What’s something from the patient’s history and/or investigations one can perform to accurately distinguish between type 1 and 2 diabetes?
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- What Is The Difference Between Type I And Type Ii Diabetes?
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- Is There A Surgery For Type 2 Diabetes To Temporarily Stop The Need Of Insulin?
- What Are The Many Factors Contributing To Getting Type 2 Diabetes?
- What Are The Best Ways To Reduce The Risk Of Getting Type 1 Diabetes?
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- What Are Some Psychological Characteristics Of Type 1 Diabetes?
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- How Do Proteins And Enzymes Hace To Do With Type 2 Diabetes?
- What Can Happen To Someone With Type One Diabetes?
- How Can We Prevent Diabetes Type 2? What Would Be The Best Diet To Prevent?
- What Are The Relationships Between Obesity And Diabetes?
{ 9 comments… read them below or add one }
There is not much in the history or physical examination that will be of assistance. The symptoms of type 1 and type 2 diabetes over-lap. Family history is typically of little value. In twin studies, if one twin develops type 1 diabetes there is a 50% probability that the other twin will develop type 1 diabetes. The specific genetic markers have been identified, but it is not know if you have such genes, what the probability of subsequent diabetes is. For type 2 diabetes the genetic link is stronger, but the genes have not been identified, and it is presumed to be poly-genetic. Family history should imply ‘first degree relatives’, meaning father, mother, brother, sister, and children. Age is of little benefit, other than to say that diagnosis before age 10 is almost invariably type 1, and that diagnosis after age 40 is usually type 2. A type 2 diabetic never becomes at a later date type 1 diabetes as someone has suggested. The answer to your question is a simple blood test. Type 1 diabetics do not produce insulin, but type 2 diabetics do produce insulin. I most commonly order a C-peptide which is a substance ‘cleaved’ off of insulin as it changes from pancreatic storage of pre-insulin to insulin. It is also possible to measure the insulin level. The latter is not quite a specific as the normal range is quite broad. (Initially, type 1 diabetics still produce a small amount of insulin). I wish you the very best of health and may God bless.
Regardless of whether you are type 1 or 2, you need to be under the care of a physician (preferably an endocrinologist).
Age isn’t the best way of making a determination, but body composition is. People who are diagnosed with type 2 are very overweight for the most part. Conversely, people with type 1 are usually very thin and have usually been losing weight in the months leading to diagnosis.
If a doctor has a question about whether it is type 1 or 2, then they usually order a C Peptide test with a standard battery of bloodwork. C Peptide is a byproduct of insulin production. If the person has a normal level of C Peptide, they are diagnosed as type 2 because their body is clearly still making insulin (but not using it correctly). If the person has a reduced or nonexistent level of C Peptide, they will be diagnosed with type 1 because they are obviously not producing the insulin their body needs.
But generally an experienced doctor or someone experienced with both types of diabetes can make an easy judgment by looking at age and body type.
There is no way EXCEPT through doctor’s blood tests.
BOTH kind of Diabetes produce identical symptoms, but the onset of these symptoms is usually faster in Type 1. A person can be a Type 2 Diabetic for YEARS, and not know it. Type 2 Diabetes is most often caught ‘by accident”, as the result of tests taken for other disease or symtpoms.
Note, too, that even AGE is not a significant indicator of Type. MANY adults get Type 1, after years of untreated or badly-treated Type 2 Diabetes. After all that abuse, the pancreas just “gives out” and the ADULT progresses from Type 2 to Type 1, and insulin shots are required.
AND, since many children these days are groassly overweight (due to junks foods, and video games instead of exercise) Type 2 Diabetes is being found in children as young as 9 Years Old!.
the ONLY way to tell the difference is with the propepr blood tests from an Endocrinologist –a doctor who specializes in disease like Diabetes.
There is no quick easy way to determine which type a person has. An endocrinologist will have to do a series of blood tests to figure out how to classify the disease. A biopsy wouldn’t be helpful. The patient’s medical history may offer some clues, age is a big factor because the younger the patient, the more likely it’s type 1. Symptoms can be a big clue too, did they have massive ketones and extremely high blood sugar levels when diagnosed? If so, more likely to be type 1 than 2.
Bottom line – an accurate diagnosis requires a series of blood tests perfomed and analyzed by an endocrinologist.
Type 1s will have GAD antibodies; Type 2s won’t. Type 1s usually test insulin deficient on a c-peptide (unless they’re honeymooning, but even then their insulin levels are probably lower than normal), whereas Type 2s usually have excess insulin in the body due to insulin resistance. Even this isn’t a guarantee, as many Type 2s also become insulin deficient over time. Another slightly less accurate indicator is when Type 2 oral medications don’t work on a Type 1. Most Type 2s, no matter how advanced their disease is, get some benefit from oral medications. Type 2 diabetes usually advances more slowly than Type 1, as Type 2s don’t start out insulin deficient. Extremely high blood sugar (500+ mg/dL) might be a warning sign to a doctor that his patient has Type 1 instead of Type 2. Again, this isn’t especially accurate, as Type 2s can–over time–reach those levels.
Age, weight, and family history are no guarantees.
Gary, once again, is wrong.
Type 1 and 2 are, biologically speaking, two completely different diseases, that have the same result.
The trouble is, there really isn’t anything to say what your asking.
You can do immunological tests, i.e see if they have certain anti-bodies, but that isn’t certain. You can test to see if they have any natural insulin,. but again, type 1’s can have a period where some insulin production is maintained.
Basically, type 1 is where the immune system attacks and destroys the pancreas.
You don’t get it by having badly controlled type 2 diabetes.
Type 2 is where the pancreas cannot produce enough, or the body cannot use the insulin it has.
Age isn’t definite, weight isn’t definite. The only way you can be certain is if they have anti bodies, it’s type 1.
Otherwise it can be, and is, difficult to tell them apart.
Edit :Type 1 is much LESS likely to be inherited. There is a much stronger genetic link with type 2.
I found an article that may help you with your question. It goes into detail.
you cannot determine if a patient has Type 1 or 2 by looking at their family history. Medical history does not determine which type you have, it only increases your CHANCES or likely hood of one or the other.
Treatment and cause for Type 1 and 2 are different. The only way to determine which one a patient has is by consultation with their Dr (preferably and endocrinologist) and blood work.
Type 1 is still sort of a mystery as to why it happens. The body attacks its self and kills off the cells that produce insulin. It can be hereditary but not always and most often is not. I just look at it as bad luck. The patient’s body produces no insulin whatsoever and has to take manual injections, otherwise known as Insulin dependent. Type 1 has a tendency to happen earlier in life and is also known as Juvenile diabetes.
Type 2 can be caused by genetics, or obesity/poor health. The body produces some insulin but not enough and oral medication is needed to help regulate the blood sugars.
No history or investigation on paper can tell you the difference, but only let you know if the patient is PRONE to developing one or the other. I have Type 1 with absolutely no history of diabetes in my family. But I also know families who have Type 1 OR Type 1 and 2 in multiple generations. It can be totally random. It is helpful in diagnosing, but not dependent in concluding the type they have.
type one diabetes is a hereditary illness, so using the history if there is a close blood relative (usually maternal) with diabetes type 1, its more likely type 1. also weight. type 2 diabetes is usually brought on by obesity, so usually if the patient is more over-weight, then its more likely type 2.