Short answer. In type 1 diabetes the immune system destroys the cells that make insulin, so the body makes little or none and needs insulin every day from diagnosis. In type 2 diabetes the body still makes insulin but cannot use it well, and it often develops slowly over years. Type 2 is far more common: WHO says more than 95% of people with diabetes have type 2. Both are diagnosed with the same blood tests, and both can be managed.
Checked against WHO's diabetes fact sheet (updated 14 November 2024) and Kenya's national diabetes guidelines on 26 October 2026. This is general information, not a diagnosis.
Get care today if you notice these
High blood sugar can become an emergency, especially in type 1 diabetes, where it can tip into diabetic ketoacidosis (DKA). Go to a health facility the same day, or call 999 or 112, if someone with diabetes, or a child with new thirst and weight loss, has:
- vomiting, or cannot keep fluids down
- deep, fast breathing or a fruity smell on the breath
- stomach pain with drowsiness or confusion
- very high readings on a glucometer that do not come down
Very low blood sugar is also urgent. Shaking, sweating, confusion or fainting in someone on insulin or certain tablets needs sugar by mouth if they can swallow, and help straight away if they cannot.
Type 1 and type 2 side by side
| Type 1 | Type 2 | |
|---|---|---|
| What goes wrong | The immune system destroys insulin-making cells | The body resists insulin and makes too little over time |
| Who it usually affects | Often children and young adults, but any age | Usually adults, increasingly younger people |
| How it starts | Often over weeks, sometimes as an emergency (DKA) | Often slowly, with mild or no symptoms for years |
| Treatment | Insulin every day, for life | Healthy eating and activity, then tablets, sometimes insulin |
| Can it be prevented? | No | Often delayed or prevented by lifestyle changes |
The symptoms are the same, the speed is not
WHO lists the same signs for both types: feeling very thirsty, passing urine more often than usual, blurred vision, tiredness, and losing weight without trying. In type 1 these usually come on fast. In type 2 they can be so mild that many people find out only at a routine check or when a complication appears.
That matters in Kenya. In the 2015 national STEPS survey, about 2.4% of adults aged 18 to 69 had diabetes and a further 3.1% had pre-diabetes, and fewer than half of the people with raised blood sugar knew it. A test is the only way to know.
The numbers that mean diabetes
These are the standard WHO thresholds, also used in Kenya's national guidelines:
| Test | Diabetes if |
|---|---|
| Fasting plasma glucose (no food for 8 hours) | 7.0 mmol/L or higher |
| Random plasma glucose, with symptoms | 11.1 mmol/L or higher |
| 2 hours after a 75 g glucose drink (OGTT) | 11.1 mmol/L or higher |
| HbA1c (average sugar over about 3 months) | 6.5% (48 mmol/mol) or higher |
Without symptoms, a high result is usually repeated on another day before a diagnosis is made. The tests do not tell type 1 from type 2 on their own: a clinician decides from your age, how fast it started, your weight, ketones and sometimes further tests. A home glucometer reading is useful for monitoring, not for diagnosis.
What treatment looks like
Type 1: insulin every day, matched to food and activity, with regular blood sugar checks. Stopping insulin is dangerous, even during illness. Children and young people in Kenya are usually followed at a hospital diabetes clinic.
Type 2: WHO's advice for preventing or delaying it is to keep a healthy weight, do at least 150 minutes of moderate activity a week, eat a healthy diet low in sugar and saturated fat, and not smoke. The same habits are the base of treatment. Most people add tablets such as metformin over time, and some need insulin.
Both types: long-term high sugar damages blood vessels in the eyes, kidneys, nerves and heart, which is why diabetes care includes yearly eye checks, kidney tests, foot checks and blood pressure control.
Where to get tested and treated in Kenya
- Getting tested: ask at a health centre, a sub-county or county hospital, or a pharmacy that offers glucose testing. HbA1c is usually done in a lab.
- Ongoing care: many county and mission hospitals run diabetes clinics. Ask your facility which day theirs runs.
- Cost: SHA lists chronic illnesses under its Emergency, Chronic and Critical Illness Fund. What is covered at a given facility varies, so check before you go: see SHA and SHIF explained and the SHIF calculator.
Questions people ask
Can type 2 diabetes turn into type 1? No. They have different causes. Some people with type 2 need insulin later, but that does not make it type 1.
Can type 2 diabetes go away? Some people bring their sugar back into the normal range with weight loss and lifestyle change, but it can come back, so keep up the checks.
Is a sugar reading from a pharmacy enough for a diagnosis? No. It is a good reason to see a clinician, who will confirm it with a lab test.
Sources
- World Health Organization. Diabetes, fact sheet (updated 14 November 2024): who.int/news-room/fact-sheets/detail/diabetes
- World Health Organization. Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus (2011).
- Ministry of Health, Kenya. National Clinical Guidelines for Management of Diabetes Mellitus: WHO document repository
- Mohamed SF et al. Prevalence and factors associated with pre-diabetes and diabetes mellitus in Kenya: results from a national survey. BMC Public Health 2018; 18 (Suppl 3): 1215: doi.org/10.1186/s12889-018-6053-x
- Social Health Authority, benefits: sha.go.ke
This article was written by the Tabibu editorial team from the sources above. It is general information, not a diagnosis. For your own results, see a clinician, or ask Tabibu, which shows the sources it used.