past I've used as many as 120 units of insulin today, right now, with the help of Symlin, I'm down to 30 units a day, AND losing weight.

That's one of the reasons I went to the insulin pump -- on shots, I kept gaining weight, and since I was already overweight, that sure wasn't fun.

The reasons are a bit simplistic, even with the Type 1. However, with Type 2, there can be many causes (and that's why there are different oral meds). The Type 2 might have insulin resistance, but they also might be producing more sugar than they should or they might not be producing enough insulin -- something that we think is happening in my case in addition to insulin resistance.
Monday, November 07, 2005 11:21:01 PM UTC
On Type 2: not quite as simple as you state it. All T2s are resistant to insulin to one degree or another, but not all produce excesses of insulin. In fact, there is a wide range of insulin production in T2 diabetics, from less than normal all the way to way more than normal.

Good post otherwise!
Andrew Shebanow
Tuesday, November 08, 2005 12:30:39 AM UTC
My 4 year old son is type 1 and I get both the "my grandmother" response or even more annoying the "won't he outgrow that?" response or a "he doesn't seem overweight!".

I have always thought that they should be called completely different names since they quite different.

One of my best friends is also a type 1 diabetic and we were talking about meters and blood sugar checks. He was confused as to why the manufacturers were stressing the pain of testing issue so much because since he's on shots (rather than a pump) "testing is not the most painful thing I do every day". I reminded him that type 2 folks typically aren't on shots and therefore testing is a big deal. We then decided that (except in the more rare cases noted above) that type 2 is essentially the wuss form of diabetes.
Tuesday, November 08, 2005 2:49:18 AM UTC
I take double that amount, 30 units in the morning and 30 in the evening. Of course that would probably be lower if I actually got off my butt and exercised, but I doubt it would be half of my current dosage.

My family covers the full spectrum. My mother's parents were both diagnosed with Type 1 late in life. My mom and two of her brothers are type 2, and I'm Type 1.
Wade
Tuesday, November 08, 2005 9:20:49 PM UTC
Yes but are the Types CLS compliant?

I have one uncle with Type 1 and another with Type 2. Former maternal, the latter paternal. So I'm covered both ways.

;)

Wednesday, November 09, 2005 4:10:59 AM UTC
This is fascinating to me, as my 10-year old son -- over a year from Type 1 diagnosis -- still takes in less than 15 units a day.

Obviously, he's still honeymooning. Amazing to think that he's still getting at least half his insulin from his pancreas...

And yeah, I hate the confusion between the two types -- can't tell you how many people have asked "So, did Joseph just eat a LOT of sweets? Is that how it happened?" Grrrr.

Nice site, by the way.
Wednesday, November 09, 2005 4:42:42 AM UTC
As Scott's cousin I represent the other "Type" Type 2, diagonosed when I was 32. I get the same weird looks trying to explain my Diabetes.

I went to get a blood test for life insurance and based on that test my broker encouraged I head on into the Dr. I had not been feeling well. I thought it was the new job, travel, not excercising yada yada yada. Anyway I found out I was Type 2. I think I got if from lack of activity, FOOD choices, and of course lots of people in my family have it too. I got it earlier than most. I've worked real hard on my diet, going from 305 to 260 in the last five years. I'm 6'4 and for the most part very close to my active weight in college. Excerise has been tough to create a new habit. I'm working on that. I was able to control my sugar levels through diet alone for a couple years and then I went to Glucophage. I had some discomfort with my GI on that, so I've been on Glyburide for a year or so. All is well and am always working on my diet and working out. I just really have to focus on the excersise this year, the diet has worked and I still have to lower my HA1C from a 7-8. I want to be in the 6 or lower range and I know its working out... I seem to talk myself out of working out in the gym. WEIRD

I thought I'd share a little bit about my diabetes because as you learn we all have it a bit different then the next person. Jack
Jack Hanselman
Thursday, November 10, 2005 2:09:49 PM UTC
Now that i've just started college I get all sorts of questions in addition to the Type1/Type2 debate. I've been asked whether my cell phone is fiber optic, if i've got a new iPod, or why am I putting strips into my walkman.
It seems like the questions are common enough that one could carry around note cards with pre-printed answers. Its all well and good anyway though. C'est la vie.
Friday, November 25, 2005 6:33:11 AM UTC
I usually get the following comments from The Uninformed, Chatty Non-Diabetic:

1. Pump? Like for morphine?
2. Diabetic? But you're not fat.
3. Do you know you're going to die from that? (Honest. They actually said this.)
4. My grandma/old uncle/overweight dog had diabetes. But they just took pills. You must be really bad.
5. You can't eat salt, right?

The differences between Type One and Type Two will forever be explained for forever misunderstood. But thanks for continuing to fight for truth, justice, and the right to consume more salt.

-- Kerri.
Monday, November 28, 2005 4:12:30 PM UTC
It's so easy to get frustrated at these questions sometimes. I'm used to it now. Explaining my diabetes is practically my elevator speech now. I get the 'but your not fat' comment too since I'm so skinny. I guess however, if people were more educated, Type 2 diabetes wouldn't be such a rising epedimic.
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Disclaimer: The opinions expressed herein are my own personal opinions and do not represent my employer's view in any way.