‘Oh look mum, it’s diabetes on the table!’, a friend exclaimed, remembering her kids’ response to a particularly sugar laden spread she served one day.
She forgot herself a moment, then realised I was the mum of a child with type 1 diabetes. Ironically, my kid could never eat a spread like that.
In my teens a friend’s grandmother had type 1 diabetes. I really didn’t know much about type 1 at the time and nothing about what it involved. Fascinated, I watched her as she pricked her fingers using the blood to test her blood sugars. I recall that she sometimes left gatherings early when she hadn’t felt well. At the time I didn’t know what it was about but remember she was judged for not managing her condition properly and accused of playing for sympathy.
Years later. My personal story took a turn when my own son was diagnosed at age 4 with type 1 diabetes. I had much to learn. After appearing ill, we took him to an emergency room where he was quickly diagnosed and pulled back from a near death situation. My husband and I hadn’t known the symptoms of diabetes, but luckily a hunch made us feel that perhaps it was more than just a tummy bug.
Public opinion hasn’t improved since 30 years ago, in fact it may have gotten worse. Largely this has been affected by the rise of type 2 from the 90’s onwards and lack of understanding around the cause, pathway and the difference between type 1 and type 2. Today I see judgments towards my child’s diabetes. Blame for the condition, misunderstandings around treatment, assumptions around dietary habits, and continued advice on how to cure type 1 ensue
There’s a lot of public confusion about diabetes. I often hear diabetes generalised with statements like – if they stopped shoving carbs into their faces they wouldn’t have diabetes in the first place!. I agree with healthy eating, in fact as a Naturopath and Medicinal Herbalist I have always placed high importance on feeding my kids healthy food. Regardless of diet, my very active child was diagnosed with type 1.
The treatment itself can bring on condemnation. I remember a time when I administered insulin to my child at a cafe. An old lady observing us, glared and immediately crossed the room. How could you! She accused. Whatever had she been thinking?…giving my child the insulin he needs to stay alive brought on condemnation.
But what exactly is type 1 diabetes?
Different to type 2, type 1 is rare – occurring in less than 5% of all diabetes sufferers. Type 1 (diabetes mellitus) is considered the original diabetes. Type 1, once considered a death sentence, was revolutionised with the introduction of insulin therapy – literally bringing patients back from the point of death. Prior to insulin a patient would simply waste away until they died of severe malnutrition.
Isn’t that quite different to the popular assumption that diabetes is related to obesity and lifestyle?. Absolutely! Type 1 is known as the skinny disease and the reason for this is due a type 1 sufferer being unable to absorb blood sugars which are needed for all bodily processes. Unlike most of us, type 1’s can’t produce their own insulin, ….even type 2’s can do that.
If I give an apple to my son without insulin instead of being able to use the goodness from the apple, his blood sugars will spike and lead to toxicity. He will remain hungry as the body isn’t able to use the energy the apple provides. It’s as good as throwing the apple on the ground in terms of providing sustenance.
Even the pathway to type 1 and 2 are quite different. Type 2 has been on the rise since the 90’s alongside a rapid change in the western diet with more processed, fast foods, trans fats, added sugar, preservatives and additives. Systems being overloaded. For this reason Type 2 is often associated with poor food choices and poor lifestyle habits but this is not always the case. Being overweight doesn’t equate to having any form of diabetes at all. You can be overweight without being diabetic and being overweight isn’t the only type 2 body type. Slim type 2’s are definitely also a thing. The pathway to type 2 is more likened to having a pump (pancreas) in a house (the body) which isn’t able to keep up with demands placed on it (water flow or food intake), Sometimes the demand actually happens to be fairly normal – but its the pancreas itself that’s inefficient.
Type 1 on the other hand is like having no pancreas at all.
The pancreas normally produces insulin of which insulin is necessary for metabolising sugars. Type 1 is caused by the autoimmune system attacking and killing insulin producing cells within the pancreas. These cells are called Beta Cells. Once the beta cells are killed the pancreas is no longer able to produce insulin.
But what does insulin do?
Insulin unlocks cells within our body to allow blood sugars to enter and be metabolised for all energy requirements to fuel all bodily processes.
If diet isn’t the cause of type 1, what is?
