[Muffie's Mom]

A Word About Type 1 Diabetes Mellitus

Type 1 Diabetes or Juvenile Diabetes is a very different condition from type 2 diabetes. Type 1 diabetes is the main type of diabetes found in people under the age of 30 years old and accounts for around 10% of all cases of diabetes in the United States.

In this form of diabetes, special cells in the pancreas that are responsible for producing insulin become damaged by cells of the immune system. It's believed that in people who are genetically prone to developing type 1 diabetes, either a viral infection or exposure to milk proteins at a young age causes the immune system to attack and kill these special cells.

Without insulin, the cells of the body cannot absorb sugar, leading to high levels of blood sugar. Unlike type 2 diabetes, however, these patients have very low or no levels of insulin in their bodies and therefore need to take insulin starting at a young age in order to live. This form of diabetes causes kidney failure, blindness, and diabetic coma much more often than type 2 diabetes does. While some type 2 diabetes patients are given insulin to try to help with blood sugar control, it is still a different condition from type 1 diabetes.

Causes

Although genetics play some role in type 2 diabetes, as it does tend to run in families, the most important causes of type 2 diabetes are diet and lifestyle. Approximately 90% of diabetic patients are obese, making extra pounds a significant risk factor for diabetes development.

It's not known exactly how obesity contributes to poor insulin production or binding, but weight reduction has been shown to have great effects on blood sugar control. Even people who lose a moderate amount of weight find that their blood sugar levels are much lower and easier to maintain.

Another very important risk factor is lack of exercise. Studies have shown that even mild amounts of regular exercising, like walking a few times a week, can make body cells and insulin bind better to reduce blood sugar levels. Exercise is also a vital part of any weight loss program. People who may have atherosclerosis or heart disease should see a doctor before starting an exercise program.

Recent research has suggested that type 2 diabetes development may begin years before it can be diagnosed. Warning signs such as hypoglycemia or mild insulin resistance may be early indications of a problem with blood sugar control. If these signs are ignored, they body may eventually progress to a state of full-blown type 2 diabetes.

This means that the prevention of type 2 diabetes should start early, possibly in childhood as more and more young adults are winding up with this condition every day. Fortunately, it may be much easier to prevent type 2 diabetes than one would think. Maintaining a sensible weight, getting regular amounts of physical activity, and following a healthy diet can really reduce your risk of developing type 2 diabetes in the future.

Dietary Causes

A poor diet is probably the most important cause of type 2 diabetes. Studies of the eating habits of different populations have revealed that diets high in fat (especially animal fat), animal protein, refined sugars, processed carbohydrates, and trans fatty acids, and low in fiber and complex carbohydrates are associated with a greatly increased risk of type 2 diabetes. This translates to a diet high in meat, dairy, margarine, refined vegetable oils, white flour products, and sugar. Unfortunately, this is the diet commonly consumed by people in the United States, also known as the Standard American Diet (appropriately abbreviated as "SAD").

Refined grains and the foods made from them (e.g., white breads, cookies, pastries, pasta and rice) are now being linked not only to weight gain but to increased risk of insulin resistance (the precursor of type 2 diabetes) and the metabolic syndrome (a strong predictor of both type 2 diabetes and cardiovascular disease), while eating more wholegrain foods is being shown to protect against all these ills. Common features of the metabolic syndrome include visceral obesity (the “apple shaped” body), low levels of protective HDL cholesterol, high triglycerides, and high blood pressure.

In one of the most recent studies, which appeared in the February 2004 issue of Diabetes Care, researchers who analyzed data on 2,834 participants in the Framingham Offspring Study, found that the prevalence of both insulin resistance and the metabolic syndrome was significantly lower among those eating the most cereal fiber from whole grains compared to those eating the least.

Prevalence of the metabolic syndrome was 38% lower among those with the highest intake of fiber from whole grains. Conversely, study subjects whose diets had the highest glycemic index and glycemic load, both of which are typically low in whole foods and high in processed refined foods, were 141% more likely to have the metabolic syndrome compared to those whose diets had the lowest glycemic index and glycemic load. In other words, compared to those whose diets were primarily composed of whole high fiber foods: whole grains, legumes, vegetables and fruits.

Red meat may also contribute to an increased risk of type 2 diabetes. Researchers at the Harvard School of Public Health, Boston, US, have found that a person’s intake of heme iron intake from red meat, but not from non-red meat sources, is associated with an increased risk of developing type 2 diabetes.

Why the link? Iron is a transitional metal that can catalyze the formation of free radicals called hydroxyl radicals that are implicated in diabetes. Previous studies have indicated an association between serum ferritin concentrations (a biomarker of the body’s iron stores) and insulin resistance. Other studies that have compared serum ferritin levels between meat eaters and vegetarians have shown that vegetarians have lower serum ferritin levels and are more insulin sensitive. However, it has been thought that these differences could be due to other components of diet or lifestyle, and it has also been suggested that donating blood reduces iron stores and might therefore influence diabetes sensitivity.

This study factored in these possibilities and still found that only iron from red meat was associated with an increased risk of type 2 diabetes. For 12 years, researchers followed 38,394 men aged 40 to 75 years, who were participants in the Health Professionals Follow-up Study. All were free of diabetes, cardiovascular disease, and cancer when the study began. All filled in dietary questionnaires, and 33,541 provided a history of blood donation. When all the data was in, results showed that heme iron, which is found in animal products, was associated with a risk of type 2 diabetes, but total iron intake and blood donation were not related. Absorption of heme iron is more complete than non-heme iron, which is found in plants and dietary supplements.

The research team then subdivided the men’s heme iron intake into heme iron derived from red meat and that from other sources. Diabetes risk increased with heme iron intake from red meat, but not with heme iron intake from other sources, such as chicken or fish. Their conclusion: Heme-iron intake from red meat sources is positively associated with the risk of type 2 diabetes. Total iron intake, heme-iron intake from non-red meat sources, and blood donations are not related to the risk of type 2 diabetes. Since the hydroxyl radicals whose formation is catalyzed by heme-iron from red meat have also been linked to cardiovascular disease, enjoying red meat less frequently and choosing chicken, fish or vegetarian sources of protein (e.g., beans, nuts and seeds, eggs, and low fat dairy products) as your dietary staples is recommended.

Diets high in fruits and vegetables, whole grains, legumes, olive oil, and fish are strongly associated with a reduced risk of developing type 2 diabetes.

This diet can also help with blood sugar control for people who already have diabetes. In addition, consumption of foods rich in nutrients, particularly omega-3 fatty acids, vitamin E, vitamin C, magnesium, zinc, chromium, vitamin D, vitamin B12, and folic acid, can help reduce risk of the long-term consequences such as heart disease.