We used to distinguish Type 1 and Type 2 as "childhood onset" and "adult onset" and had to stop that because type 2 diabetes started happening at earlier and earlier ages. We also used to distinguish Type 1 and Type 2 diabetes as "insulin dependent" and "non insulin dependent" diabetes because in general type 2 diabetics hadn't totally lost their ability to produce insulin, their bodies just couldn't produce enough of if, but again, as type 2 has become a more extreme disease, more and more type 2 diabetics have become dependent on insulin.
The defining difference is that Type 1 diabetics have a genetic auto-immune disease where their immune systems attack the islet cells in their pancreas as if they were germs, and in the process destroy the body's ability to produce insulin. Type 2 diabetes also has a genetic basis, but it is heavily influenced by so-called "metabolic disorder":
Consumption of highly refined simple starches (high glycemic index foods) produce rapid spikes of sugar in the bloodstream after they're eaten, and the body has to respond by cranking out this huge amount of insulin to pull the sugar out of the blood, but of course dropping blood sugar is what produces hunger pangs, which send us back to that bag of chips or box of cookies to do it all again, and the cycle over-stresses the body's ability to produce insulin. The pancreas essentially wears out, can't produce enough insulin, and the blood sugar stays high until the patient is diagnosed with diabetes.
Fortunately for most type 2 diabetics, this isn't the complete failure of the pancreas, and it's partially reversible - take insulin or change your eating habits to give your pancreas a rest, and it will recover some - but the longer you have uncontrolled blood sugar (i.e. the younger you are when you're diagnosed) and the more extreme the level, the more permanent damage you do.
The other piece of the metabolic disorder, which is apparently NOT genetically based - it's true of all of us - is that as you gain body fat you also gain "insulin resistance": even if your pancreas makes enough insulin, your cells refuse to put it to good use, so the pancreas has to make extra insulin to balance out its inefficient use. All of our bodies do this to some extent, but due to genetics and how overweight we are, some of us fluctuate within a healthy range and some of us have insulin resistance overwhelm our pancreas and make us diabetic.
That's why you so often hear the public service announcement saying that if you can just lose five or ten pounds of fat it will significantly decrease your risk of type 2 diabetes, even if you remain obese; and that's one of the reasons sparkpeople so pushes whole grains and complex carbs (eating your carbs with proteins and fats also slows their arrival in the bloodstream, evening out your blood sugar so your pancreas doesn't have to do as much). And as long as you have at least some insulin in your bloodstream, exercise will cause your muscles to remove blood sugar for fuel.
So there you have it - way more than you ever wanted to know about diabetes. This is why my tenth grade teacher gave me a "verbosity" award!
Edited by: GREBJACK at: 7/24/2012 (05:09)
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