What is the difference between type 1 and type 2 diabetes?

Type 1 diabetes is an autoimmune disease in which the immune system destroys insulin-producing cells, requiring lifelong insulin therapy — it typically begins in childhood or young adulthood. Type 2 diabetes occurs when the body cannot use insulin effectively, accounting for about 90% of all cases; it is strongly linked to overweight, physical inactivity and family history but has significant genetic and social determinants.

Can type 2 diabetes be reversed?

Substantial weight loss — through a very low-calorie diet or bariatric surgery — can achieve remission of type 2 diabetes in some people. The landmark DiRECT trial showed remission in 46% of participants at one year. However, remission requires sustained lifestyle change; type 1 diabetes cannot be reversed.

What are GLP-1 drugs and are they safe?

GLP-1 receptor agonists (semaglutide/Ozempic, tirzepatide/Mounjaro) lower blood glucose, suppress appetite and cause meaningful weight loss. They also reduce cardiovascular deaths in high-risk patients. Common side effects include nausea; rare serious risks include pancreatitis. They are approved for type 2 diabetes and, at higher doses, for obesity management.

What is the HbA1c test?

HbA1c (glycated haemoglobin) reflects average blood glucose over the past 2-3 months. It is used to diagnose diabetes (>=48 mmol/mol) and monitor control. A target below 53 mmol/mol (7%) is recommended for most adults with diabetes, though targets should be personalised.

How does diabetes cause blindness and kidney failure?

Chronically high blood glucose damages small blood vessels. In the retina this causes diabetic retinopathy — the leading cause of preventable blindness in working-age adults. In the kidneys it causes diabetic nephropathy — the leading cause of kidney failure requiring dialysis in many countries. Both complications are preventable with good glucose and blood pressure control.

What is the global insulin access crisis?

Insulin was discovered in 1921, yet an estimated half of people globally who need it cannot access it reliably. Three companies control 90% of the global insulin market, and in many LMICs a month's supply costs more than a month's wages. WHO has included insulin on its Essential Medicines List since 1977, but access and affordability remain critical failures.

Can diabetes be prevented?

Type 2 diabetes can largely be prevented or delayed: the Diabetes Prevention Program (US), Da Qing Study (China) and Finnish Diabetes Prevention Study all showed that modest lifestyle changes — 5-7% weight loss and 150 minutes of moderate activity per week — reduced incidence by 58% in high-risk individuals. Type 1 diabetes cannot currently be prevented.

What is the WHO Global Diabetes Compact?

Launched in 2021, the WHO Global Diabetes Compact targets ensuring 80% of people with diabetes are diagnosed and achieve good control of glucose, blood pressure and lipids by 2030. It brings together governments, industry and NGOs and specifically addresses the equity crisis in insulin access.

What are the economic costs of diabetes?

Diabetes-related health expenditure reached $966 billion in 2021 — about 9% of total global health spending. Indirect costs from lost productivity are additional. The complications of diabetes (heart attack, stroke, dialysis, amputation) are the main cost drivers, yet are largely preventable with basic primary care.

How does diabetes affect cardiovascular risk?

Adults with diabetes have 2-3 times the risk of heart attack and stroke compared to those without the condition. GLP-1 agonists and SGLT2 inhibitors have demonstrated significant cardiovascular protection in large trials — now changing clinical guidelines globally.

What are the psychosocial impacts of living with diabetes?

Diabetes distress — the emotional burden of managing a lifelong condition — affects about 45% of people with diabetes and is associated with worse glycaemic outcomes. Depression is 2-3 times more common in people with diabetes. Psychosocial support and mental health integration into diabetes care are increasingly recognised as essential components of management.

How does GMJ News cover diabetes?

GMJ News reports clinical trial results, WHO and IDF guidance updates, GLP-1 drug approvals and the policy dimensions of insulin access with mandatory PubMed citation guards. Georgia has a high NCD burden including diabetes, making this a priority for the Georgian Medical Journal and PHIG's public health work.

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Diabetes

GMJ News knowledge hub · last reviewed September 2026 · Georgian Medical Journal

Summary Statistics Glossary GMJ news FAQ Documents Organizations Research

Diabetes is one of the fastest-growing chronic diseases worldwide: the IDF Diabetes Atlas estimates nearly 590 million adults are living with diabetes, over three-quarters of them in low- and middle-income countries — and almost half remain undiagnosed. Type 2 diabetes is largely preventable through weight management, physical activity and diet, while therapeutics are advancing rapidly with GLP-1 receptor agonists and beyond. The WHO Global Diabetes Compact sets coverage targets for diagnosis, glycaemic control and access to insulin a century after its discovery.

Key messages

Scale

537 million adults live with diabetes — a figure set to reach 643 million by 2030. 75% live in low- and middle-income countries (IDF Atlas 2021).

Types

Type 1 is autoimmune and requires lifelong insulin. Type 2 accounts for 90% of cases and is strongly linked to overweight, inactivity and family history — but is not simply a personal failing.

Prevention

Up to 70% of type 2 diabetes cases can be prevented or delayed through modest lifestyle changes — as shown by landmark trials in Finland, the US and China.

Complications

Poorly controlled diabetes causes blindness, kidney failure, lower-limb amputation and cardiovascular disease — all largely preventable with good primary care.

Treatment revolution

GLP-1 receptor agonists (semaglutide, tirzepatide) now reduce cardiovascular risk and body weight in addition to lowering glucose — the biggest treatment advance in decades.

Equity

$966 billion is spent globally on diabetes-related health expenditure — yet millions in LMICs cannot access even basic insulin and glucose monitoring.

Key statistics

537M

adults with diabetes

IDF Atlas 2021

643M

projected by 2030

IDF Atlas 2021

6.7M

deaths attributed/year

IDF Atlas 2021

75%

live in LMICs

IDF Atlas 2021

$966B

global health expenditure

IDF Atlas 2021

1 in 10

adults affected globally

IDF Atlas 2021

Adults living with diabetes worldwide (millions) — IDF Diabetes Atlas series

Source: IDF Diabetes Atlas (biennial series).

Glossary of key terms

Type 1 diabetes
ADA/WHOAn autoimmune condition destroying insulin-producing beta cells. Requires lifelong insulin. Usually diagnosed in childhood or young adulthood.

Type 2 diabetes
ADA/WHOThe most common form (90% of cases). The body does not use insulin effectively. Strongly associated with overweight and inactivity but has genetic components.

HbA1c
ADAGlycated haemoglobin — reflects average blood glucose over 2–3 months. Used to diagnose diabetes (>=48 mmol/mol / 6.5%) and monitor control.

GLP-1 receptor agonist
ADA/EMA/FDAA class of medicines (semaglutide, liraglutide, tirzepatide) that lower glucose, reduce appetite and protect the cardiovascular system.

Diabetic ketoacidosis
ADAA life-threatening emergency mainly in type 1 diabetes where lack of insulin causes dangerous acid build-up in the blood. Requires urgent treatment.

Insulin resistance
WHOA condition in which cells do not respond normally to insulin, requiring the pancreas to produce more. Central to the development of type 2 diabetes.