Diabetes: Type 1 vs. type 2. What’s the difference?

diabetes expert hope warshaw

Diabetesthe difference between type 1 and type 2 with Hope Warshaw

Hope Warshaw is a registered dietitian and diabetes educator. This is our 3rd of 3 interviews about diabetes. Hope is the author of many diabetes books available at www.amazon.com and on her website—www.HopeWarshaw.com. (To watch video scroll to bottom or click here.)

Neily:Hope Warshaw is a registered dietitian, diabetes educator and author of several books. One of them is Diabetes Meal Planning Made EasyDiabetes: Type 1 vs. type 2. What's the difference?. Let’s just talk about type 1 and type 2 and explain to people that might not know the prevalence of the and how much more common type 2 is.
Hope:Ok. So, we’ll just talk about the United States. Today it is estimated by the CDC (Centers for Disease Control) and other organizations around the country that there are roughly 26 million people with diabetes and only 18 million of those actually know they have it. Because there is this other 6 million people who actually have diabetes today but have not yet been diagnosed.So, of those 18 million, about 90 – 95% of that population have type 2 diabetes. And about 5 – 10% have type 1.Let’s tackle type 1 diabetes first.
Neily:Which used to be called “juvenile onset” or “insulin-dependent” diabetes.
Hope:Right. And today the names are just type 1 diabetes. That’s because it can really develop at any time during life. It is an auto-immune disease. Its absolute origins are still not known. But basically, the body sort of attacks the beta cells. And kills off the insulin-producing cells in the pancreas.

So people over time no longer are making insulin and therefore dependent on an outside source of insulin. They take shots or they use an insulin pump and they have to be careful about what they eat. Exercise also plays an important role there.

And then we have this huge type 2 population. You have to have a genetic set-up, a genetic pre-disposition to develop type 2 diabetes. Family history is more important and plays a bigger role than in type 1 diabetes. Basically, it’s family history and then with all these people who are overweight, excess weight sort of pulls the trigger on pushing people over the edge. We know because so many people are overweight and people are developing type 2 diabetes at a younger age. We have this epidemic of type 2 diabetes.

Neily:That used to be “adult-onset” or “non-insulin dependent diabetes.”
Hope:So, we have had this whole cross-over. I have been involved in this for over 35 years and I’ve seen such incredible change. We have adults who are developing what is called latent auto-immune diabetes in adults, which is ostensibly type 1. We have adolescents and kids who are developing type 2.
Neily:Because of…
Hope:The obesity. And it’s much higher in African-American and Hispanic Americans.So, type 2 is much more at the core all-around insulin resistance. If you need to take insulin—and 40% of people with type 2 diabetes need insulin. People need to not feel guilty about that.Type 2 diabetes is a progressive disease.

The time for action is at diagnosis. In the previous video, we talked about pre-diabetes and I would like more people to know and be diagnosed with pre-diabetes because there is more action you can take.The most critical thing for people with type 2 diabetes—in terms of their long term health and preventing complications—is to keep glucose in control, keep blood pressure in control and keep blood lipids in control—triglycerides, HDL, LDL—and if you need medication to treat, then take them. There are wonderful medications we have.

Neily:But it is also often that people rely (on medications) or physicians don’t talk prevention…
Hope:And not talk lifestyle.
Neily:A lot of people say just give me the medications; I don’t want to think about lifestyle. But lifestyle can play such an important part.
Hope:An absolute huge part. So, I’m trying to make the point that there is balance.
Neily:And a great place to go is the American Diabetes Association, www.diabetes.org, and HopeWarshaw.com. You have got fabulous information on your site.
Hope:Lots of blogs..
Neily:Great. Good information. Thanks Hope. Thanks for watching Neily on Nutrition!https://neilyonnutrition.com

Jennifer “Neily” Neily, MS, RDN, LD, FAND
Registered dietitian nutritionist and certified health coach


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