Digestive Wellness: Strengthen the Immune System and Prevent Disease Through Healthy Digestion, Fourth Edition (97 page)

Irritability (in children mainly)

Skin tags

Slow healing of sores

Weight loss

If you have diabetes, a hemoglobin A1c (HmgA1c; also called glycosylated hemoglobin) test is a simple way to monitor your blood sugar levels. It gives a three-month average of the sugar levels on the outside of red blood cells. Imagine a gum drop.
Recall that it has sugar crystals on the outside of it. Imagine that your red blood cells look like gum drops. The more sugar crystals they have on the outside, the more damaging those crystals are inside a person’s blood vessels, heart, eyes, and kidneys and the greater risk of long-term health issues relating to the diabetes. Healthy levels of HmgA1c are less than 7 percent of total hemoglobin. Keeping levels as low as possible helps prevent damage throughout the body.

Uncontrolled diabetes of either type can lead to serious complications later in life. High blood glucose level is the most significant risk factor for developing heart and vascular disease, and diabetes is the leading cause of kidney failure and adult blindness. Careful blood sugar control is essential for preventing these and other complications, including nerve problems and gum disease.

Type 1 diabetes is considered to be an autoimmune disorder. It is typically diagnosed in children and young adults. Five to 10 percent of people with diabetes have type 1 diabetes. Type 1 diabetes, which used to be called juvenile diabetes, is more specifically termed insulin-dependent diabetes mellitus (IDDM). Diagnosed in about 13,000 children in the United States each year, its onset is usually sudden and can occur at any time during childhood. People with type 1 diabetes require injections to replace the insulin that their bodies can no longer make. Children with type 1 diabetes are usually thin, and they may complain of thirst. Type 1 diabetes is often triggered by an infection, typically a virus. The body’s immune system mounts an attack on the infection and also mistakenly attacks and destroys the insulin-secreting beta cells in the pancreas. Allergy to milk has also been implicated as a possible trigger for diabetes.

New Ideas About Underlying Causes of Type 1 Diabetes.
Accumulating research findings suggest that the gut immune system plays an important role in type 1 diabetes. Like all autoimmune diseases, there is a growing consensus in research indicating that people with type 1 diabetes have increased intestinal permeability (leaky gut) and dairy allergy, gluten intolerance, or celiac disease. Alessio Fasano, M.D., medical director at the Center for Celiac Research at University of Maryland School of Medicine, and his research group believe that intestinal permeability is a necessary ingredient for the development of autoimmune conditions, along with genetic and environmental factors. Outi Vaarala and her group report that a disordered gut microbiota contributes to the development of type 1 diabetes. High levels of zonulin have been found in people with type 1 diabetes. Zonulin is a protein that contributes
to leaky gut by opening up the tight junctions between cells. Zonulin levels can increase on exposure to specific foods and bacteria. Animal study shows that if zonulin is blocked, destruction of the pancreatic beta cells can be prevented.

There is a small but important crossover in people with type 1 diabetes and celiac disease. A study of 141 children with type 1 diabetes, for example, found elevated antigliaden antibodies in more than 8 percent and found celiac disease in almost 3 percent, which is 10 times the average incidence. Pyira Narula reported a 3.3 percent incidence of celiac disease in children with type 1 diabetes. Another study of 331 children with type 1 diabetes from 1987 through 2004 reported 6.6 percent of the children had celiac disease as well (determined by elevated tTg levels and confirmed with biopsy). Interestingly, the incidence of celiac in these children rose from 3.3 percent in 1994 to 10.6 percent in 2004. One has to ask the question, what specifically has changed in this decade? Two things pop into my mind: increased vaccination requirements and the introduction of large amounts of genetically engineered corn, soy, cottonseed, and canola oil to our food supply.

A considerable amount of research has shown a link between infant allergy to cow’s milk and development of type 1 diabetes. In a similar vein, an epidemiological study in 40 countries found that the incidence of type 1 diabetes in children was highest in the countries with the highest consumption of dairy and other animal foods. In children who develop both celiac disease and type 1 diabetes, celiac disease often precedes or develops at the same time as the diabetes. (See sections on autoimmune disease and celiac disease in
Chapter 14
for a more complete analysis of the gut-autoimmune connection.)

