Around 90 per cent of diabetes sufferers have type 2 diabetes, a metabolic problem that usually involves insulin resistance. There is plenty of information around for type 2 diabetics to help them manage their condition with diet and lifestyle. However, if you are part of the 10 per cent minority with type 1 diabetes, you may feel that there is nothing that you can do apart from continue to inject insulin regularly and monitor your blood sugar levels. Well, that’s a common misconception.
Type 1 diabetes is an autoimmune condition in which the body’s immune system destroys the insulin-producing cells of the pancreas. Because they can’t produce insulin, people with type 1 diabetes have to inject a pharmaceutical form of the hormone in order to control their blood sugar levels.
The first question we should ask about type 1 diabetes is “Why does the immune system malfunction and attack the body?” Your doctor may tell you that it’s all down to the genetic lottery and you were unlucky enough to inherit a faulty gene. But that is only part of the problem. The rapidly increasing incidence of type 1 diabetes in western societies cannot be attributed to genetics alone. Something else must be driving it.
Scientists have recently found that type 1 diabetes is part of an interrelated complex of autoimmune conditions that also includes coeliac disease, rheumatoid arthritis, and multiple sclerosis. There is increasing evidence that, in all of these conditions, a genetic susceptibility only becomes a reality if the relevant gene is “switched on” by an environmental trigger. In many cases, the trigger is food.
With coeliac disease, the trigger food is a protein in wheat gluten, called gliadin. New research at the Royal Hallamshire Hospital in Sheffield has discovered that people with type 1 diabetes who also have coeliac disease have poorer blood sugar control and a higher incidence of complications than other type 1 diabetics. Following a gluten-free diet led to better blood sugar and blood fat profiles and less incidence of diabetes-related kidney damage in these patients.
Because the immune system is still developing during the first few years of life, most nutritional practitioners advise against introducing wheat or cow’s milk products into a baby’s diet before the age of 12 months. These foods frequently induce immune reactions. Animal studies suggest that wheat-based diets can promote the development of type 1 diabetes and there is some evidence that the same may be true of cow’s milk.
For people who are already living with type 1 diabetes, these findings are relevant because damage to the insulin-producing cells in the pancreas (called beta cells) is not an all-or-nothing occurrence. Many type 1 diabetics still have some beta cell function and may be able to prevent further damage by following the right diet. Once the immune system is no longer attacking these cells, there is also the possibility that they could regenerate and start to produce some insulin again.
The practical message for people with type 1 diabetes is twofold. First, strengthen your immune system. Second, cut out foods that may trigger an immune reaction.
Foods that support a strong, properly functioning immune system are mainly fresh plant and animal foods in their natural state. Particularly good are oily fish, leafy green vegetables, berries, seeds, garlic, mushrooms, oats and green tea. As a general rule, the more processed a food is, the worse it is for your immune system. Taking regular, moderate exercise in the fresh air, dealing with stress and getting enough sleep are also important.
Although wheat and dairy foods may be the prime suspects, many other foods can cause allergies or intolerances. If you suspect that you have problems of this kind, it may be worth getting tests done. Some allergy testing is available on the NHS and you should talk to your doctor in the first instance. If you want a full spectrum of food intolerance testing, you will need to arrange this privately, in which case make sure that you get proper blood tests (called IgG tests) done by a reputable UK laboratory.
Type 1 diabetics can also benefit from following a low glycaemic load (low GL) diet, as described in my earlier posts. Eating a poor diet can result in insulin resistance developing in people who inject insulin, as much as in those who produce their own. A low GL diet on the other hand could mean that you can cut back your injected insulin by as much as 50 per cent and benefit from reduced risks of cancer and heart disease as a bonus.
The key for people with type1 diabetes is to make changes to the diet very gradually and monitor blood sugar carefully while doing so. Work together with your doctor to agree reduced doses of insulin as your blood sugar levels start to drop. Make changes to breakfast and lunch first, so that you are aware of their effects while you are awake. Cutting back on caffeine and alcohol will also help.
You can find more detailed dietary guidance for type 1 diabetes in Patrick Holford’s book Say No to Diabetes(Piatkus 2011). Another essential factor in the management of both type 1 and type 2 diabetes is exercise, which can really help to stabilise blood sugar and improve insulin sensitivity. That will be the subject of my next blog post.
Wishing you the best of health,
Martin Hum PhD DHD
for Real Diabetes Truth
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Bear in mind we are not addressing anyone’s personal situation and you should rely on this for informational purposes only. Please consult with your own physician before acting on any recommendations contained herein.
1. Richard-Miceli C, Criswell LA. Emerging patterns of genetic overlap across autoimmune disorders. Genome Med. 2012 Jan 27; 4(1): 6.
2. Leeds JS, Hopper AD, Hadjivassiliou M, Tesfaye S, Sanders DS. High prevalence of microvascular complications in adults with type 1 diabetes and newly diagnosed celiac disease. Diabetes Care. 2011 Oct;34(10):2158-63.
3. Flohé SB, Wasmuth HE, Kerad JB, Beales PE, Pozzilli P, Elliott RB, Hill JP, Scott FW, Kolb H. A wheat-based, diabetes-promoting diet induces a Th1-type cytokine bias in the gut of NOD mice. Cytokine. 2003 Feb 7;21(3):149-54.
Category: Diet and Exercise