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FOX43 Focal Point: Differences between type one and type two diabetes

CENTRAL PENNSYLVANIA — Doctors say millions of Americans are living with diabetes in the United States. If you have the disease, you know managing it can ...
CENTRAL PENNSYLVANIA -- Doctors say millions of Americans are living with diabetes in the United States. If you have the disease, you know managing it can be a very daunting task. There are a lot of misconceptions, and many people don’t know the differences between type one and type two.

FOX 43’s Samantha Galvez has type one diabetes, and is diving into different topics all week in this FOX 43 Focal Point: Differences between type one and type two diabetes

Most of us know someone who has diabetes, but do we really know what that means?

Dr. Renu Joshi, Medical Director of Endocrinology at UPMC Pinnacle explains.

"Diabetes is a condition where your body is not able to utilize your glucose," Dr. Joshi said. "Your glucose in the blood increases. And basically that is diabetes."

That's the basic definition. It's actually a lot more complicated than that. There are several types, but the most common are type one and type two. And though they are similar internally, and look the same on the outside, management, is a completely different story.

"What we always talk about though is type one is a different disease," Dr. Joshi said. "It's a different ball park. It's a different game."

The more common type, and the type most people are aware of, is type two. According to the American Diabetes Association, of the 30.3 million Americans living with diabetes, 96% have type two.

"Which is more a disease of environment, which means it's more related to your food habits, obesity, lack of exercise, and family history still plays a big role in type two diabetes," Dr. Joshi said. "In type two diabetes your body is able to produce insulin, but it's causing insulin resistance so it's not able to utilize insulin properly."

Insulin is needed to break down carbohydrates. Your pancreas produces the exact amount of insulin you need to cover your meals, exercises, and daily routine, which is probably why you hear of diabetics, "needing a new pancreas." Type twos can still produce some insulin. Type ones have to monitor more closely.

"It's life threatening," Dr. Joshi said. "If you did not manage for one day you can end up in the hospital. That's the problem which bothers me the most. Type two diabetes if you did not take your medications for two days. Yes, your sugar is going to be 200 or 300, but it's not going to cause you problems."

And that's the type Samantha Galvez has. She was diagnosed when she was 13 years old, and there was nothing she could do to prevent it.

"So your body has antibodies which is killing your pancreas slowly and slowly and slowly," Dr. Joshi said. "And when you do not have insulin production, your body cannot utilize glucose, and you become diabetic."

Here's how it works. Managing type one diabetes is kind of like checks and balances. Food increases your blood sugar, while insulin brings it down. And it requires a lot of math, a lot of planning. And finding that happy medium is easier said than done.

"Type one is a difficult disease," Dr. Joshi said. "It's a life long disease. So the biggest thing I see is denial. But denial comes from, 'why me? Why did I get it?' as you just said, 'I eat healthy, I exercise, I have nothing wrong with me, why did I get it?' Number 2, 'I want to be like others. Why am I different? Why do I have to check my sugar? Why do I have to take insulin? Why can't I live without it? Why can't I eat what I want?' That's the emotional part."

As for managing type two diabetes, it's all diet, exercise, and medication. It can also be reversed, in most cases, while type one can't. And if you don't take care of yourself there can be long term complications with both, including  amputations, loss of vision, kidney disease, never damage, and heart attack, to name a few.

"I'm getting emotional as I talk to you about it," Dr. Joshi said. "And I think part of that has come from my experience, and when I saw these people at age 45 or 50 with their legs chopped off or getting a heart attack it just kills me." 

When a diabetic's blood sugar goes high, symptoms include blurred vision, extreme hunger and thirst, frequent urination. Low symptoms include shakiness, seizures, high heart rate, confusion, dizziness, cold sweats, and also extreme hunger. All of which can happen at any time, even if you manage properly.  

"I always call it the silent killer," Dr. Joshi said. "Because you don't know it. And it's slowly damaging your body if you're not taking care of yourself."

But the good news is type ones can live a healthy life, with proper management, and can eat whatever they want within moderation.

Another type of diabetes, which isn't as common as type one or type two, is gestational diabetes. That can occur in women who are pregnant. Also, a pancreas transplant can have limitations including the fact that the new pancreas must come from a deceased donor.