Is T1 diabetes preventable?

What if your beta cells are still degenerating, but have not (yet) degenerated so much that they can't cope with your current very low carb diet?

Sorry. I want you to be right. Just playing devils advocate.

Hi, for me , no I don't think it was avoidable. What I ate had nothing to do with being diagnosed type 1. Very active and 8 1/2 stone and I ate a healthy varied diet. Diagnosis happened when my ex husband left, the shock, worry and the stressful situation took it's toll on my body, At first, I had suspected Colitis for the first few months, then the classic symptoms, ended up in hospital and the rest is history. Nothing I could do about that

RRB

Interesting thought, I wonder if there is an element of possibility in the case of adults who are diagnosed with T2 then rediagnosed that they have T1? In my case I have no doubt it wasn't avoidable, I was only 6/7 at the time and very tiny, I remember losing even more weight extremely quickly, thirsty, going to the loo a lot and becoming very unwell quickly. I know some people talk about a honeymoon period but I'm certain I didn't have one, if anything I needed more insulin over a very short timescale from diagnosis, and this continued over the next few years until insulin levels were achieved where my BG levels stabilized.

It wasn't food or diet that caused my T1 as a kid either. My family has a history of auto-immune problems, although no diabetes, and mine was kicked off by the flu, which lasted two weeks when I was 11/12.

I think you're confusing being diagnosed with actually having t1.
Even if you ate low carb your whole life, you'd still have t1 (ie your beta cells would still be degenerating) but your bg may be in a normal range due to a low level of insulin requirement (thanks to low carb). So you'd probably be diagnosed much later on - but you'd still had diabetes before that.

Summarising, its not preventable (that we know of), but the rise in bg can, in some late onset cases, be delayed. This doesn't mean the disease can be delayed - just its implications.

If my pump blocks and my supply of insulin is therefore stopped my levels can go up to the 20's within 40 minutes.....from a level of 4.6.....

I was diagnosed T1 young too.

Can I ask if original poster actually had the blood tests to check and confirm the T1 or whether it was just a diagnosis given without the c peptide, gad tests etc....

If you were ever a T1 you are the first ever person I have known to have it reversed...

Quite donnellysdogs. T1 is not known for reversal, principally because your body has generated antibodies that attack your beta cells rather than your beta cells simply degenerating due to insulin resistance and resulting overproduction. Reversing destroyed cells would be very difficult...

There seems to be a possible link between wheat and diabetes. Not only coeliac disease but wheat as such.

NoCrbs4Me said:

If your type 1 was simply a progression from type 2, then I think maybe (heavy emphasis on the "maybe"!!!) it could have been prevented. I am only thinking this because I read somewhere that type 2 may progress to type 1 because the high blood glucose kills beta cells (Link: http://www.phlaunt.com/diabetes/14045678.php). So, beta cell death by high blood glucose would be stopped if the blood glucose levels are under control. On the other hand, if your beta cells were being killed off due to an autoimmune problem, then there's nothing that have could stopped that. I hope that makes sense.

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Isn't that Insulin Dependent Type 2 though? You still haven't had an Autoimmune response that has casued your body to attack your beta cells, so it is still "avoidable" type 2 rather than Type 1.

Ian DP said:

I agree..... But since I have been able to maintain normal BG levels (under 5 before breakfast and under 6 2hrs after eating) I can not detect any further deterioration of my beta cells, which kind of says to me that my beta cells destruct with high blood sugar levels and that keeping low BG levels stops then destructing..... It's only a temporary thing, as I know they will start destructing again some time soon, when my BG levels rise. My point being, it would seem to me that even though I am autoimmune, low blood sugars stop the degeneration of beta cells. And that therefore low blood sugars would surely stop / delay the onset of autoimmune.

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The counter argument to this is that Type 1 diabetics that are diagnosed young and move on to insulin seem to still lose their beta cells, although there is obviously no clear data about blood sugars and degeneration in the popular domain. Having said that, my own experience was that I remained on a honeymoon like regime for three years post diagnosis, until I had nothing left. Would eating no carbs at the time have reduced the impact? Maybe. Did I need the extra insulin? Definitely.

It may be that the mechanisms that cause Type 1, Type 2 and LADA are not the same (we know this is the case for T1 and T2) and as such, it may be possible to reduce the speed of onset of LADA with diet. I think significantly more research would be needed.

It takes time for all the beta cells to be destroyed quite a long time, even with young onset T1. Forty or fifty years later many T1s still have a few around but nowhere near enough.
When you are diagnosed you have already lost a great deal of your beta cell function.(see diagram below)
How much depends on where in the process that you are diagnosed. They know that there is a pre diabetes period even in children. The autoimmune response causes the bodies own immune system to kill off the beta cells as if they are invaders. Glucose levels rise and there is a period, longer or shorter (depending on how quickly the destructive process ) during which there is too much glucose in the blood This results in glucotoxicity which may itself kill off cells or at least stop them functioning properly. If relative insulin levels are very low (relative because you need more insulin with higher glucose levels) then people start losing weight through the breakdown of fats. When there is a lot of fat in the bloodstream it may causes insulin resistance preventing glucose getting into the cells; everything gets worse signalling a crises, normally DKA.

