Type 1 diabetes is due to the lack of insulin production by the pancreas.  The usual underlying cause is an autoimmune disorder with antibodies attacking the beta cells of the pancreas.  Individuals with classic type 1 diabetes require exogenous insulin for survival.  We have seen several occasions of misdiagnosis of kids with type 1 diabetes who really had type 2.  There can be significant overlap between individuals who are insulin requiring (type 2) versus insulin dependent (type 1).

Individuals diagnosed with metabolic syndrome frequently have overt type 2 diabetes, prediabetes, or insulin resistance.  These disorders have a common underlying problem of intracellular biochemical dysfunction (sick cells).  They likely have mitochondrial dysfunction (causing poor cell energy production and metabolism) in part due to ischemia (poor blood flow to the cells) along with other biological abnormalities.  Studies have shown the presence of increased fat accumulation within the cells and dysfunction of the insulin receptors in individuals with insulin resistance with or without clinical type 2 diabetes.