Why Do More and More Adults Get Type 1 Diabetes?

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More and more Swedes get type 1 diabetes, which used to be called juvenile-onset diabetes.

It was previously thought that the increase only applied to children, but now it’s clear that the disease is also increasing greatly in people between 14 and 34 years:

University of Gothenburg: More adolescents and young adults with type 1 diabetes than previously thought

Nobody knows for sure what causes the disease. For some reason, the immune system attacks the insulin-producing cells and kills them.

The increase in type 1 diabetes follows the rise of obesity – three times more people are obese today, than in the 80’s.

Obese people have greatly elevated levels of insulin in their blood, on average four times more (!) than lean people.

The same Western food that stimulate an overproduction of insulin, making susceptible people obese, may affect other people in other ways. Perhaps a hyper-stimulation of insulin-production constitutes a risk for an attack of the insulin-producing cells.

Perhaps the Western high-carb diet is not only behind obesity and type 2 diabetes in ever more people, but also behind an increased risk of type 1 diabetes?

More

One Year on an LCHF Diet with Type 1 Diabetes

How to Normalize Your Blood Sugar

About Type 1 Diabetes

Low-Carb to Manage Type 1 Diabetes

18 comments

  1. mary baechler
    It's the zinc, IMO. We are all probably zinc deficient. This last winter I went to 25 mg/day of zinc, and did not get sick or a cold, although constantly exposed to people who were sicker than dogs, as we say here. (I also went to 5000 IU Vit D and 25,000 IU Vitamin A). Here's an important study about zinc--referenced in an old Adelle Davis book on nutrition from 1959--that addresses the important question of what is behind the onset of diabetes?

    This study is often cited--never have seen it refuted yet). THE INSULIN AND THE ZINC CONTENT OF NORMAL AND DIABETIC PANCREAS

    D. A. Scott and A. M. Fisher

    file:///Users/maryb7/Documents/Winning%20Over%20Diabetes/vitamins/THE%20INSULIN%20AND%20THE%20ZINC%20CONTENT%20OF%20NORMAL%20AND%20DIABETIC%20PANCREAS.webarchive

  2. MargaretRC
    It's totally anecdotal, but my son and two of his three male cousins are T1. My son was raised in this country and was never really obese. Overweight, yes, for a few years in college, but not obese. His cousins were never obese, were diagnosed as children, and were raised on a different continent--as in Africa. My son was diagnosed the day he turned 26 (or a day or two before), some years after he had switched to real food and lost the weight he'd gained in college. The only thing my son and his cousins have in common is family ties. Their mother is my sister. And they all suffered some kind of an infection within months of developing symptoms. So,much as I like to blame the SAD for pretty much everything, I really don't blame it for this. My personal hypothesis, based on the fact that T1 often runs in families, is that there is a genetic predisposition to autoimmune attack on the Beta cells. The trigger could be different in different cases, but....
  3. Alain
    It could be epigenetic changed du to high carb diet.

    If the parent have a diet based on carb, this could trigger DNA changed for their future children.

    Later in their life, with high carb diet the children end up with type I diabetes.

  4. Mark Jan
    If T1 was purely genetic, it should really have died out a long time ago. I suspect it's a modern lifestyle disease which we can now of course, "manage".

    There appear to be triggers, but in the absence of a modern lifestyle, I suspect the "triggers" will, in the majority of potential sufferers, have no effect.

  5. Tuck
    "The study by Mojibian et al. raises the possibility that wheat could be the driving dietary antigen in two autoimmune diseases, i.e., celiac disease and type 1 diabetes. "

    "Diet, Gut, and Type 1 Diabetes: Role of Wheat-Derived Peptides?"
    http://diabetes.diabetesjournals.org/content/58/8/1723.full

    "The development of autoimmune type 1 diabetes involves complex interactions among several genes and environmental agents. Human patients with type 1 diabetes show an unusually high frequency of wheat gluten-sensitive enteropathy; T-cell response to wheat proteins is increased in some patients, and high concentrations of wheat antibodies in blood have been reported. In both major models of spontaneous type 1 diabetes, the BioBreeding (BB) rat and non-obese diabetic mouse, at least half of the cases are diet-related. In studies of BB rats fed defined semipurified diets, wheat gluten was the most potent diabetes-inducing protein source."

    "A type 1 diabetes-related protein from wheat (Triticum aestivum). cDNA clone of a wheat storage globulin, Glb1, linked to islet damage."

    http://www.ncbi.nlm.nih.gov/pubmed?Db=pubmed&Cmd=ShowDetailView&...