Get rid of the glucose and lipotoxicity by injecting insulin and there may be enough cells to cope for a while . Normally it's called the honeymoon and can even in young people can last for quite a long time.
Before insulin by using the 'starvation' diet children could last a year or so, some longer but they all eventually died , mostly from going into a diabetic coma. Older adults lasted longer, about seven years In pre insulin days people wouldn't probably have been diagnosed until the condition was quite critical, not everyone today is diagnosed that late .

Sadly, once killed, even if we do regenerate a few cells and the juries out on if that is even possible after the age of about 30, it is very few. Even in non diabetics, the number of cells reduces through aging as cells die off and are not replaced.
Here are two slides : the first diagrams the comparative numbers of beta cells left functioning at diagnosis in T2, LADA and T1 compared with a normally functioning pancreas (Global Diabetes Course, Copenhagen University)
The second is a diagram from the Faustman lab modelling the progressive loss of insulin production in T1 over 40+ years. It's worth stressing that even at the beginning there are only very small amounts of insulin produced. It is only recently that there has been an assay good enough to detect tiny amounts, before people would say that the T1s tested to produce this model were C peptide negative.

But.... My experience over the last few months makes me think differently. In that I am 100% sure that if I had been on a LCHF diet 2 years ago I would not be diabetic now.

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You have my sympathies, but there is a reason scientists bother with large studies - because one case study is completely irrelevant.

Diagnosed T2 in sept 2013 then T1 in the honeymoon period in December 2013 aged 58 with a BMI of 22, I have gradually reduced my carb intake and upped my fat intake, until 5 months ago I started following Dr Bernstein's diabetic solution, taking no insulin or medication.

Over the last 5 months my blood sugar levels have been very consistent around 5.0 pre breakfast and under 6.0 2hrs after meals, with no sign of any deterioration at all.

This indicates (to me) that my insulin making beta cells are no longer degenerating. Thus I have my Auto immune system under control..... No longer (at the current time) is there any indication that any of my beta cells are degenerating. I am no worse now than 5 months ago (same diet, same weight).

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That is incorrect - if beta cells were holding static, you'd be lying in hospital in same state you were first diagnosed in. For you to have better BG than when you were diagnosed, you're beta cells would have to a have improved.

Which is of course exactly what you'd expect from a t1 diabetic going through honeymoon, but don't let that stop you from sending this case study to Stockholm - I'm sure you'll have your Nobel price in medicine by Christmas.

If you are still insulin-free in 5years, then we might have something to to talk about.

Ian, I see you are down as Type 1 ( LADA ) since Dec 2013, so that, surely is not the same as a 'type 1'

I keep reading the posts and as I have mentioned in the past, diabetes seems to have mutated over the past few years, with so many, if's, what's and maybe's
Regarding the 'honeymoon' period, which I never knew of until reading about it on the forum, I can say, honestly and truthfully that I never had this' honeymoon period' I was 31 when diagnosed ( 1989) and straight onto Insulin in hospital. Of course the amount of Insulin a newly diagnosed would need, would alter slightly, depending on exercise, type of work, sports, stress etc.
For the future's newly diagnosed diabetic in 10,20,30 years time. that is any ones guess on what treatment and medication is needed, if any
I still say I could not have stopped my diagnosis of type 1 or 'delayed' it.

RRB

RRB, I tend to concur with you. We seem to have three different strains of diabetes. Type 1, Type 1.5 and Type 2. What they have in common is that they mean we have limited ability to manage blood glucose on our own. The mechanisms by which these conditions are triggered seem to differ and while there may be commonalities, I wouldn't be surprised to find out that actually they are really different conditions. But we aren't there yet.

In the meantime, I don't believe that running on a low carb diet my whole life would have stopped the onset of my diabetes either.

re those pesky Inuits. They don't seem to get LADA.(they get T2) They quite probably don't have the genetic predisposition for it. A group of Inuits who were DNA tested were found to have a unique pattern of HLA alleles unlike those in the rest of Canada and the world (it is variations in these genes, concerned with the immune system that are associated with both T1 and LADA. People with ancestors from the UK and in Scandinavia have a higher probability of carrying these gene variations than most of the rest of the world )
The Inuits do though have their own particular gene variations which presumably fit their particular environmental niche. One that is very common , quite surprisingly reduces their ability to manufacture ketones They can make some but a reduced amount They would therefore be very much less likely to be able to develop DKA(increased infant mortality though , children suffer from impaired fasting tolerance and overnight hypoglycaemia can be fatal. )
I doubt though that any of us have many Inuit ancestors.