A Primer on Type 1 Diabetes
November is National Diabetes Awareness Month. This is a double-whammy of relevance to me as I work with many diabetics as an RD and my fiance, Kevin, has had Type 1 Diabetes since the age of 9. Next week I'll be publishing a Q&A with Kevin since he is the true expert of Type 1 but I wanted to preface that interview with a quick primer on Type 1 Diabetes since it is so often confused with Type 2.
There are two types of diabetes: Type 1 and Type 2 (we are starting to recognize a type 1.5 and possibly a type 3, but those are conversations for another time). Type 1 and 2 diabetes share a similar theme: both conditions impact the ability to regulate blood glucose levels in the body. Keeping blood glucose (or sugar) within a relatively narrow range is a very important task in the body and extremely high or extremely low levels have severe and possibly fatal consequences. The main organ responsible for this balance is the pancreas: a small organ located behind the stomach and connected to the duodenum (small intestine).
The pancreas, among other functions, contains cells that produce two glucoregulatory hormones: insulin and glucacon. Insulin is responsible for getting sugar into cells and out of the blood stream when high blood sugar levels are detected (think of it as a key that unlocks cell doors, letting glucose in). Glucagon is the opposite, it releases stored glucose from the cells into the blood stream when low blood sugar levels are detected (I remembered this in school as gluca-GONE, as in the glucose is out of the cell). Cells located all over the body from muscle to fat cells respond to insulin and glucagon to control how much sugar is in the blood at any given time. This is a very intricate dance that goes on all of the time and in both type 1 and type 2 diabetes this process is broken down.
Type 2 Diabetes:
Sometimes referred to as "adult onset diabetes", this condition develops slowly overtime as a result of diet, lifestyle and genetic factors. In the beginning stages of Type 2, the pancreas is still able to produce insulin but the problem lies in the muscle and fat cells. Whether the insulin secretion has been overstimulated by a high carb/inflammatory foods diet, high stress level, micronutrient deficiencies or genetics - the cells of the body become resistant to the action of insulin. This means the body is pumping out large quantities of insulin in response to high blood sugar levels, but the cells aren't listening to that signal so the sugar remains in the blood stream. A great analogy I learned in school is that insulin resistance is similar to how you feel after attending a very loud concert - when you get home you can barely hear a normal voice. The cells are getting exposed to a very high amount of insulin (or loud volume) and over time they stop responding to the signals (can't hear a normal volume).
Formerly an older adult's disease, we are now seeing younger and younger people developing this condition mirroring the rapid rise in childhood obesity rates. Type 2 diabetes is 100% preventable and, if caught early on, can even be reversed. I have seen this happen for a handful of clients. If no serious diet and lifestyle changes are made; however, type 2 diabetes will continue to worsen and the pancreas will get worn out from overproducing insulin and eventually stop producing it all together.
Type 1 Diabetes:
Previously referred to as "juvenile diabetes", type 1 is an autoimmune condition in which the body's immune system mistakenly attacks the pancreas, killing off the insulin-producing beta cells. This leads to virtually no production of insulin, requiring the individual to check their own blood sugar levels via finger prick and exogenously deliver insulin (via injections or pump) in order to regulate blood sugar levels and stay alive. This is an extremely difficult and time consuming responsibility and is quite scary for newly diagnosed individuals and their families. It is a full-time job and it will be that way for the rest of their life.
It used to only be children diagnosed with type 1, but now we are seeing older adults in their 30s, 40s and 50s get diagnosed. We are still unsure about what causes type 1 but it seems likely that a combination of genetics and environmental factors like viruses, micronutrient status, exposure to toxins and possibly food sensitivities may play a role. Unlike type 2, type 1 can't be prevented and currently there is no cure. There is a lot of good research being done every day in the auto-immune space and although type 1 often gets left out of those conversations, the hope is that some of the auto-immune protocols being studied will be transferable in type 1 diabetes as well. In the meantime there are definite benefits that can be gained from modifying your dietary intake, paying attention to micronutrient status, reducing inflammation and the overall burden on the immune system. We will get into some of that with Kevin's Q&A next week.
Hopefully this helps clear up any confusion on Type 1 vs Type 2 diabetes. If you or anyone in your life is impacted by this disease, you know just how difficult it is to manage from a physical, mental and emotional standpoint. The individuals that thrive with type 1 are some of the strongest, smartest people and I can't wait to introduce you all to one of them next week in the Q&A. Please feel free to share this article with others if you want to spread the word about Type 1. Next week I'll be asking Kevin about some of the struggles he's faced and how he's overcome them, we will talk about some of the dietary interventions we've experimented with and he will also touch on what he's learned about type 1 and sports/crossfit. If you or anyone you know has any questions for Kevin that you'd like to see answered next week, feel free to comment them below or you can send me a direct email.
Thanks for reading!