Types 1 and 2
Diabetes: A Comparison and Contrast
By Rheem Gazwa
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Diabetes mellitus is a condition in which the pancreas no longer produces enough insulin or when cells stop responding to the insulin that is produced so that glucose in the blood cannot be absorbed into the cells of the body. Diabetes can be classified according to two types; Type 1 and Type 2 diabetes. Approximately, 14 million Americans (about five percent of the population) have some form of diabetes. In the United States, diabetes almost causes 200,000 deaths every year ("Diabetes", 2001). Type 1 diabetes, also known as insulin-dependent diabetes mellitus (IDDM), usually affects people who are under 30. In contrast, type 2 diabetes, also called non-insulin dependent diabetes mellitus (NIDDM), affects people who are usually over 40 (Thomas, 1997). Type 1 diabetes may account for five to ten percent of all diagnosed cases of diabetes, including 11,000 to 12,000 children who suffer each year. On the other hand, type 2 diabetes may account for 90 to 95 percent of all diagnosed cases of diabetes (Karam & Masharani, 2002). A comparison of types 1 and 2 diabetes reveals major similarities and differences in causes, symptoms, complications, and treatment. |
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Types 1 and 2 diabetes are two diseases that can be compared and contrasted according to their causes. Type 1 diabetes is similar to type 2 diabetes in that they are genetic diseases. Recently, researchers have been attempting to locate the genes for diabetes. As a part of the genome project in which researchers around the world are attempting to map the entire gene structure of all the human chromosomes, they have isolated 18 genes that appear to be involved in the production of type 1 diabetes. Not all of these genes have equal potency. Two of them appear to be most potent, some others are least potent, and others are simply auxiliary or helper genes that seem to have some assisting effect in the process. There are also genes which are protective so that one might inherit the genes for diabetes, but if the person also inherits the protective genes, he/she will not develop the disease. Thus, development of the disease is not 100 percent in those who have inherited the genes for the diseases. Those people may have the gene but may either have protector genes or may be fortunate enough to avoid environmental stimuli. Moreover, there are probably multiple genes involved in type 2 diabetes. For whatever reason, this genetic factor can interact with some environmental factor such as obesity and excess caloric intake. When the person eats, food turns into sugar in the stomach and intestines, and it enters the bloodstream, where it is carried to the body cells. Insulin, which is a hormone made in the pancreas, is needed to help the sugar to enter the cells. Insulin is like a key, opening up the cell so it can let sugar in. After entering the cell, the sugar is used for energy. Like type 1 diabetes, type 2 diabetes is dependent on the amount of insulin produced by the pancreas. In type I diabetes the pancreas makes no insulin or an extremely small amount of it ("Type 1 Diabetes", 2002). On the other hand, in type 2 diabetes, the body neither uses its insulin effectively, nor does it produce enough insulin. |
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In addition to causative agents, the two types of diabetes can be compared and contrasted according to their symptoms. Symptoms of type I diabetes are the result of high blood sugar (glucose) whereas symptoms of type 2 diabetes are caused by the body’s response to high blood sugar level. Moreover, symptoms of type I diabetes usually develop quickly, over a few days to weeks, while in type 2 diabetes, symptoms often are not present in the early stages of this disease. Patients who have diabetes types 1 or 2 diabetes may experience similar symptoms, such as increased urination, thirst, and weight loss (Kuzuya, 2000). However, the two types of diabetes can differ in some symptoms. For example, type 1 diabetes symptoms include pain, vomiting, and rapid breathing. In contrast to type 1 diabetes, type 2 diabetes symptoms include slow healing of skin and blurred vision. |
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The third aspect for comparison and contrast is complications. Both types 1 and 2 diabetes have similar complications, such as kidney disease (diabetic nephropathy). Kidney abnormalities may be noted early in kidney disease. Also, poorly controlled diabetes may accelerate the development of kidney failure. Moreover, urinary tract infections in diabetes tend to be more severe and may result in kidney damage. Another complication is the eye disease diabetic retinopathy, which is a disorder involving a change in the small blood vessels. If bleeding and scarring have developed, retinal detachment may occur, causing blindness. Vascular changes in the iris may cause obstruction of the flow, which can cause glaucoma. Diabetics are also more likely than non-diabetics to develop cataracts. In addition, the two types of diabetes can be contrasted in some complications. For example, type 1 diabetes can increase the risk in the nerve disease diabetic neuropathy while type 2 diabetes may increase the risk of the heart disease. People with type 1 diabetes may develop temporary or permanent damage to nerve tissue. Neuropathy is more likely to develop if blood glucose is poorly controlled. Some diabetics will not develop neuropathy while others may develop this condition relatively. In type 2 diabetes, complications include heart attack, chest pain (angina), high blood pressure, stroke, and narrowing of the arteries (atherosclerosis). |
