Type 2 diabetes has become an epidemic, with 28.5 million Americans diagnosed as of 2012 and the number expected to continue growing. Lost in the discussion on how to reverse this mounting problem, however, is the plight that nearly 1.5 million Americans with Type 1 diabetes deal with.

Even though Type 1 and Type 2 diabetes seem similar at first glance, the two are actually worlds apart. Type 1 diabetics usually develop the disease at a young age, which is why it used to be known as juvenile diabetes, in contrast to Type 2 diabetes, previously referred to as adult-onset diabetes. Both diseases are a result of problems with insulin, a hormone used by the body to regulate blood sugar, but that’s where the similarities end. “The simplest way to think about the difference between Type 1 and Type 2 is that Type 1 diabetics have a deficiency of insulin,” says Kevin Goist, an assistant professor of clinical medicine at The Ohio State University's Wexner Medical Center, “while in Type 2 diabetes, the major problem is insulin resistance. The body does not use insulin properly.”

Type 1 diabetics rely on insulin injections to lower their blood sugar level, whereas Type 2 diabetics can try to manage theirs through a combination of diet, exercise and medication before resorting to insulin injections. Derek Rapp, CEO of JDRF, a research foundation dedicated to finding a cure for Type 1 diabetes, has a 20-year-old son with Type 1 and says watching him constantly test and retest his blood sugar is heartbreaking. “He has all these different variables that he’s trying to adjust for," Rapp says, "so it’s a constant balancing act to try and hit the mark with regards to ​what his insulin needs are.”

In the short term, Rapp worries that his son Turner is at risk for seizures and shock if his blood sugar isn’t managed properly, but in the long term, he worries about much more. “There’s this nagging fear of the complications that can come with the disease – blindness, kidney failure and limb amputation, to name a few," Rapp says. "These are all very real and experienced by many people with Type 1 every year.”

That’s not all Type 1 diabetics experience, says Camillo Ricordi​, director of the ​University of Miami's Diabetes Research Institute. Due to a wealth of misinformation surrounding the disease, people just assume that, like some Type 2 diabetics, Type 1 diabetics developed the disease due to poor lifestyle choices. “If you ask the general public why they think [people] get Type 1 diabetes, the overwhelming number of answers would be because they eat too much, eat too many sweets, don’t get enough exercise or spend too much time in front of a TV – almost like it's their fault or the fault of their parents,” Ricordi says. “Many [Type 1 diabetics] are now advocating even a change in the name​ of the disease to better differentiate the two conditions.” One petition asking the medical community to devise new names for the two diseases garnered more than 9,000 signatures.

Type 1 diabetics are also calling for more awareness of their condition, Goist says. “When one person hears of another adult with diabetes, they [might] assume it is Type 2,” he says. “It is often a source of confusion for some patients as well.”

Brian Herrick, JDRF's communications manager, has lived with Type 1 diabetes since he was 3 years old and says he hopes to one day not have to explain to people​ what Type 1 diabetes is. "People find out I have diabetes, and I have to explain that no, I don’t have Type 2," he says. "I’m looking forward to ​a world where people are more informed."



But even if some diabetics feel like the public has forgotten about them, researchers have not, Rapp says, and major breakthroughs in Type 1 diabetes treatment are around the corner – the most promising of which is an artificial pancreas.​ “This is a combination of two devices that can work to help a person have really great glucose control, without having to worry about the lows and highs or actively managing the condition as we do today,” he says.

The device entails a sensor, called a continuous glucose monitor, which a diabetic wears on his or her abdomen, and​ a small probe that gets inserted under the skin​. The sensor detects insulin levels on a real-time basis and is connected to an insulin pump that automatically releases the amount needed​.

The artificial pancreas is primarily aimed at Type 1 diabetics, but it may also work for some Type 2 diabetics. In addition to eliminating the need to inject insulin, it cuts down the number of times diabetics need to prick their fingers to check their blood sugar levels​. “I once saw Turner prick his finger over 100 times in one day,” Rapp says. “This machine may bring that down to the single digits.”

The first iteration of the device, the​ MiniMed 530G, was approved by the Food and Drug Administration in September 2013. Rapp says new and improved models are expected to be available in the near future. “Blood sugar can vary significantly from the time someone goes to bed to the time they wake up,” Rapp says. “To have a device that can take the worry out is a great relief, especially for parents.”

Herrick doesn't use an artificial pancreas, but does use a continuous glucose monitor, and says the ability to track trends in his blood sugar has helped him manage his disease better. "When you’re just checking your blood sugar, you’re not getting a dynamic result," he says. "You’re getting a result of that moment in time. Having trends and knowing what my blood sugar was, what it is and what it will be changes how I approach my treatment."

But it’s not just insulin-administering devices that are getting smarter – the insulin itself is as well. A new treatment called Smart Insulin, funded by JDRF, may one day help diabetics stop worrying about calculating how much insulin they need. “It‘s a form of insulin that will continuously circulate in the bloodstream and turn itself on when blood sugar levels are high and off when the levels are in a safe range,” Rapp says.

Smart insulin is a number of years away from being commercially available, but clinical trials are slated to begin later this year.