Most people don't realize that there are more similarities than differences between the two main types of diabetes (type 1 and type 2). Plus, as most of my clients know, I really love Venn diagrams. Let's see what we can find when we put these together:
Interesting, right?! Let's break it down:
Type 1 is an autoimmune condition (meaning it has a fast onset), and type 2 is progressive (meaning it changes over time).
Type 2 can be treated with a variety of medications (including insulin), while type 1 always requires insulin.
Type 1 affects the pancreas only, while the body changes that occur in a person with type 2 involve eight (!!!) different organs in the body, including the pancreas, liver, muscles and kidney (DeFronzo, 2009).
Type 2 is much more common and accounts for 90-95% of all diabetes diagnoses, while type 1 is less common, accounting for 10% or less of all diabetes diagnoses.
People with both types of diabetes have an increased risk of developing an eating disorder. A hyper-focus on food, frequent medical appointments, lots of numbers to keep track of to monitor health, and weight changes leading up to and after a diagnosis all add up to being more than twice as likely to develop an eating disorder than people without diabetes (Jones, 2000).
Onset can occur at any age. That’s right - type 1 diabetes (formerly called “juvenile diabetes”) can be diagnosed at any age! Half of all type 1 diabetes diagnoses occur after the age of 30 (Thomas, et al., 2018). That results in a lot of people being misdiagnosed. Little-known fact: former Prime Minister of England Teresa May was diagnosed with type 1 at age 56.
Research has come a long way for both types, but we still don’t know exactly what causes either. We do know that both have strong genetic links (if your direct family member has it, you’re much more likely to get it - raising my hand here!), and it's believed that environmental factors trigger the body to start changing.
Neither type requires avoiding or limiting any foods or following a special diet to have well-managed blood sugar levels. I still see “diabetic diet” listed in medical charts of patients I work with all the time - eye roll. This is outdated science. The best eating pattern for diabetes is one that benefits your physical, emotional and mental health. Cutting out foods entirely usually doesn't bode well for any of those.
Both can lead to major burnout, exhaustion, frustration, and fear. That’s a big part of what I help with. I realized I can be a much better diabetes dietitian if I focus on more than just food and blood sugars. How we feel about our eating, blood sugar and diabetes management is just as important as what we eat, what our blood sugar is, etc.
Finally, rates of both are increasing worldwide, not just type 2 like headlines often make us believe (CDC, 2017).
What surprised you the most? I'd love to hear!
Centers for Disease Control and Prevention. "National diabetes statistics report, 2017." Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services (2017).APA
DeFronzo, Ralph A. "From the triumvirate to the 'ominous octet': a new paradigm for the treatment of type 2 diabetes mellitus." Clinical Diabetology 10.3 (2009): 101-128.APA
Jones, Jennifer M., et al. "Eating disorders in adolescent females with and without type 1 diabetes: cross sectional study." BMJ 320 (2000): 1563-1566.
Thomas, Nicholas J., et al. "Frequency and phenotype of type 1 diabetes in the first six decades of life: a cross-sectional, genetically stratified survival analysis from UK Biobank." The lancet Diabetes & endocrinology 6.2 (2018): 122-129.