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Diabetes differences explained

By Judy Fortin
CNN

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ATLANTA, Georgia (CNN) -- CNN medical correspondent Judy Fortin spoke with endocrinologist Dr. Bruce Bode of Atlanta Diabetes Associates about the differences and similarities between the two types of diabetes.

Fortin: What is the difference between type 1 and type 2 diabetes?

Bode: Type 1 is absolute deficiency of insulin. Type 2 is relative deficiency of insulin. Type 1 means your body for whatever reason had its islet cells destroyed, typically by your own immune system. They just destroy them. Type 2 is due to overworking of the islet cells. They can't keep up with your insulin resistance, because you've gained weight, you're sedentary or you aren't eating right. (Watch more about the different types of diabetes )

Fortin: How common are the two types of diabetes in the U.S.?

Bode: Between one to two million Americans have type 1 diabetes. In comparison, about 18-20 million Americans have type 2 diabetes.

Fortin: Who is most at risk?

Bode: Actually, type 1 diabetes is one of the leading chronic diseases of childhood. It used to be called juvenile onset because it had its peak onset in adolescence, but now we know it can occur anywhere in life. People with type 2 are older. They're heavier and have a sedentary lifestyle. They are more likely of ethnic origin, but it can happen as easily in Caucasians.

Fortin: Are the symptoms different as well?

Bode: Typically, type 1 diabetics present with weight loss and increased thirst. They are losing weight. It can happen at any age. Type 2s are often asymptomatic; they have no symptoms. They go to the doctor or they go in the hospital and they find their glucose is high.

Fortin: How is type 1 diabetes treated?

Bode: Once you get type 1 diabetes you become dependent on insulin for the rest of your life. That typically requires taking four shots or more of insulin a day or wearing an insulin pump. It requires you to prick your finger or test your glucose at least four to six times a day.

Fortin: What about treatment for type 2 diabetes?

Bode: Many type 2 diabetics will need insulin, but they aren't dependent on insulin for living. We have nine different classes of medication for type 2. Anywhere from drugs that release more insulin ... to drugs that improve the body's sensitivity to insulin so they improve insulin resistance.

Fortin: What happens when the conditions go untreated?

Bode: Both will cause increased risk of blindness and eye damage. There is increased risk of kidney damage and possibly need for dialysis or transplant, increased risk of nerve damage and numbness in your extremities, potential of loss of limb as well as heart attack or stroke.

Fortin: Is diabetes on the rise in the United States?

Bode: Both types are on the rise, unfortunately. Obesity is on the rise, so type 2 clearly is on the rise. It is correlated with obesity. Type 1 is also on the rise because autoimmune disease in our country and in the world is on the rise.

Judy Fortin is a correspondent with CNN Medical News.

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