According to the CDC, 37.3 million people have diabetes in the US. The CDC further estimates that another 8.5 million people have undiagnosed diabetes. Of these cases, 5-10% of people with diabetes have Type 1.
In both the conventional and functional medicine worlds, more attention goes to Type 2 Diabetes because of its widespread and ever-increasing cases. However, with the prevalence and incidence of Type 1 increasing worldwide, this article will focus on this lesser-known form of diabetes and how functional medicine treats it.
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What is Type 1 Diabetes
Type 1 Diabetes (T1D) is an autoimmune condition where the immune system attacks pancreatic cells, called beta cells. This damage significantly reduces or completely inhibits the ability of the pancreas to produce insulin. Without insulin, it becomes impossible for glucose to get into the cell and produce energy.
T1D is commonly called "juvenile diabetes" because it typically develops at a younger age. However, onset can occur at any age. Though much research has been done, there is yet to be a cure for T1D.
The Role of Insulin
- The pancreas puts insulin into the bloodstream.
- Insulin travels through the body, allowing sugar to enter the cells.
- Insulin lowers the amount of sugar in the bloodstream.
- As the blood sugar level drops, the pancreas puts less insulin into the bloodstream.
If you have Type 1 Diabetes, your glucose levels will continue to rise after you eat because there's not enough insulin to move the glucose into your body's cells.
Type 1 Diabetes Signs & Symptoms
Since uncontrolled blood sugar is a factor in both Type 1 and Type 2 Diabetes, many symptoms will be similar.
- Increased urinary frequency
- Increased thirst
- Increased hunger
- Weight loss without trying
- Blurry vision
- Fatigue or weakness
- Dry skin
- Numbness or tingling in hands or feet
- Slow wound healing
- Recurrent infections
Type 1 Diabetes will differ from Type 2 in that people may also experience nausea, vomiting, or abdominal pain. Recurring yeast infections, or candidiasis, are also more likely to occur.
Since T1D frequently occurs in children, symptoms can be challenging to notice. This may look like bedwetting, changes in appetite, changes in behavior more severe than regular mood changes, or diaper rashes that won't go away.
Symptoms of T1D may take several months and even years to develop. Because of this severity and overlap with other conditions, it is vital to have your blood sugar levels checked by a doctor regularly.
Functional Medicine Labs for Type 1 Diabetes Patients
Blood Sugar
To diagnose T1D, testing blood sugar is an essential component. Doctors typically run the following labs:
- HbA1c- This test gives a good estimate of the blood sugar over three months. When levels are 6.5% and higher, it indicates diabetes.
- Fasting Blood Sugar- After an overnight fast, glucose levels in the blood should be 99mg/dL or lower. Diabetes occurs when fasting blood sugar levels are 126mg/dL and higher.
- Glucose Tolerance Test- Blood sugar is tested while fasting, the patient then consumes a sugary drink, and then blood sugar is tested again after a specific time. Blood sugar is then checked at the 1-hour and 2-hour mark. After 2 hours, levels should be 140mg/dL or lower. When levels are 200mg/dL or higher, diabetes is indicated.
From a functional standpoint, blood glucose is only one chapter in the whole metabolic book. Getting an idea of the rest of the systems-based story is helpful, especially since the goal should be more than just managing blood sugar.
Insulin Resistance
Even though people with T1D are insulin-dependent, they may still develop a resistance to insulin. This is where diving deeper into insulin resistance offers valuable clues:
- Fasting insulin- Increased levels here potentially indicate involvement in the growing problem of "double diabetes", where it is estimated that 50% of those with TID are also insulin resistant like those with Type 2 Diabetes.
- HOMA-IR- This is a mathematical score generated from fasting glucose and fasting insulin levels. A study using this test showed clear evidence of the association between insulin resistance and progression to TID.
While testing blood sugar (glucose) levels is the most immediate and distinguishing for Type 1 Diabetes, there is more to understand about how this autoimmune process affects the body.
Gut Health
Gut dysbiosis is not only associated with an increased risk of T1D but also contributes to disease progression. Leaky gut also has numerous connections to autoimmune processes, including T1D. Therefore, assessing the microbiome and leaky gut brings a greater picture into view.
Conventional Treatment for Type 1 Diabetes
The focus of conventional treatment is solely on controlling blood sugar. To control blood sugar, close monitoring is key. Thus, traditional treatment hinges on:
- Taking insulin
- Monitoring blood glucose levels
Insulin
Since the beta cells of the pancreas are no longer producing insulin, those with T1D must get it from an external source. Since insulin only manages blood sugar and does not cure, it is a lifelong therapy. Due to the acid and enzymes of the GI tract, insulin is not an oral medication. Therefore, the administration of insulin is by injection or insulin pump.
Monitoring Blood Glucose Levels
The goal for most diabetics is to keep their blood sugar between 80 and 130mg/dL during the day. After meals, it shouldn't rise above 180mg/dL for two hours. Everyone has their own rhythm, but the Mayo Clinic recommends Type 1 Diabetics measure blood sugar levels before meals and snacks, before bed, and before exercise or exertion. Of course, there are numerous influences on blood sugar, and it is advisable to check it when there is a feeling of low blood sugar.
Functional Medicine Treatment for Type 1 Diabetes
Nutrition
Even though Type 1 Diabetics require insulin, diet can significantly impact the dose and frequency needed. The right type and amount of carbohydrates vary for each person. But the attention shouldn't be on carbs alone. The right fats, proteins, and nutrients are also part of the equation. Working with a functional medicine practitioner or nutritionist specializing in type 1 diabetes can find a solution that works best for each person.
While there is not one superior diet for diabetes, there are two factors to focus on when designing a food plan: controlling blood sugar and targeting inflammation. Generally, small, more frequent meals are recommended to keep the blood sugar stable.
A study found the Mediterranean-style diet may improve glycemic control and cardiovascular health. This way of eating focuses on fiber and diversity of phytonutrients which have been shown to help lower inflammation and control blood sugar spikes.
Herbs and Supplements
- Vitamin D- Not only do studies suggest a link between vitamin D deficiency and T1D, but supplementing with vitamin D is a proven strategy when addressing autoimmune conditions.
- Magnesium Oxide- This mineral is a cofactor in metabolizing vitamin D and has been found to help control blood sugar.
- Alpha Lipoic Acid- A powerful antioxidant, ALA can prevent diabetic neuropathy and supports the cell's ability to take in glucose.
- Spices- Adding turmeric may positively affect the issues involved with diabetes as well as prevent further complications.
Lifestyle Changes
- Get moving- Whether it is walking, strength training, or HIIT workouts, the American Diabetes Association recommends regular exercise and maintaining muscle mass to support healthy blood sugar levels.
- Be still- With daily attention to tracking blood sugar and the multitude of other stressors that come with type 1 diabetes, taking time to meditate can reduce the inflammation caused by stress.
Summary
It is known that genetics and environmental triggers set off an autoimmune cascade. The same is true for T1D. A functional medicine approach to T1D focuses on nutrition, gut health, and stress reduction to help reduce the need for insulin.
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