Type 1 vs. Type 2

T1DCarnivoreRunner

I'm a member of quite a few diabetes groups on Facebook that include both type 1 and type 2 diabetics. Occasionally, the topic of which is worse comes up. Historically, I've seen that most diabetics think the grass is greener on the other side and that their type is worse... whether that is type 1 or type 2.

I realize that not all type 2's are overweight, and not all type 2's can eliminate symptoms by getting to a healthy weight (I'm not saying that is easy, but it is much easier than it would be for me to grow new beta cells). But a very strong majority are and can. I recall seeing a statistic late last year that said 70% of type 2's are overweight. Since the misdiagnosis rate for type 1's with an adult onset is so high, the real number is likely much larger. (Type 1.5 and misdiagnosis is a rant for another day.) Type 1 is an auto-immune disease. Type 2 is a metabolic disorder. As someone who has both type 1 and type 2, I would get rid of type 1 in a heartbeat if I had a choice of curing one or the other.

Here's what prompted the rant, though: I have both type 1 and type 2... I have type 1 because I am unfortunate genetically. I have type 2 because I'm fat. With the little bit of weight I've lost thus far, my insulin needs have already been cut in half (approx. 20 lbs. lost and now less than 100 units daily of U-100 insulin). So when this topic came up again on a Facebook group, there were some users who said they have type 2 and it isn't because they are overweight. One of those people is only somewhat overweight based on his profile picture, but could stand to lose 40-50 lbs. The other appears to be nearly 300 lbs. based on her profile picture. Saying you are not overweight when that is clearly not the case seems dishonest to me. Do these people really believe it?! I'm not sure if I should call them out on it, but I feel like being passive is only going to allow these heavy type 2's to continue to gain sympathy, and recognition that leads to more research dollars that could go to type 1's. Calling them out, even when I'm right, will just lead to more drama. It's frustrating.

Italian_Buju

I am a type one, and have never found the sense in the debate about 'which is worse'. They both suck, both slowly kill you and are both hard to live with. It is almost like saying "which is worse, AIDS or cancer?". I just do not understand it.

The downside, is that we get it earlier in life, the upside is if I want a chocolate bar, I take the appropriate amount of insulin and do not feel sick for two days waiting for my blood sugar to come back down. There are 'better' and worse things to both, it is not a contest......

T1DCarnivoreRunner

Many who know me will argue that I'm too sympathetic to others in unfortunate circumstances, and I will argue that if someone has type 2 due to a factor they cannot control, I'll be the first to sympathize with that person.

I'm not even going to argue that they could or could not have avoided it. In my case, I had type 1 first, then became fat and got type 2. Because of the way I was treated for type 1 in the mid-90's, I became fat (doubled my weight in a year after diagnosis). So it isn't something that I could avoid at all. Even though I couldn't avoid it, I can control it... and I'm doing that now by losing weight (better late than never).

When someone says, "I don't have type 2 diabetes because I'm overweight... it's just because my <insert relative here> had it;" is what bothers me... especially when that person is huge. Even if they could not avoid becoming obese, at a minimum they should acknowledge the obvious fact.

I suppose I'm bitter and maybe tired of hearing type 2's complaining. It goes back a number of years... I remember 19 years ago, there was a man at church who was complaining about how terrible diabetes was (he was at an early stage of managing with diet and exercise... not gaining any more weight and maybe even losing a little) because he had to test his blood sugar every single week. Meanwhile, I was testing several times every day. Ever since, I've noticed similar complaints from type 2's who clearly did not have the breadth or degree of challenges that type 1's have.

I would love to be wrong. Seriously... I really wish that type 2 was worse because I'm well on my way to being asymptomatic of type 2. If I had a choice of which to get rid of and it was only one of them, it would be type 1. Unfortunately, that isn't an option... I can keep both or essentially get rid of type 2 and keep type 1.

abatonfan

I feel like both are worse in their own way.

Type 1 is worse when you consider the immediate risk of complications associated with it (these complications are mainly due to insulin and dosaging for it). If we take too much insulin, we can experience potentially lethal hypoglycemia. If we take too little insulin and go into ketosis, we can experience a potentially lethal ketoacidosis. On the other hand, type 2 can be considered more of a silent disease. People with T2 can go for years experiencing hyperglycemia and insulin resistance without showing outward symptoms, and those years of persistently high BG levels can increase the risk of long-term lethal diabetes complications such as neuropathy and renal failure.

I'm not overweight, but a bunch of people on my father's side of the family (my father, at least one of my grandparents, and possibly a few extended family members) have T2 diabetes. Yes, they're all overweight, but, if the diabetes is caused by a genetic predisposition, I'm at a higher risk of developing insulin resistance and T2 diabetes. What upsets me the most is that it seems like everyone in my family thinks of diabetes as "pop a pill and be done." I know it's none of my business what my T2 father eats or does to manage his diabetes, but I still tend to tell him when a meal or snack is surprisingly high in carbs (his "snack" of Little Debbie Swiss rolls is 60g of carbs for two tiny pieces), and I have told him a few times that he really should be testing his BG (he hasn't tested in over two months). He simply shrugs his shoulders and says he does not care if the NP yells at him, and says the diabetes education and nutrition class will most likely be a waste of his time. I don't want to keep being a nebby and controlling pain-in-the-butt, but I do not want him to experience diabetes-related complications and have his quality of life decrease or experience an early death.

T1DCarnivoreRunner

Yes, there are some type 2's who don't do the right things and experience no noticeable immediate consequences, so they figure no harm is done. How many of those diabetics who should know better (because their medical team has told them) will complain down the road about how "diabetes made me go blind" when the reality is that their lack of attention to diabetes made them go blind? Those are the same ones who will throw up their hands, said "it's genetic, so I can't do anything about it" and "it's inevitable that I will go blind and lose a foot;" then have complications down the road because they gave up early on when it was a completely treatable disease. They are also the ones who argue that type 2 is so much worse than type 1.

tycoon460

In my opinion DKA is extremely bad and scary condition.

I had adult onset of Type 1 while over in the Netherlands in a smaller town (very few people spoke English) few months back. I nearly died in the hotel room because no one would take my condition seriously. After calling multiple hospitals and clinics and being told I had the flu and I wasn't "sick enough" for an ambulance because my Blue Cross Insurance wouldn't be accepted. I finally had to wait almost 12 hours for a coworker to drive me to a clinic. While that doesn't sound like a long time imagine doing it when you're so weak at times you can't even get out of bed to use the restroom. You just go while you lay there in it. I had horrible hallucinations of people telling me I should just commit suicide to avoid the pain. I also had extreme leg cramps due to low potassium. Once at the clinic the doctor thought I was drunk. After he ran urine and blood glucose tests I was shipped off to the local ER. I spent time in the ICU with a blood PH of 7.0 and extremely low potassium levels. I wasn't even able to lift a liter bottle of water by myself. I would have to page the nurse to do it. My brain would tell me I should be able to lift 50 lbs easily, but there was no strength to even pick up the bottle. Finally I was cleared to fly back to the US almost a week later once they were confident my heart would not stop in flight due to the potassium levels.

There are 2 things that really piss me off beyond all others:

1) Random strangers telling me I should diet, exercise, and start taking natural herbs because there "whatever" did and they were able to go off insulin permanently.

2) Diabetics that don't use test meters and just eat "snacks" to drive up what they assume is a low BG, then if they don't feel okay afterwards take insulin (assuming they are now high). Then immediately after turn to me and *kitten* about how bad finger sticks are and how diabetes is so unmanageable.