    "These researchers demonstrated that mice fed a gluten-free diet had a dramatically reduced incidence of Type 1 diabetes. These mice were non-obese diabetic mice, or mice that grow to develop Type 1 diabetes. The gluten-free diet worked to protect the mice against Type 1 diabetes. When the researchers added gluten back into the diets of mice it reversed the protective effect the gluten free diet had provided."

    "Microbiome changed by gluten increases incidences of type 1 diabetes"
    http://www.sciencedaily.com/releases/2013/11/131113182423.htm#.UoYQbw...

    Celiac disease, which is definitively caused by wheat and related grains, is also increasing in incidence.

  6. Laila King
    I agree that our body shapes are getting larger - we are heavier even at birth. T1DM is - like T2DM - heterogenous condition: NOT all T1DM people have autoimmune condition; many have 'idiopathic' T1DM, with no antibodies detected. Then there are many adults whose diabetes may be one of the many subtypes of monogenic diabetes (MODY).
    I hope that the current artificial categorisation into Type 1 and Type 2 will be improved and changed as there is such a huge overlap in them and the main difference being the acceleration tempo at which the pancreas loses its ability to produce sufficient insulin for the body's needs.
    Many experts think that the pollution in the air, foods (toxic man-made stuff) and water trigger inflammation which affects our insulin metabolic homeostasis.
  7. Eric Anderson
    No doubt the sugar and grain and maybe milk proteins can be part of the problem but milk from cows is not in the diet everywhere that diabetes T1 has increased.

    HFLC is a great alternative
    Early diagnosis can help

    On the near future is the gut microbiome

    Rodents and soon people can benifit from fecal transplants or just the bacteria in a pill.

  8. Boundless
    ... and T2D used to be called "adult onset diabetes". How many years has it been since anyone last heard that phrase?

    The trend charts for T1D/LADA and T2D, not just high, but rising, and perhaps not just rising, but accelerating, should be causing consensus medicine to consider radical theories as to what the causes are. Guess not. Probably inconsistent with the business model.

    Causes are out there, active, and gaining on us ("us" probably excluding those doing grain-free VLCHF).

    Something is changing to cause this change, and it's not the humans.

    Could it be the food?
    The following have all changed radically in the last half century, or didn't even exist back then:
    - the gluten-bearing grains, esp. wheat
    - pervasive sugars, esp. fructose, esp. free fructose
    - high glycemic diet generally
    - low fat mania, including low saturated fat mania
    - PUFA industrial seed oils pretending to be food
    - novel herbicide uptake in the crops
    - pesticide uptake in the crops
    - crops that ARE pesticides (e.g. Bt GMOs)
    - possible GMO and non-GMO mutagenic hazards generally
    There are other lurking suspects in the footnotes, but I'll bet the main problems are near the top of the list above.

    Given that T2D can be entirely avoided with a low-carb diet, and T1D can be largely controlled with a keto diet (and minimum meds), the obvious thing to do is change aisles at the market: dial down the carbs, then closely monitor the trends. Don't expect to hear this advice from Big Pharma, consensus medicine or your National Diabetes Promotion and Maintenance Association.

  9. Nate
    These comments surprised me as to how well informed people are about Type 1.

    One person that was not mentioned was Dr. Natasha Campbell-McBride and her GAPS diet. She has worked with young Type 1's who have been recently diagnosed (within a year I believe). The main purpose of the GAPS diet is to heal the gut. Once it is healed the proteins or whatever that have been leaking into the Type 1's blood are gone. Several of her young Type 1's have reversed their diabetes by following her diet. See:

    http://diabeticdharma.com/

    http://www.youtube.com/watch?v=Z_0NvcJZwa8

  10. Rock
    Use of antibiotics and toxins in food like pesticides contributing to Leaky Gut which leads to autoimmunity, allergies and other diseases?

    I wonder if any LCHF'ers have their gut microbiome checked since your beneficial bacteria may starve from too little starch or fibre. After 2 years on a low carb diet I did a stool test which showed a pH of 7.5 which is too high and a deficit in Lactobacteria, Bacteroides, Bifidobacteria. Thankfully no pathogen overgrowth so far. I also developed some joint pain in my fingers during that time. Not sure if that's related.

