Type 1 diabetes (AKA type 1 diabetes mellitus) is an autoimmune condition where the immune system attacks the beta cells of the pancreas, rendering it unable to produce insulin. Insulin is essential to moving glucose from the blood into the cells for energy. Type 1 diabetes is not to be confused with type 2 diabetes, a lifestyle disease.
Type 1 diabetes develops in people with a genetic predisposition (including the HLA genotype). Like all autoimmune conditions, it is often triggered by external factors, however in children, it is often the result of internal activation of the gene. The condition is most often diagnosed in young children(juvenile onset) or can also develop in later life (late onset type 1 diabetes in adulthood or LADA diabetes). Having a genetic predisposition does not guarantee you will develop the condition.
Type 1 diabetes can develop slowly over months or years, and symptoms can seem to appear very quickly. Medical attention should be sought quickly if these symptoms appear.
The most common symptoms of early stage type 1 diabetes are:
There are a few different types of diabetes, all with different causes. Type 1 is an autoimmune condition affecting 10-15% of people with diabetes in Australia. Type 2 and gestational diabetes make up the remaining 85-90% and are more related to lifestyle factors, although gestational diabetes may be related to a person’s kidney glucose threshold.
Other subtypes of diabetes are:
Research has found that a complex interplay between genetic predisposition and environmental triggers underlies all autoimmune conditions, such as type 1 diabetes. First generation relatives of someone with type 1 diabetes are 10 times more likely to develop type 1 diabetes. In those people (often with the presence of HLA DR3 / DR4 gene haplotypes), a variety of suspected triggers are risk factors for developing the disease. This is thought to occur via a process called molecular mimicry, where molecules entering the body look the same as beta cells of the pancreas, and the immune system mistakenly attacks both the ‘intruder’ and beta cells over months or years, eventually destroying all functioning beta cells.
These triggers include:
Particularly for juvenile onset:
There isn’t one single cause of eczema but a range of potential contributing factors that are unique to each person. These include:
Research has found people with the ‘atopic triad’ have a defective barrier of the skin and upper and lower respiratory tracts.
These genetic alterations cause a loss of function of filaggrin (filament aggregating protein), which is a protein in the skin that normally breaks down to create natural moisturisation and protect the skin from penetration by pathogens and allergens.
Filaggrin mutations are found in approximately 30 percent of people with atopic dermatitis, and also predispose people to asthma, allergic rhinitis (hayfever), keratosis pilaris (dry rough patches and bumps on the skin), and ichthyosis vulgaris (a chronic condition which causes thick, dry, scaly skin.)If one parent carries this genetic alteration, there is a 50 percent chance their child will develop atopic symptoms. And that risk increases to 80 percent if both parents are affected.
The connection between the gut microbiome and skin health is complex, however, research has found the microbiota contributes to the development, persistence, and severity of atopic dermatitis through immunologic, metabolic and neuroendocrine pathways.
Deficiency of Omega-6 essential fatty acids (EFA) has been linked with the increased incidence of atopic dermatitis, along with the inability for the body to efficiently metabolise EFA’s to gamma linoleic acids (GLA) and arachidonic acids (AA).
Changing weather conditions can certainly aggravate eczema symptoms, but the triggers are subject to change among individuals.
Mould exposure and susceptibility to mould can cause Chronic Inflammatory Response Syndrome (CIRS), of which dermatitis is a manifestation.
Poor blood glucose management can cause damage to small blood vessels in the kidneys, eyes, heart, gums, liver, feet and legs. These tiny vessels can be easily damaged by too much glucose which is a large molecule.
Whilst frequent insulin injections are often required, they can never exactly replicate a healthy body’s own insulin production in response to food, and other bodily processes can make it hard to manage blood glucose levels consistently, such as carbohydrate cravings.
In addition to this, it is common for people with type 1 diabetes to develop non-alcoholic fatty liver disease and other autoimmune conditions, especially Hashimoto’s thyroiditis and coeliac disease, further complicating health and metabolism. Other autoimmune conditions associated with type 1 diabetes are Sjogren’s syndrome and Lupus.
Other conditions that commonly appear alongside type 1 diabetes are periodontal disease and heart disease, which are connected to the depletion of coenzyme Q10. CoQ10 is related to the energy metabolism and antioxidant capacity, however there are also implications with endocarditis, systemic vascular inflammation, progressive dyslipidaemia, which all form a complex comorbidity.
