Type 1 vs Type 2 Diabetes: Differences, Risk Factors, and More

By Jennifer Nadel, MD
Medically reviewed checkmarkMedically reviewed
September 20, 2022

Both type 1 and type 2 diabetes are chronic conditions that cannot be cured. They both happen because of problems with insulin, but they are caused by different factors. In this article, we’ll explore the causes, symptoms, and how these two types of diabetes are different. We will also discuss risk factors, treatment, and how to know when you need medical care.

Type 1 vs Type 2 Diabetes

Even though type 1 and type 2 diabetes have a similar name, they are different disorders with different health consequences.

The main difference between the two is that type 1 diabetes is an autoimmune disorder that happens when the immune system prevents the pancreas from making insulin. Type 2 diabetes develops in response to metabolic changes, like weight and lack of exercise, that reduce how well the body responds to insulin.

Type 1 diabetes typically develops in childhood, although it can occur in adults. Symptoms are usually noticed suddenly or appear rapidly over the course of a few weeks. Type 2 diabetes may take years to develop, with symptoms gradually building over time.

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Causes

Researchers have associated type 1 diabetes with an autoimmune problem. The immune system is meant to protect against viruses, bacteria, and other pathogens. Sometimes it can mistakenly attack parts of the body. In the case of type 1 diabetes, it impacts how the pancreas is able to make insulin.

People may have genetic risk factors for autoimmunity, but other things like environmental exposures and infections could play a role.

Type 2 diabetes may also have a genetic risk factor or predisposition for overweight or obesity, but the most dominant risk factors are associated with lifestyle, diet, and physical activity.

Symptoms

Both types of diabetes can cause some common symptoms.

People who have undiagnosed type 1 diabetes may also experience unintended weight loss and hypoglycemia episodes.

Key Differences Between Type 1 and Type 2 Diabetes 

  • Type 1 diabetes is an autoimmune disease, while type 2 diabetes is a metabolic disorder that occurs from several factors involving weight, lifestyle, and lack of physical activity.
  • There is no cure for either type of diabetes. Type 1 diabetes will always need careful insulin management, while type 2 diabetes can sometimes be managed with diet and lifestyle modifications but also may require medications.
  • Type 1 diabetes can develop suddenly over a few weeks, while type 2 diabetes may take years to show signs or symptoms.
  • Type 1 diabetes most often appears in childhood and is sometimes called juvenile diabetes. Type 2 diabetes is typically diagnosed in adulthood.

Risk Factors

Each type of diabetes has specific risk factors.

Type 1 Diabetes

The known and potential risk factors for type 1 diabetes are:

  • Family history (parent or sibling with type 1 diabetes)
  • Immune sensitization following certain viral infections
  • Younger age

Not everyone who develops type 1 diabetes will have clear risk factors. There are also possible associations with breastfeeding status, nutritional factors, and other complex interactions between genes and the environment that may contribute to autoimmune risk for type 1 diabetes. Research is ongoing to understand the causes and risk factors for type 1 diabetes.

Type 2 Diabetes

The established risk factors for type 2 diabetes are:

  • Age 45 or older
  • Certain racial/ethnic populations
  • Family history of type 2 diabetes
  • Previous diagnosis of prediabetes or metabolic syndrome
  • Overweight or obesity
  • Increased abdominal fat
  • Physical inactivity
  • History of gestational diabetes
  • Previous delivery of a baby weighing 9 pounds or more
  • Diagnosis of polycystic ovary syndrome (PCOS)
  • High blood pressure (hypertension)
  • Genetics

While genetic risk factors are not fully understood, some genes contribute to overweight and obesity and may be involved with type 2 diabetes, too.

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Treatment

There is no cure for type 1 diabetes. Both type 1 and type 2 diabetes can be managed successfully with medication and lifestyle. Type 2 diabetes may also respond to weight loss (bariatric) surgery if indicated.

Type 1 Diabetes

Because the pancreas is not able to produce insulin in type 1 diabetes, treatment involves insulin injections. Insulin can be delivered via injections in the fatty tissue of the skin or by an insulin pump that auto-delivers medication on a preset schedule.

Careful monitoring of blood glucose is necessary to ensure that insulin treatment does not lead to low blood sugar (hypoglycemia).

Type 2 Diabetes

Type 2 diabetes can be treated and managed in several ways.

  • Oral medications like metformin and others can stabilize how the body responds to glucose and insulin.
  • Weight loss can improve insulin sensitivity.
  • Dietary management can prevent blood sugar spikes and support weight management.
  • Regular exercise helps the cells take in glucose, be sensitive to insulin, lower body weight, and support overall health.
  • Weight loss surgery can facilitate better body weight for patients who are unable to lose weight with diet or exercise.

When to See a Medical Provider

People who have either type 1 or type 2 diabetes need to let healthcare providers know if anything changes with their overall health, blood glucose balance, or insulin.

If you notice headaches, blurry vision, skin changes, or any other abnormal changes, it can mean that your diabetes treatment plan is not effectively controlling blood glucose. See a medical provider to ensure that medications can be adjusted.

Seek medical care right away if any of the following occur:

  • High blood sugar that can’t be controlled for 24 hours in adults (contact a healthcare provider within a few hours of uncontrolled blood sugar for children)
  • Fever of 100ºF or higher
  • Confusion or memory problems
  • Nausea and vomiting for more than 24 hours
  • Any new or unusual symptoms

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Frequently Asked Questions

What is the difference between type 1 and type 2 diabetes?
Type 1 diabetes is an autoimmune disorder that occurs when the immune system damages the pancreas and prevents it from making insulin. Type 2 diabetes occurs when the body does not properly respond to insulin because of overweight, obesity, or lack of exercise.
Which one is worse: type 1 diabetes or type 2 diabetes?
Type 1 diabetes typically has a more sudden onset, can not be cured, and requires lifelong insulin treatment. Type 2 diabetes develops slowly over time and can typically be managed without insulin. Diet, lifestyle, exercise, and medication can address symptoms or even reverse signs of type 2 diabetes.
Can type 1 or type 2 diabetes be cured?
Neither type of diabetes can be cured. Type 1 diabetes requires careful lifelong management, while type 2 diabetes may be managed or reversed based on diet, lifestyle, and medication treatment.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

Jennifer Nadel, MD

Dr. Jennifer Nadel is a board certified emergency medicine physician and received her medical degree from the George Washington University School of Medicine. She has worked in varied practice environments, including academic urban level-one trauma centers, community hospital emergency departments, skilled nursing facilities, telemedicine, EMS medical control, and flight medicine.

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