Monday, April 19, 2010

I'm back on insulin and I quit the paleo diet.

I'm back...
Sorry everyone for the lack of blogging, but this is probably my last one.

I'm back on insulin and I quit the paleo diet.

My sugars started increasing to the 140s-150s in March and I went back on insulin. The diet really wasn't helping. However, I stayed on the paleo diet for a few days but I couldn't take it anymore and started having dairy, grains, and legumes again.

My opinion is that the diet is too restrictive and is very difficult to follow (100%). You almost have to be obsessed with the food that goes in your mouth. I am very happy to have the freedom of my food choices.

I think the diet did something to my body, probably just put me in a honeymoon phase somehow.

Right now I take 10 units lantus and my I:C ratio is 1:20. I'm seeing my endocrinologist tomorrow. I'm eating much more carbs now, about 150g/day. It's been almost 2 years since I've been diagnosed with type 1 diabetes. Insulin therapy is honestly not that bad, for me the most horrible part about diabetes is knowing that one day I will most likely suffer from the complications of nerve damage, eye damage, heart damage, kidney damage, etc.

After following the crazy yet logical paleo diet, I still believe diet may be one of the many factors involved in TID. I think I've got it in my genes, my paternal grandfather, his sister, and my maternal great great (great?) grandmother were all type 1 diabetics.

Take care everyone, apologies for getting everyone's hopes up and lack of correspondence. On the bright side, I'm graduating this June with my BA in Spanish :) And my sugars are still pretty well under control.

-Michelle

Saturday, January 16, 2010

Still positive autoantibodies and other lab results

I got my labs done in December to share finally. I've been on the paleo diet for one year now and off insulin for six months. The diet is still working great with great blood sugars AS LONG AS I keep my carbs under about 90g/day. I can't eat a limitless amount of carbs. 60g or more of carb/meal will make my aftermeal sugar about 140.

My December A1C is 5.6. It's higher than I would prefer but I think the increase might be due to my dairy incident. I ate cheese for a total of two weeks and made my blood sugar increase for about a month like I said in my previous post. I went to my endo in Dec. and got some lab results about two pancreatic autoantibodies, insulin autoantibodies and GAD autoantibodies, which are still there.

Insulin Ab (U/ml) : Result 22.2 Reference Range 0.0-0.4
Glutam Acid Decarboxylase Ab (IU/ml):
Result >250.0 Reference Range 0.0-5.0

I checked my islet cell autoantibodes a month after going paleo in February 2009 and those actually went away. When I was diagnosed my Islet Cell IgG Ab was slightly elevated at 1-8.
Islet Cell IgG Ab (in Feb.09)
Result <1-4>Reference Range <1-4>

Knowing that I still have autoantibodies attacking my pancreas is quite disappointing. I thought theoretically by eliminating possible dietary triggers (grain, dairy, and legumes) and not needing insulin injections anymore, my body would stop the autoimmune attack (stop producing autoantibodies or decrease them). It really makes me question if the diet is going to keep on working.

There is one more dietary modulation that I could do to see if it helps. According to the Paleo diet, they suggest people with autoimmune diseases, like with Multiple Sclerosis, to avoid eggs and nightshades (tomatoes and peppers). I tried it once for a week and didn’t notice any difference in my blood sugar so I kept them in my diet. I am going to eliminate eggs and nightshades for 3 months and see if that effects my autoantibodies. Here’s a page about dietary treatment for Multiple Sclerosis, another autoimmune disease. http://paleodiet.com/ms/

In three months I am checking ALL pancreatic autoantibodies. Also my C-Peptide is on the very low side of normal. C-Peptide measures if a person can produce insulin.

C-Peptide
Results 0.8ng/ml Reference Range 0.8-3.5ng/ml

When I was diagnosed my C-peptide was low at 0.3 so it’s an improvement and I can produce my own insulin but it’s definitely on the lowest side! To me it says many beta cells are still dead or challenged. I am consuming only around 75-90g of carb per day. The past 5 months I have not regularly exercised. We'll see what happens with time and I will always keep watch on my blood sugar and make sure I am getting adequate nutrients.

