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.

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-lymphocytes1. 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 insulin2. 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 T1D4-6. 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-casein7. 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 disease8. 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 life10, 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 test13. 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 zonulin14 (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 ratio21. 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 T1D22. 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.

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!

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

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!

Type 1 Diabetes and the Paleo Diet... My Alternative Treatment to Insulin Injections

What is type 1 diabetes?

Type 1 diabetes occurs when the own body's immune system attacks the cells of the pancreas that create the hormone insulin. Without the hormone insulin, bodily cells cannot take up the sugar in blood from food and results in high blood sugar. To correct the high blood sugars, type 1 diabetics inject insulin and count carbohydrates to adequately maintain normal blood sugar. Insulin therapy is not a cure nor does it treat the initial cause of the disease.

The initial cause of autoimmune type 1 diabetes is not fully understood, but it is believed to be influenced by genetics and the environment. Studies show early consumption of cow's milk and certain cereal grain have been linked to a greater likelihood of developing the disease, as well as certain viruses. Type 1 diabetes is mainly found in developed countries and is related to other autoimmune diseases such as Celiac disease (a wheat gluten intolerance) and hypothyroidism.

As a type 1 diabetic, why do I eat a grain-free, dairy-free, and legume-free diet (paleo diet)?

I choose the paleo diet because it is known for treating autoimmune diseases and because of the many studies that indicate that type 1 diabetes is caused by environmental triggers so I figured that certain dietary antigens could play a role, such as the case of Celiac disease. I stayed on the paleo diet because my insulin needs kept dropping and dropping and because my bloating and constant hunger went away.

The Paleo diet is based upon eating foods that humans evolved to eat from the Paleolithic era (2,500,000 years ago) up to the advent of agriculture (10,000 years ago). The diet includes:

• Fruits
• Vegetables
• Nuts
• Seeds
• Seafood
• Lean meats
• Eggs

Sources:
http://diabetes.diabetesjournals.org/content/54/suppl_2/S125.abstract
http://www.sciencedaily.com/releases/2008/12/081210180841.htm

Diet resources:
http://www.healingcrow.com/dietsmain/paleo/paleo.html

Intro to my blog

Hi, I'm Michelle from Cincinnati, Ohio. I'm a Spanish major graduating in 2010. Nutrition, health, and science have always interested me. I like traveling, reading and listening to music.

On May 16, 2008 I was diagnosed with type 1 diabetes at age 20. I had all the classic symptoms of thirst and weight loss, tested positive for all the autoantibodies and had an AlC of 14%.

On January 8, 2009 I eliminated grain, dairy, and legumes from my diet and the results have been remarkable. Only after a few weeks my insulin needs dropped dramatically and after six months on the diet I quit taking insulin altogether.

I am writing this blog because I want other type 1 diabetics to know about the benefits of the diet. It's helped me and I believe it could help others. I will be posting about my progress on the diet, lab results (such as AlC's, autoantibodies, C-peptide), research studies and articles about type 1 diabetes, and recipes.

Feel free to leave comments and questions or reach me by email at michellestype1@gmail.com

Thanks,

Michelle