Type 1 diabetes occurs when the body no longer makes insulin. For children, this means life with an insulin pump. But is there a type 1 diabetes cure in sight?
For background, it is important to understand how the body functions as it relates to sugar handling.
In response to signals from the body (blood sugar, GLP-1 from the small intestine, certain amino acids) the beta cells of the pancreas produce and release insulin, which then acts on almost every cell in the body to cause those cells to grab the sugar running through the bloodstream.
However, there is a step that occurs before insulin is released. When it is produced, it is actually made up of a larger molecule called preproinsulin (and no–that is not a typo). Preproinsulin gets cut and we are left with proinsulin. Proinsulin is cut and we get insulin AND another molecule called C-peptide.
So, as a little known fact, we can actually check how well the pancreas is working by checking C-peptide levels. This does not happen often with type 1 diabetics in most doctors’ offices.
Most type 1 diabetics are told that their pancreas is no longer working and they are typically put on a pump. But what almost every type 1 diabetic will tell you is that their insulin needs can actually vary. Sometimes higher, sometimes lower.
The astute among them may actually be able to tie this into certain aspects of their lifestyle. I have one patient whose daughter is an insulin dependent diabetic. There was a period of time that they were have a hard time controlling blood sugar (it was too low) and so the mom had to lower the basal dose.
When the mom took a good look at what had changed, she realized her daughter had been off of dairy for several weeks. Since dairy is well known to contribute to the onset of type 1 diabetes, it would certainly make sense that avoidance of dairy could help manage the condition as well. The same goes for formula.
So if avoiding dairy essentially led to a lower need for insulin, what does that mean?
I have always contended that type 1 diabetics retain the ability to make insulin, but this is shut down by the immune system. Kind of like a sniper on the roof picking off insulin as it is made.
This is a very, very important distinction from what they are normally told.
This means that, while the pump may be lifesaving, diet can have a massive role in how much insulin is needed and the long term outcomes of the condition. As a parent of an insulin dependent diabetic child or if you are a type 1 diabetic yourself pay attention to this…
Merely managing your insulin dose and not paying attention to what you are doing to your body is wrong. Period. You cannot feed your child cookies and soda on a regular basis and just adjust the dose up. You may be truly condemning the diabetic to a lifetime of insulin need should we ever find an answer.
And that may not be far away.
Two particular studies actually back up my position.
The first study looked at how well the pancreas produced C-peptide even after the diagnosis of insulin dependent diabetes. What did they find?
- 93% of individuals still had detectable C-peptide 2 years after diagnosis
- 11% of subjects had no significant drop in C-peptide levels up to 2 years after diagnosis.
Basically, the beta cells were still working. In some better than others, but regardless, they were still working. It could very well be that the right lifestyle choices could keep someone in the 11% that saw no change in beta cell function at 2 years.
The next study was potentially life-changing.
Researchers took a small group of type 1 diabetics and gave them a vaccine containing Bacillus Calmette-Guerin (BCG). BCG is a component of tuberculosis that has been inactive and has been in use for almost 100 years.
They found that the small group that were given the vaccine had in increase in C-peptide levels to almost 50% of a normal group that did not have diabetes.
It gets better.
The average duration of diabetes was 15.3 years. Yes–YEARS.
This means that, if we can suppress or control the immune response that is attacking the beta cells of the pancreas we stand a very good chance at restoring normal function of the pancreas and giving these patients an insulin-free life back. Stay tuned…
But, of course, this will HAVE to be connected with a lifestyle that is conducive to preventing type 1 diabetes.
So, what have you noticed that affects your insulin need?