Billings Clinic


Know the differences between Type 1 and Type 2 diabetes

Posted at 3:57 PM, Nov 13, 2019

Diabetes is one of the most prevalent diseases in the United States. In fact, a recent federal reportestimates that as many as 100 million U.S. adults are now living with either diabetes or prediabetes. The vast majority of those cases, about 95 percent, are Type 2 – the most well-known form of the disease – but millions of Americans still live with Type 1 diabetes.

“It’s a very distinct difference,” said Gabe Blomquist, a Physician Assistant at Billings Clinic who specializes in treatment of Type 1 diabetes.

Knowing those differences is essential in diagnosing and treating the disease, whichever form it might take.

Type 1 diabetes used to be referred to as juvenile diabetes because it was mostly diagnosed in children and young adults, but it can happen at any age. While its exact causes remain unknown, it is typically an autoimmune disease that ultimately stops your pancreas from producing enough insulin, a hormone that regulates the movement of sugar into your cells.

This form of diabetes is caused by an autoimmune reaction in which the body’s white blood cells attack the cells in the pancreas that make insulin. This can happen for months or years before symptoms appear. However, symptoms can develop in just a few weeks or months and they can be severe.

With Type 2 diabetes, you aren’t responding as well to insulin as you should. People with Type 2 diabetes can produce some of their own insulin, but aren’t able to use it to completely manage their blood sugar levels. This form is most often linked to unhealthy lifestyles that include lack of exercise, poor diet and being overweight or obese. Commonly called adult-onset diabetes, it most often develops after the age of 35, but increasingly occurring in younger people as well.

Additionally, Type 1 development isn’t related to lifestyle factors – diet, exercise and weight, as typically associated with Type 2 – that can be controlled.

“It’s almost always not lifestyle-related,” Blomquist said. “The patients have no choice when it comes to getting Type 1 diabetes.”

The technology used to monitor and treat Type 1 diabetes – things like continuous glucose monitors, pumps and a hybrid closed-loop artificial pancreas that can mimic some of the organ’s vital functions – has seen significant improvements in recent years, and that means people diagnosed with the disease can better manage it in their daily lives.

“We’ve seen huge changes in the last four or five years,” Blomquist said. “We have great treatments and we just continue to grow the technology side of treatment to better and more easily control the disease.”

For example, these treatments might use a continuous glucose monitor to keep a constant eye on blood sugar levels or use the hybrid closed-loop artificial pancreas to automatically deliver doses of insulin when needed. These all use cutting-edge technology that is easy for patients to use.

“A lot of times, they don’t have to use specific settings with these devices,” Blomquist said. “It changes insulin delivery based on what those blood sugar levels are and minimizes concerns over things like hypoglycemia.”

At Billings Clinic Diabetes and Endocrinology, patients have access to comprehensive, team-based care. That team starts with the patient and includes specialized physicians, primary care physicians, nurse practitioners, a physician assistant, specially trained and certified diabetes educators, nurses, a social worker and support staff.

Each member plays a vital role in providing the right care. Educators help patients learn how to manage and treat their diabetes at home while a physician works on a treatment plan, and life coaches assist with any behavioral changes or needs that arise.

“Everybody is using their specialty to help provide the best treatment,” Blomquist said. “And we are teaching them how to do all of these things in their own lives.”

Even though there’s no cure, with proper and consistent treatment, many type diabetics can live normal, healthy lives.

“They can have a totally, completely normal life,” Blomquist said. “I have patients who play sports, who are very active in the outdoors, who do all sorts of activities. They can do their jobs and everything else they do as effectively and functionally as anyone.”

For more information on diabetes care at Billings Clinic, call (406) 238-2500 or visit