  11. Murray
    Nate, I read Dr. Campbell-McBrides book on GAPS and a few other books in that vein and have been monitoring all the science research reports I see come along. My impression is that the science is fledgling at best and the scientists have little clue how to interpret results. I think clinical experience (such as Dr. Campbell-McBride's) is the most reliable guide at this point and just watch to see how the data turns out to be significant. We really have little idea what is "normal" or "ideal" for a gut biome profile. What we do know is when there are obvious problems and what sorts of interventions seem to work well.

    My takeaway so far is that acellular sugar and starch are bad. They lead to overgrowth of undesirable bacteria too early in the GI tract. The selective carbohydrate elimination approach seems to have a lot of clinical success.

    My other takeaway is that you do not want too much of one type of bacteria food in a day. This leads to proliferation of a certain set of bacteria, which can lead to a "collapse" in the bacterial ecosphere--a bubble economy, so to speak. This creates opportunity for undesirable bacteria. Better to have a diverse ecosystem of good bacteria, to fend off better undesirable bacteria from proliferating.

    Total meat eaters do just fine. Of course they eat snout to tail and so have lots of proteins such as collagen that constitute "animal fibre" for bacteria. I was heartened to read that casein that makes it to the large intestine is broken down by bacteria and is a high source of butyrate as a byproduct of the bacterial activity. (I enjoy artisan cheese.) so the old perspective of the nutritional dogmatists about plant fibre is based on confirmation bias and not a frank bottom up assessment of what causes problems and what heals them.

    There is a lot of science and thinking to be done here.

  12. Lisa
    I believe it is caused by the gliadin protein in wheat which causes intestinal permeability initiating an autoimmune response. My boy has type 1 and I started him (and whole family) on a low carb diet straight away. I know he can't be cured but low carb results in normal blood glucose,hba1c and blood lipid levels. He does alot of exercise using fat as fuel. He is REALLY healthy !!
  13. Francois
    Type 1 (no insulin) and type 2 (excess insulin) are both called “diabetes” but though they are conditions of sugar metabolism, they are very different from one another and have very different causal mechanisms. A number of scientists now even call Alzheimer’s disease “ type 3 diabetes, as it is an inability of the brain to process glucose.
    While it is relatively easy to understand the series of mechanisms leading to type 2 diabetes, understanding the sequence of events leading to development of type 1 diabetes is much more complicated.
    In a nutshell, the immune system attacks the insulin-producing cells of the pancreas and destroys them. The question of course is why. The cow’s milk hypothesis is interesting in that regards. Most high-producing North American cows come from a single genitor and share a protein in the milk they produce. It so happens that this protein is nearly identical to a protein on the beta cells of the human pancreas. The hypothesis goes as follows: if by bad luck, a child would get attacked by a virus (enteroviruses have been considered), the immune system would get boosted and overwork. In the gut, encountering a “foreign” milk protein, it would attack it and then go on in the body to find this very protein. It would encounter the beta cells of the pancreas, confuse the body’s normal beta cell protein for an enemy and destroy it. Nothing proven of course, but an interesting hypothesis. My recollection from my personal practice is that every diabetic child in my practice was a heavy milk drinker. Coincidence? I do not know.
    The indication that type 1 diabetes is now appearing in adolescents and young adults raises many questions. And opens the door to many hypothesis. For example: wheat is now goatgrass and has much more genes expressing gluten. Does this stimulate the immune system? Maybe. Are there other factors? The modern diet now also promotes “heart-healthy omega-6” which promote severe inflammation. Does this play a role? I do not know. The average very high carb diet stimulates the pancreas constantly. Does this working overtime put the beta cells at risk of becoming more sensitive to an immune system attack, triggered by the very abnormal diet most people eat? Maybe. And the massive change in gut flora brought by both the abnormal diet and a high antibiotic intake may also play a role in the disruption of the immune system functioning. I definitely agree with Murray, this is something to look into.
    What is clear is that people eating real food, people who have a high fat, moderate protein, high vegetable intake (see the Wahls diet) have fewer auto-immune conditions and may reverse conditions that are known in mainstream medicine as impossible to cure. Dr Wahls seems to think cereal may play a immunogenic role. I know for a fact that even rice (no gluten) is significantly immunogenic in dogs and cats and though the cat is a true carnivore, the dog is an opportunistic carnivore, much closer to an omnivore.
    So until science proves one – or many of the theories trying to explain the increased incidence of type 1 diabetes in adults, I’ll stick to real food.
    Some references: Hans K Åkerblom1,* and Mikael Knip2 Putative environmental factors in Type 1 diabetes. Diabetes/Metabolism Reviews. Volume 14, Issue 1, pages 31–68, March 1998
    Anette-G. Ziegler, MD; Sandra Schmid, PhD; Doris Huber; Michael Hummel, MD; Ezio Bonifacio, PhD Early Infant Feeding and Risk of Developing Type 1 Diabetes–Associated Autoantibodies FREE JAMA. 2003;290(13):1721-1728. doi:10.1001/jama.290.13.1721.
    Hertzel C Gerstein, Cow's Milk Exposure and Type I Diabetes Mellitus: A critical overview of the clinical literature. Diabetes Care January 1994 vol. 17 no. 1 13-19
  14. Nate
    Thanks Rock, Murray and Francois, all of the theories are interesting and to me plausible. Of course, the trick now is to get funding to do the necessary studies. Unfortunately, successfully researching how to make an accurate, continuous blood glucose monitor that works with an insulin pump would be way more profitable than finding the best nutrition to prevent and/or reverse Type 1 diabetes.

