One persistent myth about diabetes is that people with type 2 diabetes can develop type 1 diabetes when they take insulin, but this is not true.

Type 1 and type 2 diabetes have many features in common, including problems with glucose control. However, the two conditions are distinct, and one does not transform into the other over time.

Roughly 90–95 percent of adults with diabetes have type 2.

In this article, we debunk the myth that type 2 diabetes can turn into type 1 diabetes and look at the differences between the two types.

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Type 2 diabetes cannot turn into type 1 diabetes.

However, a person who originally receives a diagnosis of type 2 diabetes may still get a separate diagnosis of type 1 at a later date.

Type 2 diabetes is the most common type, so a doctor might initially suspect that an adult with diabetes has type 2. Type 1 diabetes most often develops when a person is younger, although it can occur at any age.

Misdiagnosis

A person with type 1 diabetes can receive an incorrect diagnosis of type 2 diabetes if the diagnosis occurs in adulthood. This situation may be more likely to occur if the person is also overweight or has other risk factors for type 2 diabetes, such as a sedentary lifestyle.

Although it is uncommon, type 1 diabetes may develop in adulthood.

A person with type 2 diabetes, who later receives a diagnosis of type 1, has not experienced a change in their diabetes status. Instead, they likely received a misdiagnosis before.

To diagnose diabetes, a doctor will perform several blood glucose tests. However, the results do not differentiate between the two types.

A doctor may also carry out blood tests to check for antibodies that attack insulin-secreting beta cells in the pancreas. The presence of these antibodies usually means that a person has type 1 diabetes, and over 90% of patients with type 1 diabetes have these antibodies.

Another test that helps a doctor determine whether a person has type 1 or type 2 diabetes is a C-peptide test. The test measures how much insulin the person’s pancreas is producing, and a low result may indicate type 1 diabetes.

A low C-peptide is usually a sign of type 1 diabetes. However, the levels can also be low in people with long-standing type 2 diabetes, where their pancreas produces too little insulin.

Although they cause similar symptoms, type 1 and type 2 diabetes are separate conditions with different mechanisms.

In most cases, a person will receive a diagnosis of type 1 diabetes, sometimes called juvenile diabetes, during childhood or early adulthood.

Type 1 diabetes is an autoimmune disease, which means that the immune system mistakenly attacks the healthy beta cells in the pancreas that make insulin.

This process prevents the production of insulin, a hormone that controls a person’s blood sugar levels by allowing glucose to enter the cells.

A person with type 1 diabetes will need to inject insulin for the rest of their life. Lifestyle changes will not reverse type 1 diabetes, but they can help with glucose control and may reduce the risk of health-related complications.

Doctors usually diagnose type 2 diabetes in adults, with those who are 45 years of age or older having a higher chance of developing the condition.

However, it is important to note that age is not a reliable diagnostic tool for the type of diabetes a person has. Obesity is prevalent among people of all ages, so type 2 diabetes can occur as early as childhood.

This type of diabetes interferes with the body’s ability to produce and use insulin. Unlike type 1 diabetes, certain lifestyle factors, such as physical inactivity, smoking, and obesity, can increase the likelihood of developing type 2 diabetes.

Some people can control the symptoms of type 2 diabetes by making lifestyle changes. These may include doing about 150 minutes of light-to-moderate exercise every week, maintaining a healthy weight, and eating a healthful and balanced diet. A person who loses 5–10% of their weight may be able to manage their glucose levels more effectively.

People with more advanced type 2 diabetes might need to take medications, such as metformin or other medications, to help control their blood glucose.

As with other autoimmune disorders, researchers do not understand what causes type 1 diabetes, but they believe that both environmental and genetic factors might play a role in its development.

For instance, a person with a genetic predisposition to type 1 diabetes might not experience symptoms until exposure to an environmental factor, such as a virus, interacts with the relevant gene.

Once a person develops type 1 diabetes, their immune system continues attacking the pancreas until it destroys all of the beta cells. These beta cells are essential for producing insulin, so people with type 1 diabetes cannot make this hormone.

Both genetic and environmental factors also play a role in type 2 diabetes. However, type 2 diabetes has closer links to lifestyle choices and diet.

Some people with type 2 diabetes can reduce the severity of their symptoms or even eliminate them by making healthful lifestyle changes. However, other people may remain resistant to insulin even after adopting lifestyle changes.

Additionally, some people with type 2 diabetes will require insulin injections to manage their blood sugar levels. However, it is often possible to manage this condition without insulin. As such, doctors will often prescribe other medications and lifestyle changes for people with type 2 diabetes instead.

Learn more about the differences between types 1 and 2 diabetes here.

While rare, a subtype of type 1 called latent autoimmune diabetes in adults (LADA) can develop in adulthood.

A person with LADA may have no symptoms or they may notice the following:

  • excessive urination, including at night
  • thirst
  • fatigue
  • vision changes
  • tingling in the feet
  • weight loss

To diagnose LADA, the Immunology of Diabetes Society has three main criteria:

  • The onset occurs in people over 30 years old.
  • Tests show that islet cell autoantibodies are present.
  • The person does not need insulin for at least 6 months after diagnosis.

Learn more about LADA.

People with type 1 diabetes may need to make lifestyle changes, such as reducing their intake of foods high in carbohydrates. Lifestyle changes alone, however, will not prevent or reverse type 1 diabetes.

As a result, people with type 1 diabetes are dependent on insulin, and people sometimes call the condition insulin-dependent diabetes.

People with type 1 diabetes must closely monitor their blood glucose levels. Even with frequent monitoring and regular insulin injections or the use of an insulin pump, they might develop dangerously high blood glucose levels at times.

When blood sugar spikes occur, a person might require further insulin or emergency medical care.

People with type 2 diabetes will need insulin if other treatments ineffectively help them manage their blood glucose levels. They may also need insulin if there are contraindications to non-insulin diabetes medications, or if the condition, which is usually progressive, becomes chronic with a significant reduction in the pancreas’ ability to produce insulin.

Type 1 and type 2 diabetes are distinct types that do not change into one another. However, a person may use insulin to treat either type.

While insulin is the only treatment available for type 1 diabetes, some people with type 2 also use it in more advanced stages of the condition or if other treatments are not effective.

The symptoms of both types of diabetes may be subtle at first, and they may not cause symptoms at all. However, people not effectively treating either type of their diabetes might experience long-term, sometimes life threatening complications.

The first symptoms of diabetes may include increased thirst, increased urination, and unexplained weight loss.

Anyone with these symptoms should seek a medical opinion and undergo blood testing, especially if a person has a family history of diabetes.

Having the support of people who understand what it is like to live with type 2 diabetes is important. T2D Healthline is a free app that provides support through one-on-one conversations and live group discussions between people with this diagnosis. Download the app for iPhone or Android.

Read this article in Spanish.