Published 16th May 2022

What are the differences between type 1 and type 2 diabetes?

Types 1 and 2 diabetes have key differences: They develop differently, can require different treatments, and they show symptoms in a range of ways. 

In this article, we’ll explain how the causes, risk factors, symptoms, and treatments differ between type 1 and type 2 diabetes.

If you have type 1 diabetes, your body doesn’t make enough of a hormone called insulin, which is essential in controlling your blood sugar levels. This condition tends to develop during childhood or early adulthood, but it’s possible to get it at any age. Type 1 diabetes is a lifelong condition. 

In contrast, if you have type 2 diabetes, your body can’t use the insulin it makes properly, or it can’t produce enough of it to keep your blood sugar in check. 

It’s possible to reverse type 2 diabetes by changing your diet and regularly exercising while keeping an eye on your blood sugar. 

Type 2 diabetes is much more common than type 1 diabetes — around 90–95% of people with diabetes have type 2.

Eating the right diet is important for everyone. ZOE’s research — the largest nutrition science study of its kind, involving over 20,000 people so far — has shown that blood sugar and blood fat responses to foods vary from person to person.

ZOE’s at-home test allows us to create a personalized nutrition program that helps you eat the best foods for you. This may help lower your risk of type 2 diabetes and heart disease. We can also give you an insight into your unique gut microbiome.

Take our free quiz to find out more.

Diabetes causes

Even though type 1 and 2 diabetes have different underlying causes, they both develop due to problems with the way your body makes or uses a hormone called insulin. 

Insulin allows sugars that you get from food to leave your blood and enter the cells of your body to be used as energy or stored. If insulin isn’t working or isn’t there in the right amounts, blood sugar levels can remain too high. 

This can lead to a range of health complications, including kidney problems, heart disease, stroke, vision loss, and limb damage. 

Type 1 and 2 diabetes both involve a loss of blood sugar control, but it occurs in different ways.

What causes type 1 diabetes?

Your immune system plays an important role in defending your body from outside threats like an infection. Sometimes, though, it can attack healthy cells.

If you have type 1 diabetes, your immune system attacks beta cells in the pancreas, which produce insulin. With fewer beta cells, your body can’t make enough insulin. Some people with type 1 diabetes make no insulin at all.

What exactly causes or triggers type 1 diabetes is not clear. Some people are at higher risk, but lifestyle factors, like diet and exercise, don’t appear to cause the condition. 

What causes type 2 diabetes?

If you have type 2 diabetes, your cells do not respond to insulin effectively. Experts call this insulin resistance. To compensate for this, your pancreas tries to produce more insulin.

Over time, your pancreas finds it harder to produce enough insulin to control blood sugar levels. 

This leads to high levels of sugar in the blood, which can damage your body’s organs and nervous system in the long term.

Risk factors for type 1 and 2 diabetes

There are ways to reduce your risk of developing type 2 diabetes. With type 1 diabetes, it’s less clear cut, although there are studies that focus on the prevention of type 1 diabetes. 

Risk factors for type 1 diabetes

Researchers are still unsure what triggers the immune system to attack beta cells in type 1 diabetes. 

People with close relatives who have the condition have a higher risk of developing type 1 diabetes than others. But that doesn’t mean that everyone who has a higher risk will develop type 1 diabetes. 

Lifestyle factors, such as diet and exercise, do not appear to increase your chances of type 1 diabetes. However, lifestyle changes can help manage the condition once it has developed.

Risk factors for type 2 diabetes

Several factors increase your risk of developing type 2 diabetes, including:

  • overweight or obesity

  • an age of 45 years or more

  • exercising fewer than three times each week

  • a family history of type 2 diabetes

  • prediabetes

  • a history of diabetes during pregnancy, known as gestational diabetes

People who are African American, Hispanic/Latino, Native American, or Alaska Native also have a higher risk of type 2 diabetes. 

While there’s nothing you can do to change some of the factors above, you can reduce your risk of diabetes by switching to a healthier diet, becoming more active, and losing weight if you have overweight or obesity.

Symptoms of type 1 and 2 diabetes

Although there are differences between type 1 and type 2 diabetes, there are some shared symptoms

  • waking up regularly during the night to pee

  • feeling thirsty and hungry most of the time

  • experiencing unwanted or unexpected weight loss

  • having blurred vision

  • numbness and tingling in the hands, feet, or both

  • fatigue

  • dry skin

  • slow-healing sores

  • frequent infections

Although people with type 1 and type 2 diabetes may share these symptoms, with type 1 diabetes, the symptoms are likely to appear more quickly

Specific symptoms

If you have type 1 diabetes, you might experience symptoms that people with type 2 diabetes do not, including:

  • vomiting

  • nausea

  • belly pain

These, along with the shared symptoms mentioned above, can become obvious within a few weeks or months. 

Type 2 diabetes symptoms may take longer to develop — years, sometimes — or you may not have any symptoms at all.

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Managing and treating type 1 and 2 diabetes

The focus of diabetes management  — whether type 1 or type 2 — is on controlling blood sugar levels to avoid the harmful effects of elevated levels.

If you have type 1 diabetes, taking insulin shots or using an electronic insulin pump will become part of daily life.