There are many triggers to the autoimmune response. Genetic disposition is the basis, and from this starting point there are secondary triggers which can include toxins, vaccines, trauma, additives, alloxan in white flour, or illnesses like a virus. It’s like a house being wired and something triggers the switch to turn type 1 on.
Diet is not considered the pathway to type 1 diabetes, however a controlled diet helps to better manage blood sugar levels alongside insulin therapy, but diet in itself is not a cure.
Low carb or no carb is great but let’s say a person with type 1 never ate again, blood sugar levels would actually continue to rise. The reason is gluconeogenesis which is a process that converts macronutrients within the liver. This process plays a huge part in the keto diet.
When a non type 1 diabetic fasts, carbohydrates by process of gluconeogenesis (glucose-new-creation) are transformed into blood sugars via the liver, when no carbs are present fats are digested or proteins if no fats are present. If a person doesn’t include fat and protein in a keto diet, the liver will metabolise fats and proteins from tissues of the body which is why weight loss occurs. For this reason, the keto diet is known to promote eating fats and proteins for it to be sustainable, while eating almost no carbohydrates to bring you into a state of ketosis. Ketosis is the term used where the bodily tissues are being metabolised.
In the case of a type 1 diabetes, during fasting or eating rapid weight loss occurs when no insulin is administered. Blood sugars will also increasingly spike to a deadly level. This process is called Diabetic KetoAcidosis. Prolonged DKA causes knock on health issues and without insulin a type 1 can take as little as a few days to die.
Diets such as keto, low carb, carnivores, whole foods or plant based diets can help, but they are unfortunately not the answer to a type 1 becoming free from the need for insulin. Although these diets have had great results for type 2’s, helping greatly to reduce pressure on an inefficient pancreas and to improve overall health.
Type 1 diabetes management has changed a great deal. At the time of my friend’s grandmother type 1 management was much harder. This involved finger pricks, and insulin needles, prior to this there was just paper urine strips to indicate a general spike in blood sugars. Today we have the help of modern technology in the form of continuous glucose monitors and insulin pumps. Without this it’s something like over 200 life risking decisions a sufferer must make per day alongside 63 factors to consider when calculating insulin and carb intake. But the management of type 1 always surrounds keeping blood sugars balanced and this is a constantly moving target so it’s important to get it right. A serious low can lead to seizure, coma or death, a serious high can lead to damaged tissues, nerves and organs or death. Roller coaster levels also lead to damage.
Herbal medicine and supplements are often mentioned as the source of a potential cure. I’m a medicinal herbalist and I’m all for natural health, but unless the herb mimics human insulin, reverses the autoimmune response, regrows beta cells or all of the above it will not replace the need for insulin. Insulin equates to life.
The take home is that there needs to be greater awareness surrounding type 1. This lack of awareness puts type 1’s at risk and adds stress. Confusion between type 1 and 2 is driving a growing concern that there needs to be a name change to clearly define each distinct condition.
Stigma surrounding diabetes is not only unfair, its dangerous.
There is a diagnostic need to not generalise. Type 1 itself does not discriminate – it can occur in any gender, race, at any age from birth all the way to old age, and with any lifestyle. If the assumption continues to be that diabetes is caused by a sedentary life with poor food choices then otherwise healthy people would be less likely to consider this in themselves. As with my family, we always ate healthy food and had an active lifestyle. Not once did we think that my son had type 1 diabetes. We only picked up on type 1 due to a lucky hunch, that we should take my son to the hospital rather than home to bed.
Sadly many people in New Zealand still loose their life due to undiagnosed type 1 diabetes. Increased awareness will bring a greater chance of recognising symptoms before fatality occurs.
The signs and symptoms of type 1 diabetes include constant eating, constant hunger, constant thirst, constant urination and weight loss. Primary care for type 1 is insulin, monitoring of blood sugars alongside a healthy diet and exercise. Learn the signs and symptoms so you can save a life.
If I were to meet my friend’s grandmother again I would give her a hug and tell her I understand. Please next time you meet someone with type 1, don’t judge, instead realise that type 1 is a hard, hard condition. You really don’t know what it is like to have t1 until you walk in these shoes…but I hope you never do.
