Type-1 Diabetes

Part 2: Living healthily with Type-1 diabetes

The medical profession generally regards type-1 diabetes is incurable. It is managed conventionally with a low-fat, carbohydrate-based diet. As such a diet inevitably puts large amounts of glucose in the bloodstream, daily insulin injections have to be administered to bring these high levels down to normal. This means walking a tightrope for life, as exactly the right amount of insulin must be given or it will either reduce glucose levels too much or not enough.

But the human body rarely produces no insulin at all. At diagnosis of type-1 diabetes, some 5% to 15% of the pancreas's beta cells are usually still producing insulin. If these are relieved of the burden of continually reducing excessive levels of glucose, this helps to preserve beta cell function and they can often produce sufficient insulin for the variety of other metabolic processes that need it, without supplementation with injected insulin.

Until recently, the only hope of reversing the disease seemed to be replacement of beta cells by transplantation. However, a team from the University of California in Los Angeles showed that most people with long-standing type-1 diabetes — in some cases as long as 60 years — still had detectable insulin-producing beta cells in their pancreas.[1]

They also showed that most people with long-standing type-1 diabetes have beta cells that continue to be destroyed. For this to happen, new beta cells must be forming. Regeneration of beta-cells could also be possible if they are not taxed by high carb intake during a longer time period, in which case type-1 diabetes may be reversed.

One of the mechanisms underlying this increased beta cell death involves glucose toxicity. Thus, merely reducing carbohydrate intake, particularly from fruit and cereals, may be all that is required to cure the condition, or at least reduce the symptoms of type-1 diabetes from a serious health hazard to a mere annoyance. And, even if it is still necessary to inject insulin, the amount needed can be reduced substantially.

By cutting right down on your carb intake, and increasing your animal fat intake to make up for the shortfall of calories, you can change your body from depending on glucose for energy, to using fats and ketone bodies instead. They require very little insulin.

There is no way I can know whether or not your pancreas is still producing insulin. If it isn't then you will still have to inject — but at least eating this way, you won't have to inject anywhere near as much. However, if your pancreas is still making some insulin, even a small amount, then by eating this way you may be able to stop injecting altogether.

But either way, reducing your carb intake will halt the neuropathy and prevent you suffering any more of the complications of diabetes. So you can't lose.

Once your body is used to getting its energy from fats and ketone bodies, it will make what glucose it needs from the breakdown of stored fats (triglycerides). You don't have to eat any.

Hypos

One of the worries is that in cutting down on carbs, you might suffer a hypo. But a hypo is caused by too much insulin, NOT by insufficient carb intake. The answer is not to eat more carbs once it has happened, but to reduce your insulin so that it doesn't happen in the first place. That said, you can still carry sweets to be on the safe side until you get used to eating this way.

Method

Using the advice for type-2s on this website, this way of eating is entirely healthy for a type-1. However you do need to take some precautions when making the change from your current diet.

Firstly, TAKE IT SLOWLY. Reduce your current carb intake slowly over a few weeks. For example, if you eat 4 slices of bread a day now, cut that to 3, then 2 then 1 than none. You need to cut your carb intake to no more than about 30 grams a day. You will do yourself no harm by eating only 30 grams of carbs a day, or even less, for the rest of your life, but do take it easy during the changeover period.

IMPORTANT

You MUST reduce your insulin dose as you reduce your carb intake to compensate for the lower levels of glucose in your blood or you risk a hypo.

The way to do this is to lower both carbs and insulin simultaneously in small amounts over several weeks. And monitor yourself so that you know what is going on. Once you get used to the effects of foods, you can stop this. If you do experience a hypo, then by all means counter it as you would now. However, note that a hypo means you are injecting too much insulin.

Remember, if you only make small changes, you can only make small mistakes.

Reference

1. Meier JJ, Bhushan A, Butler AE, et al. Sustained beta cell apoptosis in patients with long-standing type 1 diabetes: indirect evidence for islet regeneration? Diabetologia 2005; 48: 2221-8.