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April 6, 2002

Hyperglycemia and DKA, Research: Causes and Prevention

Question from Ontario, Canada:

Can you explain the differences between type 1 and type 2 diabetes? Can people with type 2 have insulin shock or DKA?


Type�1 diabetes is usually autoimmune in nature, which means the body is fighting itself. There are usually antibodies present at diagnosis. If no insulin is given, the person has to use fat for energy and ketones form in the body, which are toxic. If this process continues for very long, DKA [diabetic ketoacidosis] will develop and can be deadly.

Type�2 diabetes is usually related to being overweight, having a strong family history of the disease and there is at least some degree of insulin resistance. Even if someone with type 2 diabetes progresses to using insulin injections, they have not switched to type 1 diabetes. These folks do not usually go into DKA, but they can develop another life-threatening condition (HHNS( hyperglycemic hyperosmolar non-ketotic syndrome), usually caused by lack of fluids. This condition is not related to ketones. By insulin shock, I assume you mean hypoglycemia, and folks with type 2 diabetes can develop this if they are on oral hypoglycemic agents and/or insulin, and omit meals, exercise a lot or accidently give extra medication.