Heart attack, stroke, kidney failure and amputations of toes, feet and legs are associated with poor blood glucose management, and subsequent nerve damage that leaves people unable to feel damage to feet and toes. Candida overgrowth can also be common. There is growing awareness of the link between poor blood glucose regulation and Alzheimer’s disease, which is now being referred to as type 3 diabetes.
Management of type 1 diabetes requires lifetime insulin injections to ensure the transportation of glucose from the bloodstream into cells for energy production. The pancreas produces none, or very little, insulin in people with type 1 diabetes, and so without insulin, it is a life threatening condition.
Once diagnosed, your doctor or diabetes educator will design a management plan that includes:
Ideal fasting blood glucose levels are maintained at between 4-5.5 mmol /L, although this can vary from person to person. The optimal levels of blood glucose vary depending on a person’s age, weight, activity level and diet to avoid hyperglycemia (too much glucose in the blood), hypoinsulinaemia (not enough insulin in the blood), or life threatening ketoacidosis. Ketoacidosis is a condition where insufficient insulin over hours or days causes the body to burn an alternate source of fuel, ketones, which can alter blood biochemistry problematically, leaving dangerous chemical accumulation in the blood. Hypoglycemia is when there is too much insulin, leaving very little blood glucose, causing dizziness and fainting.
Your doctor will monitor this with regular blood tests, in particular HbA1c (glycosylated haemoglobin) test. Red blood cells have a lifespan of 90-120 days, and glucose naturally attaches itself to haemoglobin (a blood protein). The HbA1c is a measurement of this combination, meaning the more glucose in the blood over the last 90-120 days, the higher the HbA1c result.
While conventional medicine is very good at diagnosing chronic conditions, treatments often miss addressing the fundamentals of health that can make a big shift in someone’s overall health. This is why many people seek natural treatment for type 1 diabetes, to reduce the risk of complications and effectively manage blood glucose levels through dietary and lifestyle measures.
Type 1 diabetes functional medicine specialists can provide natural management strategies to reduce the complications of living with type 1 diabetes. Starting with an in depth investigation into the root causes and contributing factors, by looking at your:
Functional testing may identify gut microbiome disruptions, nutritional deficiencies and signs of poor nutrient absorption, food allergy and intolerances, and other factors contributing to complications.
Treatment strategies include dietary recommendations, lifestyle medicine, herbal medicines and supplementary medicines with the following aims:
Herbal medicines, supplementation of vitamins and minerals may include:
Most importantly, when you choose functional medicine to support your type 1 diabetes management, you are choosing natural, holistic and evidence based treatment strategies, delivered by skilled practitioners who are invested in seeing you succeed in making healthy changes.
At Melbourne Functional Medicine, we pride ourselves on providing a high level service in our unique 6 month program that delivers results. Your healthcare team will include a type 1 diabetes functional medicine practitioner and a health coach, who are there to guide, support and empower you to be in the best health you can be.
Are you ready for a personalised, natural functional medicine treatment? Our unique model of care was designed with you in mind. Find out how here, then book a call today!
Yes, most people with type 1 diabetes are likely to have the presence of HLA DR3 / DR4 gene haplotypes. If you have a first generation relative with type 1 diabetes, it is 10 times more likely that you will have the same gene type, and could develop type 1 diabetes.
However, having the gene does not guarantee you will develop the disease.
All autoimmune conditions develop with a complex interaction between genes and environmental factors. It is often said ‘the genes load the gun, and the environment pulls the trigger’, describing how gut microbiome dysbiosis, viruses, chemical exposures, environmental toxins, and early life exposure to high dairy and gluten consumption can all trigger the onset of the disease.
Some other types of diabetes are not genetically inherited, such as type 2 diabetes (which is predominantly lifestyle related), surgical & trauma induced diabetes and some health conditions such as cystic fibrosis and Down & Turner syndromes, or medication that damages the pancreas causing diabetes.
The vast majority of people with type 1 diabetes develop the disease in childhood, and around 8-10 % develop it in later life.
Whilst it is very uncommon, it is possible to be born with developed type 1 diabetes.