    Lisa, I'm jealous. As a young Type 1, I found that my mother was the most important member of my diabetes team. She made sure that I knew what to do and helped me do it. Unfortunately, the doctor told her to feed me a diet with 40 to 50% carbs, 20% protein and 30 to 40% fat. If she would have know about a LCHF diet, I'm sure I would have been on it. Anyway, good luck.

    By the way, the GAPS diet uses a lot of bone broth to help heal the gut. I'd recommend that for you and your son. I've been having bone broth with 4 or 5 meals per week. Usually, I throw my meat and veggies into the broth and warm them up. Many good benefits from it. Any way, good luck.

  15. Carol
    This week I had a health assessment at work. The stated goal is to reduce heart disease among the company workforce. A young woman sitting next to me was concerned about her fasting glucose score, which was 99. The physician there to council us told her not to worry about diabetes because diabetes does not start until 125. He told her to reduce fat in her diet, especially saturated. He told her to avoid red meat and consume only the leanest cuts, such as the breast of chicken. He expressed doubt that low carb diets were helpful and stated that our ancient ancestors consumed very little fat. Same old same old.
  16. Karen
    I do not agree with the argument that obesity may be contributing to the increase in adult Type 1 Diabetes. I developed Type 1 Diabetes at 47 years of age and was slim. Everybody I know that became a Type 1 Diabetic as an adult was slim to plain skinny. I had a virus before I developed it. I believe the virus may have been the final straw on the camel's back, so to speak, but our bodies are overloaded with toxins - from vaccinations, pesticides, air pollutions, additives in food, etc - to where they cannot deal as well with viruses and clear them out like they should be able to do. Please, let's not blame everything on obesity without some statistics to back it up...
  17. Galina L.
    I have a guess that the D1 is on the rise for the same reason why many autoimmune conditions are on the rise. I have a Hashimodo thyroid which is also on the rise and also the case of an immune system attacking the wrong thing. From my field observations I noticed that many cases of sudden offset of D1 happened after a very bad flue or a persistent infection. I also know from my personal experience the importance of the consumption of butter, eggs and broths and avoiding carbohydrates when it is necessary for a human body to fight infection without going into an overdrive. Humans have to have the better understanding of life-style/health connections, and don't rely on the medicine alone to do all the job.
  18. Brian
    This is purely anecdotal. I have type 1 diabetes, and was diagnosed shortly after a severe, prolonged stomach infection at the age of 39. I took 3 rounds of antibiotics to cure the infection. But I do not think that the infection actually caused my diabetes. There had been signs a decade prior indicating that I had slightly elevated fasting blood sugars. I was never overweight, but I did eat a very high carbohydrate / calorie diet. The reason for the high carb consumption was to fuel my very athletic (ultra endurance) lifestyle. There is some recent research suggesting that "stressed beta cells" could cause T1D ( https://www.sciencedaily.com/releases/2012/03/120322151522.htm ). The stressed beta cells model is currently just a theory (and I doubt that it applies to very small children and babies who develop T1D)... My lifestyle likely stressed my beta cells in a feast-famine sort of way. So who knows - a lot of people in my T1D groups had a serious GI infection that almost immediately preceded their diagnosis. But as many T1's know, illness causes a big rise in blood glucose - so maybe that was what pushed them over the edge and into the doctor's office. We still have a lot to learn. Strictly following a low carb lifestyle has allowed me to manage my blood sugars quite well. I haven't cheated once, and my results (average glucose, standard deviation) as reported by my CGM are both on the lowest end of normal suggesting excellent health and management.

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