Wednesday, July 4, 2012

Type 1 vs Type 2 vs Gestational Diabetes

So I have received a couple really good questions inquiring about the different types of diabetes.  To save time I'll point out that there are basic definitions to the right in the vocab column, but for those wanting more of an explanation here you go...

So on the very basic level, diabetes is a disease that implies a person's pancreas is not functioning properly.  On a more specific level, the different types of diabetes distinguish the source of the malfunction.

TYPE ONE:  (what I have)

In type 1 diabetes, the body's immune system attacks the islet cells in the pancreas and destroys their ability to produce insulin.  As a result of this, a person with this type of diabetes becomes permanently dependent on external supplementation of artificial insulin in order to be healthy.  At this point, there is no cure to this pancreas failure and without regular injection of artificial insulin a type 1 diabetic will die from complications caused by hyperglycemia and diabetic ketoacidosis.

Type 1 diabetics are inherently at a higher risk for complications like heart disease regardless of their glucose control.  But the majority of other complications caused by this disease are predominantly avoidable with appropriate self-care.


Type 2 diabetes, on the other hand, is as a result of lifestyle choices - specifically obesity, minimal exercise and poor diet - that cause the body's over-strained system to become insulin resistant.  In other words, the islet cells in the pancreas have not failed and still produce insulin, but not in the quantity necessary to compensate for the damaged body's increased insulin requirements.  As a result of this, most type 2 diabetics are put on oral medications that a) boost the islet cell's production of insulin and b) medically induce weight loss.  It is possible for type 2 diabetics with very poor self-care to require additional insulin via injection to maintain healthy blood glucose levels, so some may become both insulin-dependent and insulin-resistant.

With lifestyle changes and dedicated effort to weight loss, type 2 diabetics can in effect "cure" themselves of their insulin resistance.   However, using the word cure isn't entirely fair because even if the symptoms of type 2 are eradicated the reality of a predisposition for insulin-resistance makes it so that a type 2 diabetic requires a permanently diabetes-conscious lifestyle.

Some of you may have come across the phrase "pre-diabetic" at some point.   This phrase refers to the initial stages of insulin-resistance a type 2 diabetic exhibits.  If diagnosed with pre-diabetes a person can prevent their diagnosis with type 2 through significant, immediate lifestyle changes.   This phrase is not relevant to either type 1 or gestational diabetes.


As a result of the complex hormones necessary to build a baby, the placenta can make a pregnant woman insulin-resistant and require the administration of medication or external insulin.  ANY pregnant woman can be diagnosed with gestational diabetes - it does not discriminate by lifestyle or any other factor than how an individual's body responds to the demands of pregnancy.   The vast majority of gestational diabetics do not remain diabetic after the end of their pregnancies and can return to living a normal, healthy life once the baby is born and the placenta is removed.

So does that make sense?   Essentially insulin-dependence vs. insulin-resistance vs. temporary insulin resistance... very different causes, but similar results if uncared for.  Let me know if you have other questions!


  1. Gestational diabetes is a very tough disease to care for. You have to make huge changes in your diet and also carefully monitor and maintain your disease.

    Gestational diabetes

    1. That is absolutely correct, gestational diabetes is a very serious condition! It takes all of the negative factors of diabetes and throws them at non-diabetic (aka blissfully ignorant) women right when it is most crucial for the health of their growing baby. I didn't have gestational diabetes with GW and cannot speak to it specifically, but, as a type one who is stuck with this disease long after delivery, I thoroughly encourage any one with gestational to do everything you can to make the necessary changes to care for your little one and to get your life back. Gestational diabetes is a beast, but it is temporary -- YOU CAN DO IT!