Children eating a mainly vegetarian diet had a lowered incidence of type 2 diabetes. This needs to be explored more fully to determine what components of a vegetarian diet helped to protect these children. What can be supposed is that vegetarian diets have a higher level of polyphenols and fiber which both have protective properties.

Food Sensitivity and Diabetes.
Looking for food sensitivities and allergies may help stabilize the blood sugar levels and reduce the need for medications in people with type 1 diabetes. A recent study done by Russell M. Jaffe, M.D., Ph.D., and colleagues looked at the role of diet and food intolerance in 26 adults with type 1 diabetes. The control group ate their regular diabetic diet and followed their usual lifestyle program. The test group ate a dairy-free diet, removed any additional foods that showed antibody reactions, and were given specific nutritional supplements. After six months, the test group showed significantly greater improvement in blood glucose
levels and hemoglobin A1c than the control group. Clinical nutritionist Jayashree Mani reports that by working with an allergen-free and alkalizing diet, she was able to lower blood glucose levels in a type 1 diabetic teenage boy from 350 to 125 mmol/l, while also reducing his insulin needs by more than a third.

Type 2 diabetes, which used to be called adult diabetes, is more specifically termed non-insulin-dependent diabetes mellitus (NIDDM). Type 2 diabetes occurs mainly in adults older than 45 and constitutes 90 to 95 percent of all diabetes cases. Type 2 diabetes was virtually unknown in children 30 years ago, but it is on the rise. In some Native American communities, it occurs in 45 percent of children. In children, it is first diagnosed between the ages of 10 and 19 years, and the hormonal changes around puberty seem to be an important trigger. Between 45 percent and 80 percent of children with type 2 diabetes have a parent with diabetes. Children with type 2 diabetes are commonly overweight but typically have no other symptoms until they are diagnosed.

Type 2 Diabetes Is Largely Preventable.
Type 2 diabetes at first appears to be a disorder of overly elevated blood glucose (blood sugar) levels. Yet for most people with type 2 diabetes, disordered glucose levels are just the end of a long road that led to diabetes in the first place. Type 2 diabetes is often the result of lifestyle choices. In other words, we “earn” it. It’s often termed “a feast in the middle of a famine” because your blood has excessive amounts of glucose (the feast) while your cells starve for the sugar they desperately need to produce energy. If left unchecked, high insulin levels affect our kidneys, eyes, and heart and are linked to fatty liver, nerve damage, brain compromise, gastroparesis or dumping syndrome, maldigestion and malabsorption, sexual dysfunction, and problems with the genitourinary system, such as polycystic ovary disease.

Eating a low-nutrient, highly refined diet; eating a diet low in antioxidants and polyphenols and fiber; obesity; lack of exercise; and lack of sleep all help us build to a point where our metabolism begins showing signs of metabolic syndrome: weight gain around the middle (apple shape or beer belly), low serum HDL cholesterol levels with high LDL cholesterol levels, high insulin levels, rising blood pressure, and/or rising triglycerides. In metabolic syndrome, also called Syndrome X, we don’t have the right cellular conditions to properly use glucose. Our pancreas responds by making more insulin to get the glucose into the cells. This is called insulin resistance, which leads to more weight gain and even more insulin resistance in a vicious
circle. Eventually we cannot overcome this by just producing more insulin, and our blood sugar levels skyrocket. This condition is diabetes. Often we have decades of warning signs before we are diagnosed with diabetes. We can stop metabolic syndrome by changing our lives, and in most cases we can prevent diabetes.

Eating a low-glycemic diet, getting plenty of exercise, and having the right nutrients can turn type 2 diabetes and metabolic syndrome around.

A third type of diabetes is called gestational diabetes. It occurs only during pregnancy and typically resolves once the baby is born. This affects about 4 percent of all pregnant women. It’s important that these women be closely monitored during pregnancy for the safety of the mom and baby. Babies born of women who developed gestational diabetes are more likely to develop type 2 diabetes later in life.

There are three other types of diabetes that have been more recently codified.

Latent autoimmune diabetes of the adult (LADA) happens in people who are not obese but have antibodies to insulin. They typically have signs of metabolic syndrome, so if monitored they can prevent diabetes decades earlier.