Type 1 vs Type 2 re Diabetic Complications

[Energize]

Does anyone know of any research in relation to comparing the Complications of both Types 1 & 2? I’m interested to know what, if any, research might show in light of the ‘Type 2s’ don’t need to test’ and ‘Eat healthy diet, which includes carbs’ etc.

I suspect that Type 2s may well have significantly more diabetic complications purely as a result of not testing and not reducing/cutting carbs (especially having been told testing and not reducing carbs are not necessary)

I’ve not heard anything in this vein mentioned and am particularly interested to discover if there is any specific or particular differences that would raise the question whether Type 2s should be told to test frequently and to reduce carbs.

Please offer your views. Thanks

 

[chalup]

Here in Canada type 2's are given meters and told to test. The problem is we are not told what to do with the information and the dietary advice, if any, is the same as everywhere else. The official line is low fat 55% carb blah blah blah. I am lucky enough to have a very good doctor who nudged me into looking at low carb online but he was still not allowed to just say go on a low carb diet. As a care aide in long term facilities, I saw the diet being fed to type 2 diabetic patients. Oatmeal and fruit for breakfast with sugar and milk, pasta or sandwiches for lunch with more fruit, potatoes and carrots and more fruit for dinner. My guess would be something like an 80% carb diet and then they get splenda with their coffee because they are diabetic. This food is cheap. Cost is a much bigger factor than health and the guidelines support it so it continues. These people despite a ton of meds, are all suffering complications. Many have ulcers, most have neuropathy, many are going blind and kidneys are failing. But they are old so it gets blown off as inevitable. I don't know that this really answers your question but I thought it was important.

 

[catapillar]

I think when they look at the onset of complications they "start the clock" for people with type 2 a lot earlier than for people with type 1 because type 2 can and does go undiagnosed for a long time, so they might compare someone with type 1 10 years post diagnosis with someone with type 2 5 years post diagnosis.

 

[Brunneria]

Even if the raw data exists comparing numbers of T1s to numbers of T2s with figures on their various complications, I think the variables would make it quite useless.

So many T1s are diagnosed young, so they have much longer to develop complications.
While so many T2s are undiagnosed and untreated for years, if not decades, before they get to be put on the diabetic register.
How can you compare those two situations?

It would also be necessary to compare the rate of complications alongside the diabetic control. But that would not give the info required, unless the rate of testing was factored in. Not the availability of meters, but the rate that those meters were used. Just because a meter is provided (to a T1 or a T2) doesn't mean that it gets used. So issuing the equipment is no guarantee that control will improve.

It would be a nightmare to get meaningful data out of that mess. Over time. Across a large enough sample.

Have you seen the www.bloodsugar101.com website? On it, Jenny Ruhl looks at a few studies showing the rate of complications (for T2s, I believe) against the amount of blood glucose control - but then she adds the warning that in at least one study the very medications used to intensively lower the participant's HbA1cs caused side effects (heart problems) which were attributed to the lower HbA1cs and which was only realised later, leading to many health care professionals handing out advice that 'tight control leads to heart attacks'. Some of them still believe it.

Of course, if the data could be gathered, and put into a useful format, it would make a fascinating read. But I still don't think it would get meters into the hands of T2s.

Edited to add: @catapillar thanks for that info about 'starting the clock'. Makes sense.

 

[himtoo]

also -- as type 1 can be from birth onwards -- the clock settings will be different

in addition the % of type 2's is about 9/10 whereas type 1 is about 1/10 ( as a total of diabetics )

 

[Energize]

Thanks everyone for your posts. Yes, I realise it would be a difficult aspect to research but did wonder if there was anything done.

Clearly, to me anyway, with the dietary advice currently given to type 2's and lack of testing, I would have expected too many Type 2's would have complications, possibly more so than Type 1's who are encouraged to test and to judge their insulin requirement etc.

So, thanks again. Interesting to ready your thoughts

 

[Freema]

http://www.healthline.com/health/type-2-diabetes-life-expectancy#Overview1

 

[Robinredbreast]

http://www.medscape.com/viewarticle/861542

 

[catapillar]

http://www.medscape.com/viewarticle/861542

@Robinredbreast your link isn't working, for me anyway I could be doing it wrong

 

[Robinredbreast]

@catapillar I opened the link and copied and pasted it, sorry you couldn't view the link.
Medscape Medical News
Type 1 Diabetes Life Expectancy Still 12 Years Short of Norm
Marcia Frellick

April 07, 2016

• Doubling of Post-CABG Mortality Seen in Type 1 Diabetes
• 
  Excess Mortality of Type 1 Diabetes Far Greater in Women

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Two large new studies have found that, although there have been life-expectancy gains for people with type 1 diabetes, similar gains have been seen in the general population, thus failing to narrow a gap that stands at nearly 12 years.

Both studies were published online in Diabetologia, one detailing findings from Australia and the other from Sweden over the past 2 decades.

The two sets of authors both conclude that a multipronged approach is required to improve life expectancy for those with type 1 diabetes, including better glycemic control, as well as more focus on preventing chronic cardiovascular disease in these patients, who are at high risk of the latter. This should include more concentration on smoking cessation and better lipid management.

Penning a commentary that discusses both studies, Lars Stene, PhD, of the Norwegian Institute of Public Health, Oslo, says these two "impressively large population-based registries" have "documented a [life-expectancy] gap [in type 1 diabetes] compared with the general population that has…remained largely unchanged since the turn of the millennium."

The two papers fill "some knowledge gaps," he notes, "but others remain."

Australian Findings Broadly Generalizable, Similar to Swedish Ones

In the first study, Lili Huo of the Baker IDI Heart and Diabetes Institute, in Melbourne, Australia, and colleagues derived mortality rates of Australians with type 1 diabetes listed on the National Diabetes Services Scheme (NDSS) between 1997 and 2010 (n = 85,547) by linking them to the National Death Index.

Because the contemporary study was nationwide, authors said the results likely would translate to similar Western countries.

A total of 5981 deaths were found among the type 1 diabetes patients during the 902,136 person-years of follow-up.

While life expectancy in 2004–2010 improved for those with type 1 diabetes compared with 1997–2003, it also increased in the general population, and therefore the gap didn't close.

They found that Australian type 1 diabetic patients had an estimated loss in life expectancy at birth of 12.2 years compared with the general population (11.6 years less for men and 12.5 years less for women.)

For type 1 patients, estimated life expectancy at birth was 66.7 (men) and 70.9 years for women.

"We observed marked reductions in life expectancy across all age intervals, even in the very old, as compared with the general population," the authors write.


Death from endocrine and metabolic disease was the major factor in lost years between the ages of 10 and 39 years — this reduced with advancing age, while the contribution of deaths from circulatory disease increased as people got older. Continue Reading


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