Tuesday, December 15, 2009

Update during winter break and more fun literature

It's been a long time, sorry about that everyone! My fall quarter at the University of Cincinnati is finally over! I now have time to write again :) My grain-free, dairy-free, and legume-free diet (paleo diet) is working very well still and my blood sugars are great. Today my sugars were 80mg/dL and 84. I'm still not injecting insulin.

Last month I found out that I can make my diabetes reappear if I add some dairy to my diet (while still eliminating grain and legumes). A couple of days later I had high blood sugar readings of 120-150, the highest ever since going paleo. I quit the dairy and my sugars are back to normal again (70-115).
This makes me truly believe that I have food sensitivities to dairy and as well as grain and legumes which are triggering my autoimmune type 1 diabetes. This week I see my endocrinologist for a new A1C and C-peptide test.

The textbook, Nutrition and Immunology: Principles and Practice, has chapter 26 entitled “Nutritional Modulation of Autoimmune Diseases” which is about dietary triggers and their role in autoimmune diseases. Most of the entire chapter is free on books.google.com.

The text states,“First, food-related antigens might induce hypersensitivity responses leading to autoimmune-related symptoms. Second, nutritional factors might alter inflammatory and immune responses and consequently modulate the course of selected autoimmune diseases (316)." Type 1 diabetes is a delayed hypersensitivity response/reaction. The chapter also explains how food antigens may upset the immune system. “For a response to food to be linked plausibly to a hypersensitivity reaction, food antigens would have to cross the gastrointestinal barrier and circulate in antigenic form until recognized by...cells in the immune system. Although large molecules with antigenic proprieties are known to have very limited access to the circulation, some food antigens do cross the gastrointestinal barrier and circulate not only as food antigens but also as immune complexes." The chapter also talks about future use of dietary therapy to help treat autoimmune diseases. Type 1 diabetes is also discussed in chapter 25, but has a much limited preview on google books. It does have a good picture showing possible food antigens...until next time!



Click on "books" in blue to see full preview.

Thursday, October 29, 2009

Scientific backup for a grain-free, cow's milk-free diet and type 1 diabetes?

Hi Everyone,

As an update, I've been off insulin injections for four months now! My blood sugars are still in the normal range of 70-120md/dL. Today my sugars were 83 and 72 (before meals). I have been on the paleo diet for over nine and a half months. The newsletter, "The Paleo Diet Update," did an excellent report about my type 1 diabetes and the paleo diet which may help explain as to why the diet is helping. For a free subscription to the newsletter, go to http://www.thepaleodiet.com/newsletter. This specific newsletter came from v5, #35 - "Type 1 Diabetes and the Paleo Diet."

Type 1 Diabetes and the Paleo Diet by Pedro Bastos

We believe that the autoimmune disease type 1 diabetes (T1D) may be preventable through diet if caught early enough. This seems reasonable because it typically takes some time for the complete destruction of beta cells, which make and release the hormone insulin that controls the level of glucose in the blood.

The following report from Michelle is very interesting because some type 1 diabetics are "brittle." In other words, the beta cells are completely destroyed and cannot produce insulin. Diabetes becomes apparent when 80-90% of the beta cells have been destroyed.

In Michelle’s case, there may have been sufficient function in some residual cells that were allowed to regain function when the change in diet halted the autoimmune response.

Here's Michelle's experience and you can follow her progress on her blog.

"I'm a type 1 diabetic and have been on the Paleo Diet for 7 months. After weeks of going Paleo, my insulin needs dropped dramatically, and after 6 months, I quit taking insulin altogether!

The Paleo Diet is a miracle for autoimmune type 1 diabetes! I just started a blog about it: http://michellestype1diabetes.blogspot.com/."

Michelle

Dairy and Diabetes

Eliminating dairy, as Michelle did by following the Paleo Diet, may remove potential proteins found in cow’s milk that may be involved in T1D, such as:

Beta (ß)-lactoglobulin (BLG)

BLG is a protein found in the whey portion of cow’s milk (but not in the whey of human’s milk) that has structural homology with the human protein glycodelin, which is responsible for the modulation of T-lymphocytes
1. This means that BLG could generate antibodies to glycodelin, and indirectly lead to autoimmunity in genetically susceptible children1, especially if introduced early in life when there is increased intestinal permeability1, 2.

