The association between a poor diet, sedentary lifestyle and diabetes is well documented. It is misleading, however, to assume that type 1 and type 2 diabetes can only affect those that are overweight. The condition can be found in people of all shapes and sizes and being too heavy is only one risk factor that can contribute to your likelihood of developing diabetes. Dr Muhammad Hamed Farooqi, Director and Consultant Endocrinologist, Dubai Diabetes Centre, DHA, says both type 1 and type 2 diabetes can affect people at a range of different ages. “Either one of these can occur at any age. Mostly, type 1 diabetes is seen in younger people while type 2 tends to affect older individuals.
“In the majority of cases, overweight individuals have type 2 diabetes and those with type 1 tend to be on the leaner side, but this is not always the case.”
Type 1 vs type 2 diabetes
The two subtypes of the condition have similarities but there are also a number of distinctions, including what causes them. Type 2 diabetes accounts for the majority of cases with type 1 affecting less than 10 per cent of people with the condition. Type 1 diabetes is an autoimmune condition, where the body attacks the cells in the pancreas meaning that people can’t produce insulin. Although there is no cure, patients manage their blood sugar levels by taking insulin.
Mostly, type 1 diabetes is seen in younger people, while type 2 diabetes tends to affect older individuals.
Type 2 diabetes is where the body is unable to create enough insulin or the insulin being produced doesn’t work properly. While insulin can also be prescribed, people can also control the symptoms through lifestyle modifications such as improved diet and regular exercise. Although there is no cure for type 2 diabetes, it can be prevented or put into remission through lifestyle improvements.
Dr Farooqi says that there are multiple risk factors for type 1 diabetes. “The possible risk factors for type 1 diabetes include a genetic predisposition, geographical location to the equator, and exposure to viruses.
There is also a genetic predisposition to type 2 diabetes, especially if you have a family history of the condition. Ethnicity can also be a risk factor, with South Asian populations more likely to suffer from the condition. Age is also a risk factor, with type 2 diabetes more likely to be diagnosed in those over 25 years old.
Signs and symptoms
What the two subtypes of diabetes share is that the signs and symptoms can be similar. Dr Farooqi says that patients tend to report increased feelings of thirst and appetite. “Patients also report an increased frequency of urination, including needing to get up during the night. People may also complain of fatigue and weakness as well as intermittent blurry vision. Other symptoms can include slower healing of wounds and a tingling, feelings of numbness, pain or a loss of sensation in the hands or feet.”
Dr Farooqi says that dark velvety patches of skin around the neck or other skin folds can also be a sign of diabetes.
One risk factor for type 2 diabetes is often referred to as skinny fat. It is typified by people with slender bodies and small amounts of visible fat. It is when people are metabolically obese but of an average weight. People affected tend to have higher levels of visceral fat, which is fat that accumulates around the organs, so it isn’t visible.
The stress factor
An additional consideration for why apparently skinny people may develop diabetes is the role of stress. When someone is stressed, their body tends to produce higher levels of the hormone cortisol.
Although cortisol plays a number of different roles, one of its main functions is to raise blood sugar levels during times of stress. In fact, cortisol is capable of raising blood sugar levels in people who are fasting, so people who are following a healthy diet and exercising could also suffer from high blood sugar levels if they are chronically stressed.
While stress can be a cause of diabetes in a minority of cases, obesity is undoubtedly a risk factor for type 2 diabetes and Dr Farooqi says that the symptoms of the condition can be reversed if blood glucose levels are brought under control. “In type 1 diabetes blood sugar control is achieved by using the right kind of insulin in the right amount at the right time,” he says.
“In type 2 diabetes, this is achieved by following a healthy diet and regular exercise, which then leads to a loss of the excess weight. In addition, the correct combination of tablets and injections as required, under the supervision of your doctor, will result in achieving better sugar control.”