How serious is type 2 diabetes? Is it more serious than type 1 diabetes?

A fellow caregiver asked...

How serious is type 2 diabetes, and is it less or more serious than type 1 diabetes? My mom, just diagnosed with type 2 diabetes, keeps it under control without taking insulin. So is type 2 diabetes less of a problem than insulin-dependent type 1?

Expert Answer

Theresa Garnero is clinical nurse manager of Diabetes Services at California Pacific Medical Center in San Francisco.

No, definitely not. In fact, in some ways type 2 diabetes is a more serious disorder because your mom may have had it for years before she was diagnosed. So she may well have developed some of the long-term, debilitating complications linked to the condition without knowing it.

In addition, since type 2 diabetes is a progressive disorder without a cure, over time her body may not be able to produce insulin or use it as well as it does now, and she may wind up needing insulin injections or pills.

A person with type1 diabetes ignores it for a day at his own peril. He'll likely end up in the emergency room because his body can't absorb glucose without a continuous supply of insulin via injection or an insulin pump. People with type 1 diabetes typically develop such severe symptoms over a short time in childhood or early adulthood that they're forced to deal with it.

Type 2 diabetes is a sneakier condition: Its harmful health effects can slowly build for years until full-blown complications, such as vision loss, heart disease, or foot problems, make it impossible to ignore. Plus it often comes with its own set of problems. For instance, people with type 2 diabetes are frequently diagnosed with high blood pressure and cholesterol along with high blood sugar. This damaging threesome can lead to progressive thickening of the arteries and reduced blood flow, putting your mom at greater risk for a slew of complications including heart disease, stroke, and nerve damage. If your mom is overweight as well, particularly if she's carrying excess pounds around her middle, she's at even greater risk of getting heart disease.

So while calibrating insulin dosages from an early age is no walk in the park for folks with type 1 diabetes, you can see that potential chronic complications and co-existing medical conditions make type 2 diabetes challenging to deal with as well. This doesn't mean your mother can't manage the condition; it just means she needs to do everything she can to safeguard her health.