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What Are The Differences Between Type 1 vs. Type 2 Diabetes?
11/12/2021 • Posted by By Dr. Natalie Schwartz, Fidelis Care Medical Director and endocrinologist in Diabetes, Health and Wellness

Man testing his blood sugarDiabetes affects 34.2 million Americans - that’s over 1 in 10 people. But, 1 in every 5 people with diabetes don’t even know they have it.

What is diabetes?

Diabetes mellitus occurs when your body cannot use glucose (or sugar) normally, as its main source of fuel. If you don’t make enough of a hormone called insulin (deficiency), or your cells don’t respond properly to insulin (resistance), sugar builds up in your bloodstream and over time, can damage your eyes, kidneys, nerves, heart, and blood vessels.


There are two main types of diabetes, type 1 diabetes (T1DM) and type 2 diabetes (T2DM). 

What is type 1 diabetes and how do I know if I have it?

In T1DM, the body’s immune system attacks the insulin-producing cells. People with T1DM make little to no insulin, so the blood sugar rises quickly.

Unintentional weight loss, excessive urination, feeling thirsty all the time, being very tired, and blurry vision are classic early symptoms.  Some people with T1DM have diabetic ketoacidosis (“DKA”), with sudden symptoms of nausea, vomiting, belly pain, rapid breathing, and fruity-smelling breath.

How do I know if I am at risk for type 1 diabetes?

Ten percent of all people with diabetes have T1DM. T1DM usually starts in childhood, but it can develop later in life. If you have a parent or sibling with type 1 diabetes, or a disease of your pancreas (which makes insulin), you should get checked.

How is type 1 diabetes treated?

Because there is not enough insulin produced and circulating in the body, people with T1DM must take insulin every day to stay alive.

What is type 2 diabetes and how do I know if I have it?

People with T2DM have a problem using the insulin that is available in the body - this is called “insulin resistance.” You may not notice symptoms of T2DM for years. By the time you have classic symptoms of high blood sugar (tiredness, increased thirst, increased hunger, blurred vision, weight loss, slow healing),  you may already have damage to your eyes, your nerves (causing numbness or tingling in your hands/feet, sexual problems, foot ulcers and deformities), and/or kidneys.

How do I know if I am at risk for type 2 diabetes?

More than 90% of all people with diabetes have T2DM. It is most commonly seen in adults. Obesity is a major contributor to “insulin resistance”, and we are seeing more and more T2DM in overweight children and adolescents. 

If you are an adult without symptoms, but are overweight or obese, you should start being screened for diabetes, if you have one or more of the following risk factors: a close family member with diabetes, high risk race/ethnicity (African- American/Asian-American/Hispanic-Latino/Native American/Native Hawaiian-Pacific Islander/Native Alaskan background), a history of heart disease, high blood pressure, or abnormal cholesterol levels, you exercise less than 3 times a week, you were diagnosed with diabetes during pregnancy, or have a condition called polycystic ovary syndrome. For all others, screening should begin at age 45 with simple blood tests.

How is type 2 diabetes treated?

Once a diagnosis of T2DM is made, it is important that you eat healthy foods, lose weight if you are overweight, get plenty of physical activity, and not smoke. Your doctor may prescribe pills, non-insulin injections, and/or insulin, depending on your personal situation and other medical conditions. 

Educating yourself about diabetes, following your doctor’s advice, and self-care are important to prevent long term complications.

For more resources about diabetes prevention and management, visit our Diabetes Resources page.

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