Put very simply, diabetes is a health issue that affects how the body converts food into energy. This simple understanding is complicated, however, by the fact that it’s actually a term for several conditions. When trying to understand the (rather large) differences between type 1 and type 2 diabetes, we find that it’s helpful to start with what they have in common—namely, a problem related to the hormone insulin. 

Your cells use a simple sugar called glucose for energy. Your body obtains it by breaking down the carbohydrates that you eat. Once the glucose enters your bloodstream, your pancreas releases insulin in response, which promptly helps move the sugar out of your blood and into your cells. In a person with diabetes, however, one of the following things happens: 

• The pancreas does not produce any insulin at all

• The pancreas produces too little insulin

• The body doesn’t respond to insulin in the right way, which is known as “insulin resistance.”

Without treatment, a person with diabetes will develop a condition called high blood sugar, which is just as it sounds—too much glucose in the blood. This can lead to serious and even life-threatening complications such as heart disease, vision loss, kidney disease, or nerve damage. There is currently no cure for diabetes, but it can be managed through lifestyle interventions and, depending on the type, oral medication and/or insulin injections. 

According to the Centers for Disease Control and Prevention (CDC), over 34 million Americans, or about 1 in 11, have diabetes. In addition, it’s estimated that 1 in 3 adults are currently at serious risk of developing type 2 diabetes, meaning more than 40% of American adults are in some way affected by this disease. In case you glossed over that last statistic, we’ll let it sink in again. Experts believe that nearly half of all American adults have either diabetes or prediabetes. 

To understand this disease’s startling prevalence, let’s take a look at how and why each type occurs. 

Type 1 diabetes: The immune system on the attack

Type 1 diabetes is an autoimmune condition that occurs when the body mistakenly attacks the pancreas with antibodies. This destroys the pancreas’s insulin-producing cells, meaning people with type 1 diabetes don't produce any insulin at all and must rely on insulin injections to control their blood sugar. 

Because type 1 diabetes commonly begins in childhood, it used to be known as juvenile-onset diabetes. However, it can happen at any age to people of all races and body sizes. The CDC estimates that it affects nearly 1.6 million Americans, making it much rarer than type 2 diabetes.

Symptoms of type 1 diabetes usually come on very quickly and can include excessive thirst or hunger, frequent urination, sweating, nausea or vomiting, and weight loss. The cause is unknown, but genetics plays a role and those with a family history of type 1 diabetes are at increased risk. If you experience these symptoms, it’s important to contact your doctor right away.

Type 2 diabetes: A silently growing epidemic

In the case of type 2 diabetes, the pancreas is usually able to produce some insulin. The problem is either that it’s not enough insulin or the body isn’t able to use it properly. This means glucose doesn’t easily reach the body’s cells to provide essential fuel. 

Type 2 accounts for over 90% of all people with diabetes. It develops over the course of many years due to a mix of genetic, lifestyle, and environmental factors. Unlike in the case of type 1 diabetes, those at risk for type 2 can often prevent its onset through lifestyle interventions such as losing weight, eating healthy, and staying active. 

This high-risk phase is known as prediabetes, and occurs when a person’s blood sugar levels are significantly elevated, but not high enough for a type 2 diagnosis. It’s estimated that more than 88 million adults have prediabetes and 85% of them have no idea. 

So how do you determine if you’re within this group? Well, you could be at higher risk of prediabetes if you are:

• Overweight

• Physically inactive

• Over 45 years old

• Black, Hispanic/Latino, American Indian, Asian American, or Pacific Islander (The reasons are not yet understood, but researchers have found varying rates of diabetes among different racial and ethnic groups)

Or if you have:

• High blood pressure or take medication for it

• Low HDL cholesterol and/or high triglycerides

• A parent or sibling with diabetes

• Been diagnosed with Polycystic Ovary Syndrome (PCOS)

• Had gestational diabetes

Falling into just one of these categories puts you at higher risk, however they do not mean that a diagnosis is in your future. Staying active and eating well is the best way to lower your risk.

Indicators of type 2 diabetes include tingling in the hands and feet, excessive hunger or thirst, fatigue, frequent urination, slow-healing cuts and bruises, and blurry vision. Quite often, however, there are no symptoms at all or they develop very gradually. If you’re feeling uncertain, talk to your doctor. They may recommend an A1C blood test to check your average blood sugar levels over the past few months. The American Diabetes Association offers a free one-minute test that can help you or a loved one learn more about your risk. They also provide a variety of tools focused on preventing or managing a diagnosis, from recipes to fitness plans.

Living with type 1 diabetes

Since a type 1 diabetes diagnosis means you cannot produce your own insulin, you will require regular insulin injections and frequent testing of your blood sugar levels. Even with an insulin prescription, meal planning and daily exercise will help to further regulate your blood sugar. The important thing to remember is that this disease is manageable and it doesn’t have to mean being held back in life. The American Diabetes Association puts out a magazine called Diabetes Forecast that’s full of information, recipes, and fitness tips and there are many online communities you can join for advice and support.

Managing your insulin prescription might feel overwhelming at first, but the team of pharmacists at Alto will have your back, answering your questions and ensuring the seamless delivery of your insulin and other medications. 

The type 2 diabetes lifestyle

Treatment for type 2 diabetes works a little differently for everyone. You may need to take oral medications or insulin injections, or you might be able to manage it with lifestyle changes alone. 

Oftentimes, treatment includes a mix of several oral medications and/or insulin. To minimize confusion over multiple prescriptions, the Alto app can help you easily manage everything in one place and set up automatic refills. Not to mention, our team of pharmacists will always be standing by to offer guidance. 

But whether you need a prescription or not, eating right and exercising will be extremely important parts of your life with type 2 diabetes. A healthy lifestyle will help keep your blood sugar stable, maintain healthy cholesterol levels, and control your blood pressure. The American Diabetes Association offers free resources that can help you get started, and you certainly won’t be alone. There are many millions of people currently living and thriving with type 2 diabetes around the world. An online community is a great place to start connecting.

A diabetes diagnosis can be daunting, but it never has to mean missing out on life. Remember, we’ll be here to help you understand your medications and set up a delivery plan that fits into your schedule. 

Looking for a partner to help you manage your prescriptions? Our team is available to answer your questions from 6 am - 9 pm PT Monday - Friday, and 7 am - 6 pm PT on weekends; reach out by phone or in-app secure messaging.

The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.