Type 1 Diabetes or Type 2 Diabetes, Which Is Worse?

Okay, before getting into the meat and potatoes of this post, it’s important to note that for most of us living with diabetes this question is a rather silly one. That’s because there is no “worse” when it comes to the differences between Type 1 and Type 2 diabetes. They’re both serious conditions and both can lead to serious health complications, including heart disease, kidney disease and stroke.

It's not a matter of which one is worse. It’s a matter of which one you happen to be living with and are managing each day. Your personal diabetes journey is not better or worse than anyone else’s – it’s simply yours and it comes with its own set of challenges and treatments and lifestyle adjustments.

So why this post?

Because there are still many people out there who hear the terms and see all the commercials with Type 1 and Type 2 diabetes being bantered about and have no idea as to what the differences are and what those differences might one day mean for their own health.

This is particularly worrisome, considering there are some 96 million Americans out there in the prediabetic stage and 80% of these individuals have absolutely no idea they’re on the fast track to developing Type 2 diabetes.

So, let’s forget the “better or worse” and look at the differences and similarities between Type 1 and Type 2 diabetes.

For both Type 1 and Type 2 – it’s all about blood sugar

Diabetes, regardless of whether it’s Type 1 or Type 2, is a metabolic disease in which a person develops high blood sugar due to problems related to the production and/or use of the hormone insulin. Insulin is produced in the pancreas and is necessary for the body’s cells to be able to absorb glucose from the blood and use it to create energy.

When the body is unable to process blood sugar, it remains in the bloodstream and gradually increases until it reaches levels that are above normal. This increase in blood sugar is what leads to either a Type 1 or Type 2 diabetes diagnosis. Though a rise in blood sugar is what leads to a diagnosis in both cases, why and how this happens is what distinguishes the two types of the disease.

Type 1 diabetes

Type 1 diabetes is an autoimmune disorder in which the body’s immune system mistakes the beta cells in the pancreas – the ones that produce insulin – for foreign invaders. It attacks these beta cells just like it would a disease and gradually destroys them. Once they’re all destroyed, the body can no longer produce any insulin. Therefore, it also can’t process blood sugar.

Type 1 diabetes is not caused by anything you can control. If you have it, you didn’t do anything wrong, nor was there anything you could have done differently to avoid it. Quite simply, Type 1 diabetes is the luck of the draw. Type 1 diabetes usually manifests during childhood or adolescent years and develops quite rapidly. Once diagnosed, it will be a part of a person’s life forever. Since the body cannot produce any insulin, the only way to control blood sugar is to regularly administer insulin as prescribed by a diabetes physician. There are a number of ways to do this, including insulin pumpsinsulin patch and pod solutionsinsulin pens, and the traditional way – injecting insulin with a syringe. The point is a person with Type 1 diabetes will be administering some form and quantity of insulin for life.

It's important to note than only 5% to 10% of people diagnosed with diabetes in the United States have the Type 1 form of the disease. That’s still millions of people, but not nearly as many as have Type 2 diabetes.

Type 2 diabetes

Perhaps the biggest difference between Type 1 and Type 2 diabetes is the vastly larger number of people who have Type 2 diabetes. There are approximately 34 million Americans currently living with diabetes and upwards of 95% are managing the Type 2 form of the disease.

People with Type 2 diabetes can usually produce some insulin, however, the body has become resistant to it and is unable to effectively use it to process blood sugar, which is what eventually leads to elevated blood glucose levels and a diabetes diagnosis.

Here’s another big difference. Type 2 diabetes usually develops after the age of 30 and there are some very definite factors that contribute to it. These include:

  • Obesity
  • Lack of physical activity
  • Unhealthy diet

Not everyone develops Type 2 diabetes solely because of these lifestyle factors. There are others including family history, ethnicity and age that can also increase risk. However, we are seeing an alarming rise in Type 2 diabetes as the United States continues to wrestle with an obesity problem, and, unfortunately, Type 2 diabetes is becoming more and more common among younger individuals.

Diagnosing Type 1 and Type 2 diabetes

Both Type 1 and Type 2 diabetes can be diagnosed with a variety of simple blood tests:

  • A1C Test measures average blood sugar over the past 2 to 3 months
  • Fasting Blood Sugar Test measures blood sugar after an overnight fast
  • Glucose Tolerance Test measures the body’s reaction after drinking a liquid loaded with a high level of sugar

Using any one of these blood tests, your doctor can determine if you have diabetes and tell you what type. These tests can also diagnose prediabetes, which is a precursor to developing Type 2 diabetes.

Prediabetes and the prevention of Type 2 diabetes

Unlike Type 1 diabetes, Type 2 diabetes happens very gradually and there are usually few if any symptoms until the disease has already developed. However, there is a stage called prediabetes that can identify rising blood sugar before it warrants a Type 2 diabetes diagnosis. In other words, you can find out if you’re on the way to developing diabetes. Better yet, because it’s Type 2 diabetes there’s a good chance if caught early enough lifestyle changes can prevent the development of the disease. The only way to know for sure if you are prediabetic is with one of the blood tests mentioned above. So, if you are over the age of 30 and have risk factors such as obesity and a lack of regular activity, ask your doctor about testing for prediabetes. If you find out early enough, you might just be able to avoid a Type 2 diabetes diagnosis.

Treating Type 1 and Type 2 diabetes

Though they’re quite different when it comes to the root causes, treating both Type 1 and Type 2 diabetes is very similar and can include:

  • Insulin treatments – by pumppatch, insulin pen or standard syringe
  • Regular blood sugar testing – this is often done using glucose meters and test strips, though more and more people are moving to continuous glucose monitoring (CGM) devices, such as the Dexcom G6 and FreeStyle Libre.
  • Oral medications as prescribed by a physician
  • A healthy diet that is low in carbohydrates and sugars and features plenty of lean proteins and vegetables
  • A recommended minimum of 150 minutes of physical activity each week

Everyone’s personal diabetes management plan is unique. Your diabetes physician will work with you to build a testing, treatment and lifestyle program to suit your needs.


Which one is worse, Type 1 or Type 2 diabetes? The answer is neither. However, they are both serious health conditions and need to be managed properly in order avoid the risk of additional complications, such as heart disease, kidney disease, nerve damage and stroke. If you’re living with Type 1 or Type 2 diabetes, all that really matters is how well you control your blood sugar and how effectively you manage your condition. It’s not about which type of diabetes is better or worse. It’s about how well you live with your diabetes.


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