For people with type 2 diabetes, lifestyle changes — like eating a diet that helps to keep their blood sugar levels in range, managing their weight, and incorporating physical activity — can help. Sleep can also be a key lifestyle factor in type 2 diabetes.

Some people take prescription medication to manage their condition. And a small proportion of people with type 2 diabetes take insulin. 

Monitoring blood sugars and fats

Regularly taking the following tests can help you understand your blood sugar levels and manage your heart risk if you have type 2 diabetes:

  • A1C test: This test shows your average blood sugar level in the preceding weeks and months. 

  • Blood pressure: People with diabetes are more likely to have high blood pressure.

  • Cholesterol: High levels of low-density lipoproteins (LDL) or “bad” cholesterol can increase your risk of heart disease or stroke. Testing your cholesterol levels can help doctors understand whether they are a risk.

Monitoring your blood sugar levels is important if you have diabetes. You can do this with a blood glucose meter.

If you take insulin, regular glucose monitoring is vital for your diabetes care plan. People with type 2 diabetes who don’t take insulin can use this technology to help create a meal plan, set up an exercise routine, or know when to take medicines.

Exercising regularly

Exercise is a valuable tool for controlling blood sugar levels. Packing out your week with as much physical activity as possible is one way to help manage your blood sugar levels if you live with diabetes.

If you’re short on time, try taking a brisk walk to the store instead of driving, or walk your dog for 20 minutes longer every day. Swimming, cycling, yoga, and jogging are also safe, enjoyable ways to level up your physical activity.

Taking prescribed medication

Your doctor might prescribe one or several medications to control various aspects of your health and reduce your risk of diabetes complications like stroke and heart disease.

These may include metformin, which reduces how much blood sugar your liver makes, helps your body use insulin more effectively, and supports weight loss. All three of these can reduce the health impact of diabetes.

It’s important that you take medications as instructed by your doctor.

Quitting smoking

Nothing bad ever came from either avoiding tobacco or quitting it if you’ve started, and the same applies to its effects on diabetes.

According to the Centers for Disease Control and Prevention (CDC):

“No matter what type of diabetes you have, smoking makes your diabetes harder to manage. If you have diabetes and you smoke, you are more likely to have serious health problems from diabetes.”

Eating the right foods for your body

General food guidelines for diabetes focus on foods that increase blood sugar slowly, also known as low-glycemic-index (low GI) foods. 

However, everyone’s body works differently, including how your blood sugar levels respond to what you eat.

The National Institute for Diabetes and Digestive and Kidney Disorders recommend that your diet includes the following:

  • fruits

  • vegetables

  • legumes, pulses, and beans

  • whole grains

  • skinless white meat

  • fish

  • lean proteins

  • low-fat or nonfat dairy

However, what works for some people might not work for you. ZOE understands that it’s important to eat the right foods for your unique body, whether you’re managing diabetes or looking to prevent it.

ZOE runs the world’s largest ongoing nutrition science study with more than 20,000 participants and counting. Using continuous glucose monitoring, we have shown that blood sugar responses to food can vary greatly between individuals. 

ZOE’s at-home test can reveal how your blood sugar and blood fats respond to specific foods, and it can show you the one-of-a-kind makeup of your microbiome. Our team can help you find the best foods for you and your long-term health goals.

Take our free quiz to find out more.

Summary

Type 1 and type 2 diabetes develop in very different ways, and type 2 takes much longer to show symptoms. You can prevent type 2 diabetes but not type 1 diabetes.

Most people with diabetes have type 2. People with type 1 diabetes need to take supplemental insulin and monitor their blood sugar for life. 

Some people with type 2 diabetes can manage or even reverse the course of their condition with a diet that works for their body, regular medications, and a consistent exercise routine.

Sources

Diabetes and high blood pressure. (n.d.). https://www.diabetes.org/diabetes/high-blood-pressure

Diabetes diet, eating, and physical activity. (n.d.). https://www.niddk.nih.gov/health-information/diabetes/overview/diet-eating-physical-activity

Diabetes fast facts (n.d.). https://www.cdc.gov/diabetes/basics/quick-facts.html

Diabetes risk factors. (n.d.). https://www.cdc.gov/diabetes/basics/risk-factors.html

Diabetes symptoms. (n.d.). https://www.cdc.gov/diabetes/basics/symptoms.html

Differences between type 1 and type 2 diabetes. (n.d.). https://www.diabetes.org.uk/diabetes-the-basics/differences-between-type-1-and-type-2-diabetes

Environmental risk factors for type 1 diabetes. Lancet. (2017). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5571740/

Influence of lifestyle on the course of type 1 diabetes mellitus. Archives of Medical Science. (2014). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3953982/

Insuilin resistance and prediabetes. (n.d.) https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance

Managing diabetes. (2016). https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes

Metformin and diabetes. (n.d.). https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/treating-your-diabetes/tablets-and-medication/metformin

Smoking and diabetes. (n.d.). https://www.cdc.gov/tobacco/campaign/tips/diseases/diabetes.html

Type 1 diabetes. (n.d.). https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/type-1-diabetes

What is type 1 diabetes? (n.d.).  https://www.cdc.gov/diabetes/basics/what-is-type-1-diabetes.html

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