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The fourth consideration is treatment. Both types 1 and 2 are similar in that the treatment should control the amount of glucose in the body by means of a balanced diet and exercise. The patient should follow a diet that contains more vegetables, fruit, and whole grains, which are high in nutrition and low in fat and calories. Also, he/she should eat fewer animal products and sweets. There are many advantages for this diet. For example, it keeps the blood glucose as near to normal as possible and decreases or possibly prevents the development of diabetes-related health problems. Moreover, regular exercise is very useful for the person with diabetes. It helps control the amount of sugar in the blood and helps burn excess calories and fat to achieve optimal weight. Some good choices are walking, jogging, swimming, hiking, tennis, biking, and cross-country skiing. While type 1 diabetes should be basically treated by taking insulin injections every day to survive, type 2 diabetes can be treated by oral medications. In type 1 diabetes, the injections are needed from one to four times a day. People are taught how to give the insulin injections by their health care provider or a diabetes nurse educator. When the person with type 2 diabetes cannot achieve normal or near-normal blood glucose levels with diet and exercise, medication is added to the treatment plan. A person with diabetes may require oral agents. There are many kinds of oral agents. The first type is sulfonylurea drugs. These medications work by triggering the pancreas to make more insulin. The sulfonylureas include tolbutamide, tolazamide, acetohexamide, and chlorpropamide. Newer drugs in the same class are now available and include glyburide, glimeperide, and glipizide. Another type of oral medication is biguanides (metformin). These medications work by telling the liver to decrease its production of glucose in the blood stream. Alpha-glucosidase inhibitors are the third type of oral medications. These pills work by decreasing the adsorption of carbohydrates from the digestive track, thereby lowering the after-meal glucose levels. Thiazolidinediones are the fourth group of medications, which are worked by helping the insulin work better at the cell site. The final type of oral medications is meglitinide. This medication triggers the pancreas to make more insulin in response to how much glucose is in the blood. |
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In conclusion, diabetes mellitus is a group of diseases characterized by a high level of blood glucose resulting from defects in insulin secretion and insulin action. Both similarities and differences are found between types 1 and 2 diabetes when they are examined for cause, symptoms, complications, and treatment. Their causes share one similarity but differ in one aspect. Both diseases are genetic diseases. Although each disease has specific causes, they are similar in that both of them depend on the amount of insulin that controls the blood sugar. While the pancreas makes no insulin or produces a small amount of it in type 1 diabetes, it does not produce enough insulin in type 2 diabetes. Moreover, type 1 diabetes is similar to type 2 diabetes in that both of them have complications. Kidney and eye disease are the similar complications in both diseases. Unlike type 1 diabetes, which can increase the chance of developing a nerve disease, type 2 diabetes increases the possibility of heart disease. Furthermore, types 1 and 2 diabetes are two diseases which can be compared and contrasted according to their treatment. A healthy diet and exercises are the best treatment for both diseases. In addition, in case of type 1 diabetes, the patient should take injections. Conversely, in the case of type 2 diabetes, oral medications are needed if diet and exercise cannot lead to normal blood glucose. Oral medications include different types such as sulfonylurea drugs, biguanides (metformin), alpha-glucosidase inhibitors, thiazolidinediones, and meglitinides. Despite the differences noted, both diseases depend on the amount of insulin in the body. |
Questions
1. The organizational pattern for this essay is ___.
a. classification
b. cause and effect
c. comparison and contrast
2. The essay uses the ___ method of organization.
a. block
b. cause and effect
c. comparison and contrast
3. The method of organization for paragraph 4 is ___.
a. block
b. cause and effect
c. comparison
4. ___ can be treated by diet and exercise.
b. type 2 diabetes
c. both a and b
5. Which type of diabetes is more common?
a. IDDM
b. NIDDM
c. both a and b
d. neither a nor b
6. ___ is not an effect of diabetic retinopathy.
a. Blindness
b. Glaucoma
c. A cataract
d. Retinal detachment
7. Paragraph 3 has a problem with its ___.
a. minor supports
b. organization
c. concluding sentence
d. none of the above
8. The word “however” in paragraph 3 should be replaced by ___.
a. furthermore
b. on the other hand
c. thus
d. next
9. Paragraph 5 is missing ___.
a. a topic sentence
b. transitions
c. its second major support
d. a concluding sentence
10. The author uses the term “he/she” in paragraph 5 because ___.
a. the author has made a mistake
b. her teacher told her to do so
c. a patient can be either a male or a female
d. none of the above
11. The term “oral agents” in paragraph 5 are ___.
a. medications
b. pills
c. sulfonylurea drugs
d. insulin
12. Paragraph 6 is missing ___.
a. its second major support
b. its topic sentence
c. both a and b
d. neither a nor b
13. Based on the reading passage, you can infer that ___.
a. people should just eat vegetables and avoid all meats
b. people with protective genes will not develop diabetes types 1 or 2
c. people with a family history of diabetes should eat a healthy diet
d. people with diabetes must take daily injections of insulin
14. Rewrite paragraph 6. Be sure to include any important information omitted in the original paragraph.