Am I a Type 1 or a Type 2 Diabetic Patient?

 Am I a Type 1 or a Type 2 Diabetic Patient?

Every diabetic patient should know his/her type of diabetes.

Diabetes mellitus has two subtypes: Type 1 and Type 2.

95% of the diabetic patients are Type 2. Only 5% are Type 1.

You can be either Type 1 or Type 2.

These are different disease processes.

You cannot be both Type 1 and Type 2. (Some people do have this misconception).

Chances are that you are a Type 2 Diabetic if:

• You are not on insulin.

• Even though you are now on insulin, in the past you were successfully treated with diabetic pills for several years before you were placed on insulin.

• You are on relatively large doses of insulin ( usually more than 50 units per day ).

• You are obese.

• You also have high triglycerides and low HDL cholesterol.

• You also have high blood pressure.

• You have a family history of diabetes, high blood pressure, heart disease, stroke or high cholesterol.   

Chance are that you are a Type 1 Diabetic if:

• You have been on insulin ever since the diagnosis of your diabetes or shortly thereafter.

• You are on relatively small doses of insulin (usually less than 40 units per day).

• You are thin.

• You do not have a family history of diabetes.

• You do not have high triglycerides and low HDL cholesterol.

• You do not have high blood pressure.
  

In the past, Type 2 diabetes was also called NIDDM (non insulin dependent diabetes mellitus) or Adult onset diabetes. Type 1 diabetes was called IDDM (insulin dependent diabetes mellitus) or Juvenile onset diabetes.

We have stopped using these older terms because these can sometimes be inaccurate and misleading. For example, some Type 2 diabetic patients end up on insulin and sometimes, Type 2 diabetes starts in teenagers. Actually, Type 2 diabetes in teenagers is on an alarming rise, primarily due to our "fast food culture" and a lack of activity in the teenage population.

On the other hand, Type 1 diabetes can develop in an adult person.

Is there a test for categorizing the type of diabetes?

In difficult cases, special blood testing, such as a blood test for C-peptide (a hormone produced in conjunction with insulin) can be done to distinguish between Type 1 and Type 2 diabetes.

In rare difficult cases, further testing such as anti-islet cell antibodies, or anti GAD antibodies can be carried out. 

Why is it so important to know the type of diabetes?

It is crucial to know the type of your diabetes because treatment  is different for the two diseases.

In Type 1 diabetes , the body is unable to produce any insulin and therefore, these patients have to take insulin on a regular basis in order to sustain their life. If these patients stop taking their insulin, they can rapidly lapse into a coma and can die if treatment is not instituted in time.

In Type 2 diabetes, the body is able to produce insulin, but this insulin is not very effective as these patients have developed insulin resistance. New drugs such as Actos, Avandia and Glucophage act by reducing the insulin resistance and consequently, the body's own insulin becomes more effective. These drugs are therefore called insulin sensitizing drugs.

In year 2000, most Type 2 diabetic patients can be effectively treated with oral pills, often used in combination. Since the availability of these insulin sensitizing drugs, many Type 2 diabetic patients have been able to come off their insulin gradually, under the supervision of their physician. Patients should never stop their insulin on their own. Some Type 2 diabetic patients have very little insulin production and therefore, they have to take insulin.

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