How Does Type 2 Diabetes Differ From Type 1 Diabetes?
Type 1 diabetes is known as an autoimmune disease. That means that the body's immune system cells (cells that usually protect the body from germs and infection) actually destroy the beta cells of the pancreas that produce insulin. You can tell when autoimmune destruction is taking place in the body when beta cell antibodies appear in the blood. Destruction of the beta cells in this way leads to a serious lack of insulin.
Unlike type 1 where the body lacks insulin, in type 2 diabetes, the body is resistant to insulin, which is almost always associated with obesity. So unlike people with type 1 diabetes who stop making insulin, people with type 2 continue to make some insulin – although not enough to overcome insulin resistance.
Table 1: Type 1 diabetes vs Type 2 diabetes in children and adolescents
|Typical clinical course
||Usually rapid onset; symptoms are present for a few weeks to one month.
||Usually slower or more subtle onset; symptoms are present for many months.
||Primarily lean, although as more children become overweight, increasing numbers of children with type 1 are overweight at diagnosis.
||Almost all of the children with type 2 are overweight or obese.
|Diabetes ketoacidosis(DKA) is diagnosed when a child has ketones in the urine and blood, and is dehydrated and sick. It usually requires hospitalization and the administration of fluids and insulin by vein.
||This occurs in about 35%-40% of children at the time of diagnosis of type 1
||A very mild form is found in some children with type 2. It has been reported to occur in type 2 in about 15% of cases at diagnosis.
||Only 5% have a relative with type 1 diabetes.
Up to 20% may have a relative with type 2 diabetes.
||Almost all will have at least one relative with type 2.
|Other conditions in addition to diabetes
||Several autoimmune diseases such as thyroid and/or adrenal disorders, vitiligo (loss of pigmentation of the skin) and celiac disease are seen in children with type 1 at a higher rate than the general population. Autoimmune disorders may also run in family members
||Polycystic ovary syndrome. Acanthosis nigricans. (90%) High Blood Pressure. Other obesity-related conditions.
|C-peptide - this indicates insulin is being made in the pancreas
||Can be preserved at diagnosis when a few cells still persist and can manufacture insulin.
||Always present, which indicates that not all insulin producing cells have been destroyed
|Presence of islet auto-antibodies
||Although this is the hallmark of type 1, only 85% of those felt to have type 1 have antibodies
||Although this is the hallmark of type 1, 15% of those presenting with what looks like type 2 diabetes have antibodies.
Last Updated: Saturday April 20, 2013 13:31:32
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