Diabetes of the first and second type: the doctor explained the difference

Endocrinologist, Deputy Chief Physician for the medical part of the Minsk City Clinical Endocrinology Center Elena Otlivanchik told what the difference is between diabetes mellitus of the first and second type and in which case the disease can be affected by changing lifestyle. Details she shared on the air of the talk show “PRO HEALTH” on the YouTube channel “Watch and live”, writes sb.by.

Elena Otlivanchik noted that diabetes is a chronic increase in blood glucose levels.

- The development of diabetes is mainly affected by two mechanisms. This is a decrease in the amount of insulin and a violation of its work. This is a differential feature in the distinction between diabetes of the first and second types, she explained.

The expert explained why we need insulin:

- This is a protein hormone that affects primarily carbohydrate metabolism and ensures the entry of glucose into the cell. When we eat, glucose is absorbed into the blood, its level rises. And insulin is the key that opens the door for glucose to enter the cell. That is, with a lack of insulin, glucose in the blood can be a lot, but the cell will remain hungry.

A condition in which the cells of the body lose their normal insulin sensitivity is called insulin resistance.

- In this case, insulin can be enough or even more than necessary, but the tissues do not feel this, the hormone simply cannot fully perform its work. Insulin resistance is formed with a constant excess intake of calories in the body, with sharp jumps in sugar levels. When glucose flows into the blood continuously, the pancreatic beta cells that produce insulin constantly respond to increased sugar levels. There is a continuous “bombing” of insulin receptors. In the end, they seem to close from this insulin, get tired of working, stop responding to this hormone, explained Elena Otlivanchik.

If glucose does not enter the cell, it remains hungry. However, this increases the level of glucose in the blood.

- How do beta cells react? They see that there is too much glucose in the blood, which means more insulin is needed. This is how hyperinsulinism is formed, that is, increased insulin production. Sooner or later, beta cells are depleted and in principle stop producing insulin. In diabetes mellitus of the second type, this hormone is quite a lot, but it cannot fully perform its work. And type one diabetes is an autoimmune disease in which antibodies are produced that damage pancreatic beta cells. That is, diabetes of the first type is an absolute insufficiency of insulin, the doctor noted.

When asked what type of diabetes is most dangerous, she said:

- Both types of diabetes are dangerous. Diabetes mellitus of the first type is immunomediated. It develops more often in childhood and at a young age, has a brighter onset and requires basic bolus insulin therapy. Diabetes of the second type is easier to control, because we can influence its course by lifestyle modification: changing your eating habits, physical activity. So it's easier to fight him. But there is a dangerous point: diabetes of the second type develops slowly. First, insulin resistance develops, then the state of prediabetes and only then diabetes. And the problem is that the patient may feel completely healthy and not know that he already has a violation of carbohydrate metabolism, while elevated blood glucose destroys the body. Watch the PRO HEALTH project on the Watch and Live YouTube channel every Sunday at 12:00. Specialists in various fields will answer popular questions of concern to everyone in simple language and with humor.

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