this post was submitted on 09 Nov 2024
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You are confidently incorrect.
Nah that's pretty accurate.
Type 1 is characterized by an autoimmune response against the beta cells specifically. There are other type 1-ish conditions that can be caused by pancreatitis for example. And then there is of course LADA, double-diabetes etc.
Conversely a type 1s pancreas still produces insulin early on especially in the remission/honey moon phase where they might not even need injections for months (this is where all the people who are not educated on it or falling for health gurus trip up)
Iirc more recent research has also shown that T1Ds produce small amounts of insulin. But not enough to really be clinically relevant.
(Got the sake of brevity, diabetes here refers to diabetes mellitus cause nobody ever talks about insipidus)
So if your immune system is attacking your pancreas but you are still producing some insulin then you actually have type 2?
If your body is producing “enough” then you don’t have diabetes, type 1 or 2. That’s where you are incorrect.
Type 1/2 terminology came about before any understanding of the pathology. “Diabetes mellitus” specifically refers to glucosuria. Its a symptom of insulin deficiency - absolute (typical type 1) or relative (typical type 2). It’s like calling pneumonia “cough type 1” and lung cancer “cough type 2”.
When you say “not necessarily… not enough [insulin]” You managed to get wrong what diabetes is entirely - it is necessarily “not enough” insulin again whether type 1 or 2.
Regarding your question about autoimmune destruction of the pancreas- if it is happening but there is enough insulin to maintain glycemic control, then again it is not diabetes type 1 or 2. I’m not sure if there’s uniform widely accepted terminology for it but something like “pre-type 1” is reasonable for layman terms . You have to be careful though because there’s cases of folks who had an autoimmune response but it abated and they ended up not developing (type 1) diabetes.
Its better to think of diabetes as beta cell function (and insulin) +/- and autoantibodies +/-. That leads to 4 combinations, typical type 1 is -,+ and typical type 2 is +,- but the other combinations are like 10+ % of cases (mostly being +,+ as in many “typical” type 2s have some autoantibodies but still produce insulin).