Bovine insulin (BI)

Cow’s milk, human’s milk, and presumably milk from all mammals contain insulin
2. Immunity to BI is common in children who consume cow’s milk or who have been exposed to infant formulas containing cow’s milk2. Because BI differs from human insulin by only three amino acids, it can generate antibodies against human insulin in genetically susceptible individuals with increased intestinal permeability and other gut dysfunctions2 and/or enteral virus infections in their early years2, 3.

Bovine serum albumin (BSA)

This is another protein in cow’s milk that doesn’t exist in human’s milk. Antibodies against a specific peptide in BSA, called ABBOS, have been found repeatedly in the majority of patients with T1D
4-6. This is relevant because there is molecular mimicry between the peptide ABBOS and a beta-cell surface protein p694, one of the autoantigens attacked by T cells in T1D patients.

Peptide beta (ß)-casomorphin 7 (BCM-7)

BCM-7 results from the breakdown of proteins into peptides and amino acids during digestion of the A1 variant of bovine ß-casein
7. Since this peptide has opiate-like activity7, it could “influence the development of gut-associated immune tolerance, or suppress defence mechanisms towards enteroviruses, both of which have been implicated in the aetiology of diabetes mellitus type 1”7.

Grain and diabetes

By following the Paleo Diet, Michelle also eliminated grains that include gluten (wheat, rye, barley and oats). Gluten is a well-known environmental trigger of another autoimmune disease frequently associated with T1D called celiac disease
8.

There is an interesting report in medical literature of an adolescent, who had abnormal blood glucose and insulin levels, testing positive for islet cell auto-antibodies (a marker of T1D development) and celiac disease. After following a gluten-free diet for 6 months, the adolescent became islet cell auto-antibody negative, and presented normal glycemia (glucose in the blood) and insulinemia (insulin in the blood).
9

It is also known that diabetes progresses faster in rats when gluten is included in their diet early in life
10, 11.

One research study reported that: "Diabetes onset was delayed and diabetes incidence was significantly reduced in female mice that received the wheat and barley protein-free diet throughout life"
12.

Similarly, a gluten-free diet in people with a high risk for T1D led to significant improvements in their insulin response during a glucose tolerance test
13.

The main reason why gluten may be involved in T1D (and other auto-immune diseases), and why celiac disease is normally associated with other autoimmune diseases involves one of the proteins in gluten - gliadin. Gliadin up regulates zonulin
14 (a protein expressed in gut tissue), thereby increasing gut permeability (not only in celiac patients, but also in “normals”)14, which is a very important factor underlying T1D2,15-20.

Other factors involved in increased intestinal permeability

As readers are aware, there are other dietary factors in Neolithic foods that can increase intestinal permeability. This includes lectins (present in legumes and grains), saponins (found in legumes, potatoes, peppers, alfalfa sprouts, root beer, quinoa and amaranth), and alcohol.

Fatty acids, vitamin D and diabetes

In addition to eliminating dairy and gluten, the Paleo Diet may help stop beta cell destruction by correcting the omega-6/omega-3 ratio
21.

We also recommend that people optimize their vitamin D status by getting enough sunlight or with supplements. This may also help to halt beta cell destruction and prevent the development of T1D
22.


Next time, we'll take a look at new research that shows how well the Paleo Diet protects you from disease compared to other diets. We'll also suggest ways to help your kids keep up their great nutrition at school.

References:

1. Goldfarb MF. Relation of time of introduction of cow milk protein to an infant and risk of type-1 diabetes mellitus. J Proteome Res. 2008 May;7(5):2165-7.

2. Vaarala O. Is it dietary insulin? Ann N Y Acad Sci. 2006 Oct;1079:350-9.

3. Mäkelä M, Vaarala O, Hermann R, Salminen K, Vahlberg T, Veijola R, Hyöty H, Knip M, Simell O, Ilonen J. Enteral virus infections in early childhood and an enhanced type 1 diabetes-associated antibody response to dietary insulin. J Autoimmun. 2006 Aug;27(1):54-61. Epub 2006 Jun 6.