As an autoimmune condition, it requires both genetic susceptibility and an environmental trigger such as a virus, chemical exposure, environmental toxin, microbiome dysbiosis, and early life exposure to high dairy and gluten consumption can all trigger the onset of the disease. Some triggers are thought to occur in utero, including:
Type 1 diabetes is an autoimmune condition that develops in genetically susceptible people when it is triggered by environmental factors. It is sometimes referred to as insulin dependent diabetes.
Type 2 diabetes is a condition that develops due to lifestyle factors, often due to overconsumption of simple carbohydrate foods such as fast foods, bread, sugar, cakes etc.
There can be family predispositions that make it more likely and can occur in people of any weight or size. It is important to maintain a healthy diet high in vegetables and fruits, and whole grains, which contain complex carbohydrates rather than highly processed foods.
The best diet for someone with type 1 diabetes is one that is low in simple carbohydrates like white bread, pasta, cakes, sugar, doughnuts, muffins, lollies, and high in plant based complex carbohydrates from fruits and vegetables, whole grains, grass fed animal meat and wild-caught oily fish such as sardines, mackerel, anchovies, salmon and herring (SMASH).
It is important to avoid any food allergies, intolerances or sensitivities as they can disrupt the gut microbiome and create inflammation, and may be triggers for other autoimmune conditions. If you have one autoimmune disease you are more susceptible to developing others.
A person with type 1 diabetes will manage their own insulin in accordance with the calories eaten, and blood glucose levels so it’s important to make those calories high in nutrients that are not inflammatory. There are many complications of poorly regulated blood glucose, such as eye, heart, liver, kidney, foot and leg diseases and neurological conditions, and eating well can help to avoid these complications and live a healthy and happy life.
To summarise, the best diet is one that is personalised for you, considering your health state, nutritional needs, allergies and intolerances that provides you with maximum nutrition. A functional medicine type 1 diabetes practitioner can help with this.
Type 1 diabetes is managed with insulin injections, or via an insulin pump and close observation of blood glucose levels.
Other specialists such as an ophthalmologist, podiatrist, cardiologist, etc. may be required to manage the complications of type 1 diabetes.
With the guidance of a functional medicine type 1 diabetes specialist, the management of blood glucose can be made much more simple and more effective.
A range of strategies can ensure a more efficient uptake of glucose into the cells, meaning less insulin is required and there is less blood glucose that can cause complications. In addition, your type 1 diabetes specialist can support your heart, liver, kidney, and nervous system function, and help prevent other autoimmune conditions from developing so you can get on with living a healthy, happy life.
Type 1 diabetes is considered to be irreversible due to the late detection of the destruction of pancreatic beta cells. This means that the body is not able to produce insulin to transport glucose from the blood into the cells, which is a life threatening condition.
Recently, however, in some exceptional cases of early detection prior to the complete destruction of pancreatic beta cells (called the ‘honeymoon period’) it has been possible to put the condition into remission.
Recent studies show the theoretical possibility with one case reported in 2020 in a 17 year old boy with reversed type 1 diabetes. Clinical trials of pancreatic islet cell transplantation also show a promising future of living without injected insulin dependence, however, holistic management would be necessary to prevent reoccurrence.
Research is also looking at stem cell technology to replace pancreatic beta cells.
Other studies have shown reversal of type 1 diabetes in mice using the fasting-mimicking diet, but more research is required to confirm that the same results can be achieved in humans. It is important that any person with type 1 diabetes who is interested in undertaking a fasting mimicking diet does so under the care of a type 1 diabetes specialist to ensure safety, as there may be other considerations and it may not be right for everyone.
Functional medicine trained, naturopathic type 1 diabetes specialists at Melbourne Functional Medicine in South Melbourne are ready to help you manage your type 1 diabetes. If you’re not able to come to our beautiful clinic space, we can arrange telehealth for you.
Your practitioner will design a type 1 diabetes diet that is personalised to meet your body’s requirements.
They will support and guide you with functional testing to identify food allergies or intolerances, gut microbiome issues, and any other factors that will affect you, or contribute to complications or comorbidities.
The key goal is for you to manage your type 1 diabetes to avoid the complications that often accompany the disease.
Type 1 diabetes is an autoimmune condition that in around 85-90% of cases develops in children, and this is referred to as juvenile-onset diabetes.
In around 8-10% of type 1 diabetes, it develops in later life - generally before 40 years of age.
This is referred to as late-onset autoimmune diabetes in adulthood or LADA diabetes.
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