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Type 1 in a Type 2 World

What not to say to someone with type 1 diabetes.
By
WebMD Feature
Reviewed by Louise Chang, MD

Andrea Kolligian has learned that she's likely to get well-meaning comments if she eats a donut.

"Can you eat that? Are you sure you can eat that?" a friend or coworker will ask.

Kolligian, an administrative assistant at the Dana-Farber Cancer Institute in Boston, was diagnosed with type 1 diabetes when she was a teenager, and has been taking insulin ever since. But like many people with type I diabetes, she's learned that the growing prevalence of the type 2 form of the disease, which is often linked to weight and lifestyle, makes for a lot of misunderstandings about her own health.

"People assume that you have type 2. They ask if you've lost a lot of weight, or they'll say, ‘But you don't look fat!'" she says.

In fact, the many myths and misconceptions about type 1 vs. type 2 have even sparked a movement to have type I diabetes renamed. A Facebook group, called "Rename Type I," now has 861 members and has compiled suggestions for new names ranging from IDS (Islet Destruction Syndrome) to ABCD (Autoimmune Beta Cell Degeneration) or just plain Pancreatic Failure.

Similarities and Differences

About 25 million people in the United States -- more than 8% of the population -- have diabetes. About 95% of them have type 2 diabetes, while only about 5% have type 1.

Many of the public health messages about lifestyle strategies for people with diabetes don't distinguish between type 1 and type 2 diabetes. Weight, nutrition, and exercise matter for both types of diabetes, but people with type 1 diabetes need more than that to control their diabetes.

"They just say ‘diabetes,' which can be confusing," says Jessica Markowitz, PhD, a clinical psychologist who runs a support group for young adults with type 1 diabetes at the Joslin Diabetes Center in Boston.

Both forms of diabetes involve problems with insulin, a hormone that the body needs to use blood sugar for energy.

Type 1 diabetes, which used to be called juvenile diabetes because it is more often diagnosed in children and young adults, occurs when the body's immune system attacks the cells of the pancreas that make insulin. People with type 1 must take insulin therapy to survive.

In type 2 diabetes, the pancreas still makes insulin, but the body cannot use it properly. The pancreas responds by making more, until it eventually loses its ability to generate the hormone. People with type 2 may eventually have to take insulin, but early on in the disease, they usually take oral medications only and can sometimes control it with diet and other lifestyle changes alone.

Type 2 has a strong genetic component, and obesity and poor diet often play a role in developing the disease. It was once known as adult-onset diabetes, but as the childhood obesity epidemic increased, more and more children began to develop type II, so the name was changed.

Is This Normal? Get the Facts Fast!

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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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