Diabetes is like this…using analogies
I have met many successful and intelligent non-medical people do not have quite a clear understanding of the difference in Type 1 and Type 2 diabetes. I can empathize with that. For example, I am a girl who does not know much about tools, so I mix up tools. If someone asks me for a wrench, then I might return with a screwdriver. They are both tools, but two totally different tools that work differently. Likewise, there are different types of diabetes. The different types of diabetes work very differently in the body.
About 1 in 9 people have diabetes, so chances are that you know someone with diabetes other than yourself. Type 2 diabetes is by far the most common type and that is the type of diabetes that most people think about. About 90% of all people with diabetes have Type 2 diabetes. About 5-10% of people with diabetes have Type 1 diabetes. Then, there are other rarer forms such as LADA and MODY, etc.
If you are reading my blog, then you want to know the fundamental difference in the different types of diabetes… An analogy is a wonderful, useful and most important form of thinking, and biology is saturated with it. Nothing is worse than a horrible mass of undigested facts, THere is no better way to explain human anatomy and physiology than by using analogies. Who else loves analogies!
Type 1 and Type 2 Diabetes
First, we must start with the textbook definitions...
A basic understanding of insulin is necessary. Thus, before reverberating the definitions, you must have a fundamental understanding of what insulin is and what it does. Insulin is the hormone that allows the body to use the glucose (sugar) in the bloodstream as energy – it kind of acts as a key that unlocks the body’s cells, allowing glucose to enter and be absorbed. Converting blood glucose is the body’s main way that it gets energy, so without insulin, it has to resort to breaking down bodily tissue such as muscle and fat stores.When we eat, our bodies break down complex carbohydrates into glucose, the fuel we need. The pancreas releases insulin that acts as a kind of key to unlock the cells, allowing glucose to enter and be absorbed.
What is Type 2 Diabetes?
Type 2 diabetes occurs when the body cannot properly use insulin, a hormone that regulates blood sugar. This is also known as insulin resistance. In Type 2, the pancreas initially produces extra insulin, but eventually cannot keep up with production in order to keep blood sugar levels in check. Without insulin, sugar stays in the blood and can cause serious damage to the entire body.
What’s the difference between Type 1 and Type 2?
Type 1 differs from Type 2 in that Type 1 is an auto-immune condition that occurs when the body’s own immune system attacks the insulin-producing beta cells of the pancreas. They have little to no ability to create the hormone insulinPeople with Type 1 are insulin-dependent for life and there currently is no cure.
Now, let’s say the same thing with analogies to real life…
ANALOGY: LOCK & KEY
This is an absolutely classic analogy for how insulin works in the body…
ANALOGY: THE POOR PIZZA MAN
This analogy is for anyone who likes pizza… and that it almost everyone. I like this analogy because it gives us a better picture of how insulin works in the body. Image that you ordered pizza delivery on one Friday night splurge.
Pizza: Insulin
Pizza delivery guy: The blood stream
The Doorbell: Insulin Receptor
In Type 2 diabetes, there are a lot of pizzas. The delivery guy bring the pizza to the door and rings the doorbell. If the door bell is not working loud enough, you do not hear it and you do not answer it… as a result, then he can not deliver your pizza to you. Let’s pretend, that this pizza guy is really motivated, so every time he rings that doorbell, he adds another pizza to his stack to entice you to answer it. How does this play out in Type 2 diabetes? Type 2 diabetes has insulin resistance. When there is insulin resistance, that doorbell does not work well and the body (the pancreas) puts out more insulin.
In Type 1 diabetes, it is a much different motion picture. The delivery guy did not bring any pizza because The Pizza Hut (the pancreas) could not make enough pizzas that night, (which is actually a believable story when everyone is cooped at home because of COVID). The extra compassionate pizza man still drives to your house and rings your doorbell to tell you that he does not have any pizzas to deliver tonight. Your doorbell works very well and you are very receptive to his random act of kindness. In Type 1 diabetes, the body does not make or deliver insulin. This can also be the scenario for a person with moderate to severe Type 2 diabetes, whose pancreas has become exhausted from many years of overproducing insulin and the pancreas burns out some.
To a degree, all people with diabetes have a pancreas that does not work as well as it needs to. By time, that someone is diagnosed with Type 2 diabetes, nearly 50% of the pancreas is no longer functioning. But just like someone can live with one lung, one kidney or part of a liver, not very many people with Type 2 diabetes need supplemental insulin. In fact, their pancreas is like a red hot nuclear plant working on overload and it is putting out lots of insulin trying to overpower the insulin resistance. It is a viscious cycle, because all that workload eventually burns it out. Can that function be regained? Possibly, yes. I have another blog to explain.
ANALOGY: VROOM! VROOM!
This analogy is for the men… let’s compare your body to a car and understanding how our bodies are affected by the dysfunctions in diabetes.
· Your body is the car.
· You body with diabetes is the car engine.
· Insulin is the fuel.
Type 2 diabetes is like a car that is badly out of tune. It burns through more fuel than it should, but doesn’t produce enough power. It is rough taking off at the lights and blows a little bit of smoke. It runs rough, uses more oil and occasionally stalls. It is sometimes difficult to start.
Type 1 diabetes is like a car that has run out of fuel and is stopped by the side of the road. It might be a normal family sedan, a high powered sports car or a 4WD. Regardless, without fuel in the tank it simply stops.
The lesson of this analogy is that you are going to feel less energy and not feel as good as you should.
