Diabetes is not a one-size-fits-all diagnosis. Understanding whether someone has Type 1 diabetes or Type 2 diabetes is critical, because the treatment approach is very different—and the wrong treatment can lead to serious, even irreversible complications.
As a diabetes specialist, I have seen firsthand how misdiagnosis delays proper care, accelerates complications, and places patients at risk for wounds, amputations, and hospitalization. The good news is that with the correct diagnosis and proper management, many of these outcomes can be prevented.
Type 1 Diabetes: An Autoimmune Disease That Requires Insulin
Type 1 diabetes is an autoimmune condition. This means the body’s immune system mistakenly attacks and destroys the beta cells in the pancreas, which are the cells responsible for producing insulin.
Insulin is essential for life. It allows sugar (glucose) to enter your cells so it can be used for energy. Without insulin, sugar builds up in the bloodstream, causing damage throughout the body.
Because the pancreas no longer produces insulin, people with Type 1 diabetes require insulin replacement therapy to survive. This is why nearly all individuals with Type 1 diabetes use insulin.
Many people associate Type 1 diabetes with childhood, and it is commonly diagnosed in children and adolescents. However, there is also a form called Latent Autoimmune Diabetes in Adults (LADA), sometimes referred to as adult-onset Type 1 diabetes. These individuals may be diagnosed in their 20s, 30s, or later, and are sometimes mistakenly labeled as Type 2.
Type 2 Diabetes: A Disease of Insulin Resistance and Metabolism
Type 2 diabetes is different.
In Type 2 diabetes, the pancreas is still producing insulin—sometimes even large amounts—but the body’s cells become resistant to insulin. As a result, sugar cannot enter the cells efficiently and instead builds up in the bloodstream.
Over time, the pancreas becomes overworked, and beta cell function declines. Some beta cells may eventually die.
The key difference is this:
Many people with Type 2 diabetes can be managed with:
Some people with Type 2 diabetes do require insulin, especially if the condition has progressed.
Type 2 diabetes can often be placed into remission, particularly when treated early and aggressively. Remission means blood sugar levels return to normal or near normal without the need for certain medications. However, ongoing monitoring and care are still essential.
Why Misdiagnosis Is Dangerous
Misdiagnosis can be harmful.
If someone with Type 1 diabetes is incorrectly treated as if they have Type 2 diabetes and is not given insulin, their body remains in a state of insulin deficiency. This can lead to:
Early and accurate diagnosis protects the body from preventable damage.
How Each Type Is Properly Diagnosed
For Type 2 diabetes, the primary screening and diagnostic test is:
For Type 1 diabetes, additional testing is needed to evaluate insulin production, including:
These tests help determine whether the pancreas is producing enough insulin.
If your blood sugars have remained uncontrolled for years despite treatment, it may be time to re-evaluate your diagnosis.
The Right Treatment Changes Everything
With proper diagnosis and targeted treatment, blood sugars can be stabilized, wounds can heal, and serious complications can be prevented.
Specialized diabetes management focuses on:
This level of care often works alongside your primary care provider and home health team—not in place of them, but in partnership with them.