Type 1 diabetes isn’t just a children’s disease

Even as an adult, it’s possible to develop type 1 diabetes.

Some people tend to think the typical person with type 1 diabetes is a thin person under the age of 18. But people of all ages and body weights are diagnosed every year with type 1 diabetes, the disease in which the pancreas produces little to no insulin, causing blood sugar levels to erratically shift from high to low.

Type 1 diabetes and autoimmunity

About 5 to 10% of people in the United States with diabetes have type 1, the autoimmune disorder in which their immune system attacks the cells of their pancreas. That prevents the pancreas from producing insulin, the hormone that controls the movement of glucose from the food you eat, into cells.

Type 2 diabetes is not an autoimmune disease. If you have type 2 diabetes, your pancreas still makes insulin, but about half of what it used to. Also, your cells don’t respond as well to taking in the glucose to use as energy, leaving more glucose in your bloodstream.

Usually type 2 diabetes develops in people over 40. However, increasingly younger people, particularly those who are obese, are being diagnosed with the chronic condition.

The symptoms of type 1 and type 2 diabetes, such as blurry vision, urinating often and feeling thirsty can be similar. But treatment and progression of the two types of diabetes are very different.

Does type 1 diabetes get worse with age?

Not like type 2 does. If you have type 2, about 10 years after your diagnosis, your risk for a heart or stroke increases.

With type 1, those same risks don’t typically increase until about 20 years after you’re diagnosed. We who treat diabetes think that part of the problem is that most people with type 2 have had inflammation in their body for many years before it progressed to high blood glucose levels.

Can type 1 diabetes be cured?

No. Currently, there’s no cure for the disorder.

What triggers type 1 and type 2 diabetes?

For both type 1 and type 2 diabetes, family history can play a role, such as if you have a parent or sibling with diabetes. Beyond family history, it’s uncertain what causes type 1 diabetes.

What you eat and drink, and how much you exercise can influence whether you get type 2 diabetes. So being overweight greatly increases your risk of getting type 2 diabetes.

Type 1 diabetes is less influenced by your diet and exercise. You could be a marathon runner or a couch potato and still be diagnosed with type 1 diabetes.

How are people diagnosed with diabetes?

Both types of diabetes are diagnosed with blood tests. There are three possible tests that can be taken, all measuring the level of glucose in your blood.

Hemoglobin A1c test: This blood test measures your average blood sugar levels over the past three months.

Fasting blood glucose test: A blood sample is taken six to eight hours after you last ate.

Glucose tolerance test: You take a glucose drink, then two hours later a sample of your blood is drawn to see how well your body handles sugar. A shorter, one hour version of this tests is used in pregnancy, typically done between 24 and 28 weeks of pregnancy. The test is done to see if the pregnant individual has gestational diabetes, which can occur at the transition to the third trimester of pregnancy.

Is there a test to determine if I have type 1 or type 2 diabetes?

Yes. A blood test can determine if you have certain antibodies, which are proteins that are markers for type 1 diabetes. Your blood should be tested for all five of these antibodies:

• GAD (glutamic acid decarboxylase antibody)
• ICA (islet cell antibody)
• IAA (insulin autoantibody)
• IA2 (islet antigen 2 antibody)
• ZnT8 (zinc transporter 8 antibody)

If have a high blood glucose level, and your blood test shows you have even just one of these antibodies, you’ll be diagnosed with type 1 diabetes.

If you have a normal blood glucose level but your blood test shows you have two of these antibodies, then you would be considered at high risk of eventually developing type 1 diabetes.

What is a type 1.5 diabetic?

Some doctors use the term type 1.5 diabetes or latent autoimmune diabetes of adults (LADA) to refer to people who share features of both type 1 and type 2 diabetes. They’re often adults who are obese or significantly overweight and are believed to have type 2 diabetes but cannot produce insulin.

I don’t believe there’s such a thing as type 1.5 diabetes. These are actually people with type 1 diabetes who happen to have some insulin resistance because they’re either overweight or obese. They don’t make insulin, so their treatment needs to include insulin therapy but also possibly some additional medications commonly reserved for people with type 2 diabetes.

How is type 1 and type 2 diabetes treated?

Typically if you have:

Type 1 diabetes, you give yourself insulin either with an insulin pump or a disposable pen that contains insulin.

Type 2 diabetes, you control it through diet, exercise and often, medication. The medicine either helps manage your blood sugar levels or causes your cells to become more sensitive to insulin to eliminate dramatic shifts in your blood glucose levels.

Can Type 1 go into remission?

No. However you might experience a “honeymoon phase” in the first couple of years after you’re diagnosed. That’s when your pancreas can still produce some insulin. But the organ eventually stops making any insulin.

Type 2 can only go into remission if you experience dramatic weight loss, such as through bariatric surgery.

How can I keep from getting type 1 or type 2 diabetes?

It’s unclear how to prevent type 1 diabetes entirely, but there are medications that can slow the disease from progressing.

You can prevent or delay type 2 diabetes through a healthy diet and exercise. If you’re at high risk of diabetes, you can delay the onset by many years just by losing weight, staying active and eating whole or minimally processed foods.