4. Karjalainen J, Martin JM, Knip M, Ilonen J, Robinson BH, Savilahti E, Akerblom HK, Dosch HM. A bovine albumin peptide as a possible trigger of insulin-dependent diabetes mellitus. N Engl J Med. 1992 Jul 30;327(5):302-7.

5. Pérez-Bravo F, Oyarzún A, Carrasco E, Albala C, Dorman JS, Santos JL. Duration of breast feeding and bovine serum albumin antibody levels in type 1 diabetes: a case-control study. Pediatr Diabetes. 2003 Dec;4(4):157-61.

6. Banwell B, Bar-Or A, Cheung R, Kennedy J, Krupp LB, Becker DJ, Dosch HM; Wadsworth Pediatric Multiple Sclerosis Study Group. Abnormal T-cell reactivities in childhood inflammatory demyelinating disease and type 1 diabetes. Ann Neurol. 2008 Jan;63(1):98-111.

7. Kaminski S, Cieslinska A, Kostyra E. Polymorphism of bovine beta-casein and its potential effect on human health. J Appl Genet. 2007;48(3):189-98.

8. McGough N, Cummings JH. Coeliac disease: a diverse clinical syndrome caused by intolerance of wheat, barley and rye. Proc Nutr Soc. 2005 Nov;64(4):434-50.

9. Banin P, Perretta R, Ravaioli E, De Sanctis V. Regression of autoimmunity and abnormal glucose homeostasis in an adolescent boy with silent celiac disease. Acta Paediatr 2002;91:1141-3.

10. Hoorfar J, Buschard K, Dagnaes-Hansen F. Prophylactic nutritional modification of the incidence of diabetes in autoimmune non-obese diabetic (NOD) mice. Br J Nutr. 1993 Mar;69(2):597-607.

11. Scott FW. Food-induced type 1 diabetes in the BB rat. Diabetes Metab Rev 1996;12:341-59.

12. Schmid S, Koczwara K, Schwinghammer S, Lampasona V, Ziegler AG, Bonifacio E. Delayed exposure to wheat and barley proteins reduces diabetes incidence in non-obese diabetic mice. Clin Immunol. 2004 Apr;111(1):108-18.

13. Pastore M-R, Bazzigaluppi E, Belloni C, Arcovio C, Bonifacio E, Bosi E. Six months of gluten-free diet do not influence antibody titers, but improve insulin secretion in subjects at high risk for type 1 diabetes. J Clin Endocrinol Metab 2003;88:162-5.

14. Drago S, El Asmar R, Di Pierro M, et al. Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines. Scandinavian journal of gastroenterology 2006;41(4):408-19.

15. Meddings JB, Jarand J, Urbanski SJ, Hardin J, Gall DG. Increased gastrointestinal permeability is an early lesion in the spontaneously diabetic BB rat. Am J Physiol. 1999 Apr;276(4 Pt 1):G951-7.

16. Watts T, Berti I, Sapone A, Gerarduzzi T, Not T, Zielke R, Fasano A. Role of the intestinal tight junction modulator zonulin in the pathogenesis of type I diabetes in BB diabetic-prone rats. Proc Natl Acad Sci U S A. 2005 Feb 22;102(8):2916-21.

17. Neu J, Reverte CM, Mackey AD, Liboni K, Tuhacek-Tenace LM, Hatch M, Li N, Caicedo RA, Schatz DA, Atkinson M. Changes in intestinal morphology and permeability in the biobreeding rat before the onset of type 1 diabetes. J Pediatr Gastroenterol Nutr. 2005 May;40(5):589-95.

18. Sapone A, de Magistris L, Pietzak M, Clemente MG, Tripathi A, Cucca F, Lampis R, Kryszak D, Cartenì M, Generoso M, Iafusco D, Prisco F, Laghi F, Riegler G, Carratu R, Counts D, Fasano A. Zonulin upregulation is associated with increased gut permeability in subjects with type 1 diabetes and their relatives. Diabetes. 2006 May;55(5):1443-9.

