Type 1 Versus Type 2
Most patients with diabetes—about 90 percent of them—have Type 2. This means that most people's knowledge of diabetes is based on what they know about Type 2. Understanding the differences between the two types is crucial for parents and for anyone interacting with your child.
Autoimmune Versus Metabolic
As you will see in Chapter 2, Type 2 diabetes is a metabolic disease, not an autoimmune disease like Type 1. What this means, in simple English, is that a person with Type 1 diabetes does not produce his own insulin and never will, no matter what he does. A person with Type 2 diabetes still produces insulin, but her body has a hard time using the insulin properly and sometimes does not produce enough. This is why, with diet and exercise, a person with Type 2 diabetes can improve somewhat, while a person with Type 1 cannot.
Be ready for people who think your child has the same diabetes as their great aunt. They'll tell you that she did just fine once she cut out jelly doughnuts, and that there are pills available now to treat it. You'll need to explain the differences calmly, and you may have to accept that they won't believe you.
Another important point is that there is nothing you or your child did wrong to cause Type 1 diabetes. It does not matter how or what you eat or don't eat, or how often you exercise or don't exercise: Nothing that you control can start or stop the progression of diabetes. You will have to drive this point home to your child and to everyone who knows her. You and your child are not to blame. Similarly, although lifestyle has a powerful influence, genetic and environmental factors also are strong contributors to the risk of Type 2 diabetes.
Is It Genetic?
Everyone will ask if diabetes runs in your family. First, there is no known connection between Type 2 diabetes and Type 1 diabetes running together in a family. Most people know that Type 2 diabetes is highly familial, or genetic, so many will assume that your child's Type 1 diabetes is as well. The answer, while somewhat simple, is as complicated as everything else in this disease. Families that have a member with Type 1 diabetes do have a higher chance of another family member having Type 1, but the chance is still so low that it is not expected. In fact, only single-digit percentages of families have more than one person with Type 1 diabetes.
Type 2, on the other hand, can be quite common in family members, particularly in older adults. If you have a family member with Type 2, your physician will watch you through the years and will most likely counsel you to exercise and keep your weight down to offset the probability of Type 2 in your future.