19. Bosi E, Molteni L, Radaelli MG, Folini L, Fermo I, Bazzigaluppi E, Piemonti L, Pastore MR, Paroni R. Increased intestinal permeability precedes clinical onset of type 1 diabetes. Diabetologia. 2006 Dec;49(12):2824-7.

20. Vaarala O. Leaking gut in type 1 diabetes. Curr Opin Gastroenterol. 2008 Nov;24(6):701-6.

21. Norris JM, Yin X, Lamb MM, Barriga K, Seifert J, Hoffman M, Orton HD, Barón AE, Clare-Salzler M, Chase HP, Szabo NJ, Erlich H, Eisenbarth GS, Rewers M. Omega-3 polyunsaturated fatty acid intake and islet autoimmunity in children at increased risk for type 1 diabetes. JAMA. 2007 Sep 26;298(12):1420-8.

22. Hypponen E, Laara E, Reunanen A, Jarvelin M-R, Virtanen SM. Intake of vitamin D and risk of type 1 diabetes: a birthcohort study. Lancet 2001;358:1500-3.

Sunday, September 27, 2009

3 months no insulin, time to celebrate with cake!






As a type 1 diabetic, I've been 3 months off of insulin and almost 9 months of going grain-free, dairy-free, and legume-free (paleo). Blood sugars have all been good. I just started my senior year of college!

I found a bread recipe on the blog The SCD girl and her kid. It's a grain free, dairy free, paleo and low carb recipe. I turned it more into a cake by adding some stevia and coconut oil frosting (not pictured). It's very easy to make and is very filling!For the recipe click here: http://scdgirl.blogspot.com/2009/09/kariannes-bread.html

Here's how mine turned out. I can't wait to make it again!



Thursday, September 17, 2009

A1C is 5.4!

My new A1C is 5.4% and I am very happy! An A1C test measures a person's average blood glucose control for the past 2 to 3 months. The normal range for an A1C is 4-6%. My A1C was taken after two months without using insulin.

A few weeks ago I saw my endocrinologist for my type 1 diabetes and she happily knows that I'm not using insulin and she does not want me to go on any medication. I still do blood sugar tests about 4 times a day.

So far I've been grain-free, dairy-free and legume-free for 8 months and it's going great. Considering I used to be a vegetarian, I really enjoy eating meat and fish, along with veggies, big salads, fruits, nuts, and eggs! For a dairy alternative I use almond milk or coconut milk.

As for the A1C, it's lower than what I thought it would be. I thought it was going to be in the upper fives not middle fives! My sugars have been really good still (70-120mg/dL) and the next A1C will be in December. I appreciate all the comments, questions, and emails!

Thanks,
Michelle

Saturday, August 29, 2009

Happy and healthy with no insulin injections for 2 months!

The past two months without requiring insulin injections has been quite incredible. I traveled this summer to San Francisco and Chicago without needing any insulin supplies.
I have had no hyperglycemia nor hypoglycemia since taking no insulin. My lowest reading was 68mg/dL and highest was 126mg/dL. My fasting blood sugars range from 70-100mg/dL. My after meal blood sugars are usually around 100mg/dL. Unlike when I was on insulin injections, I now have no fear of falling into a coma due to hypoglycemia nor do I have to make mathematical calculations or stick a needle in me whenever I eat (ouch!).

I feel treating my type 1 diabetes with the paleo diet is far superior than injecting drugs in myself because the paleo diet takes away dietary triggers that may play a role in the autoimmune disease process. Secondly, I would rather not take drugs just so that I could eat food that I couldn't properly digest anyway and most likely cause me another autoimmune disease!

Here's an article about a recent study linking type 1 diabetes to wheat.
http://www.sciencedaily.com/releases/2009/08/090820124038.htm

For the actual study and commentaries:
http://diabetes.diabetesjournals.org/content/58/8/1789.abstract
http://diabetes.diabetesjournals.org/content/58/8/1723.extract

So far I've been paleo (grain-free, dairy-free, legume-free) for almost 8 months. Next blog will have a new A1C. Thanks for reading!