Link between dairy and type 1

[elaine77]

Hi smidge,

I'm LADA but I'm the opposite. My fasting is uncontrollable (7-8 mmol regardless of what I eat or dont eat) but my PP are controllable (5-8 mmol) with Metformin..... I wouldn't feel too bad about going onto a base insulin to help with my fasting overnight levels it weren't for the fact I'd have to declare it everywhere. At the moment that would cause too many problems. If u only had to declare insulin-dependence rather than insulin usage I guess i might feel a bit different about it....

I still don't understand how insulin would really help me though as my immune system will keep killing the cells whether I inject or not? My levels rarely ever reach danger levels where they will die and also, type 2 diabetics can become insulin dependent due to their cells dying but that usually takes years and years so surely it must take a really prolonged period of highs for the cells to die of their own accord? I asked my GP about this and they couldn't answer me? So I'm still confused about insulin preserving the beta cells when the immune system is the one killing them? I don't have insulin antibodies just GAD.....?


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.

 

[smidge]

Hi Elaine!

I think the questions you ask re: how insulin can help preserve something that is being killed by an autoimmune reaction are very valid. It is known that in children with Type 1, the beta cells are all but destroyed within weeks of Type 1 triggering. However, in adults with LADA that isn't the case. We also know that out of 3 GAD tests for example, the antibodies might only be present once. I guess this means that our beta-cells are not under constant attack, but that something triggers an attack under certain conditions - but that is just a guess on my part, I have never seen any sensible/plausible description of how that happens.

We do know that high BGs are toxic to beta-cells, so we need to avoid that. We also know that overworking our pancreas can burn out the remaining beta cells and that as our ability to produce insulin reduces, the pancreas is having to work ever-harder. We know that both these things happen in Type 2s so it stands to reason that it happens to LADAs too. From my point of view, I see insulin as a way of avoiding the high BGs that cause the death of my beta cells and giving my pancreas a break so it doesn't work so hard causing burn-out. I have no idea if this works, but I am more than prepared to use insulin in the hope that it does! My reasoning is two-fold:

1. Having some functioning beta-cells helps control (I don't know if this is true, but it is what I've read in several articles)
2. If they find a cure for diabetes, the chances are that they might be able to prevent further damage but not reverse the existing damage - and I want to give myself the best chance of having some beta-cells left when that 'cure' comes.

I'm not sure if that sounds a bit daft, but I'd rather take it early in the hope it works than leave it later and wish I'd taken it earlier if you see what I mean.

There are some downsides to taking insulin of course. Telling the DVLA and having your license restricted to 3 years is the biggest! However, in your position, you would probably only need a few units of intermediate at bedtime to get that fasting level down as the metformin is working for you at the moment to stop the PP spikes. On low doses of Insuman basal I had no hypos at all and it really didn't impact on my life as I took it 10.00pm when I was at home usually anyway. The bolus is a bigger impact as I have to take it with each meal. Only you can decide what's right for you, but in your situation I would certainly consider it.

Take care
Smidge

 

[phoenix]

What Smidge says is in plain English what one of the papers I linked to said (apart from the final explanation which is beyond me, one to ask an endocrinologist to explain)

It seems somehow paradoxical to initiate early insulin treatment in LADA, since this disease is characterized by lack of insulin requirement at onset. The rationale for early insulin therapy though would be to improve glycemic control while protecting β-cells. The exact mechanisms for the apparent beneficial effects of insulin treatment are yet to be fully understood, but it is thought that administration of exogenous insulin would allow β-cells to rest and decrease insulitis at least by decreasing their metabolism and by relieving hyperglycemic stress.[16,33] It is also suggested that active β-cells, producing high amounts of insulin, are more susceptible to immune destruction, and therefore rest to β-cells could preserve them longer. Also, as insulin itself is an autoantigen, immunization with exogenous insulin is thought to initiate an immune modulation possibly by tolerance induction or “bystander” suppression of autoreactive T-cells through release of regulatory cytokines

Smidge also said:

I guess this means that our beta-cells are not under constant attack, but that something triggers an attack under certain conditions - but that is just a guess on my part, I have never seen any sensible/plausible description of how that happens.

The trial paper above shows quite clearly in one of the figures (I think it was fig 1) that the destruction of the beta cells wasn't a steady downward slope but rather one where there was some loss of function, some regain and then some more loss. That certainly fits the pattern I think that I followed in the 3 years before diagnosis(symptoms that came and then seemed to resolve) I think this up and down continued for some time after going onto insulin , probably less so now but it is 11 years since I first experienced weight loss, thirst etc.

 

[elaine77]

Thanks smidge... I have a question and its going to sound ridiculous lol but because it happens with other 'things' I just want to see what your opinion is on it.

My grandad, who is no longer with us, was terribly old fashioned (fought in 2nd world war) and he was against 'enabling' as he put it lol. He always use to tell me that if you make things easier for something it gets lazy and dependent! So he would say...if I inject insulin (when im not insulin dependent of course) it will make my pancreas/cells lazy or dependent on the injected insulin quicker.... It's kind of like when my sister was little she had a lazy eye so the optician patched up her good eye to force her lazy one to do some work! Lol or if you take painkillers every time you have a headache you will have to keep taking painkillers every time u get a headache because you will become dependent on it and won't be able to handle the headaches!

I know it's ridiculous but I just thought I would put it out there! Lol


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.

 

[mo1905]

Thanks smidge... I have a question and its going to sound ridiculous lol but because it happens with other 'things' I just want to see what your opinion is on it.

My grandad, who is no longer with us, was terribly old fashioned (fought in 2nd world war) and he was against 'enabling' as he put it lol. He always use to tell me that if you make things easier for something it gets lazy and dependent! So he would say...if I inject insulin (when im not insulin dependent of course) it will make my pancreas/cells lazy or dependent on the injected insulin quicker.... It's kind of like when my sister was little she had a lazy eye so the optician patched up her good eye to force her lazy one to do some work! Lol or if you take painkillers every time you have a headache you will have to keep taking painkillers every time u get a headache because you will become dependent on it and won't be able to handle the headaches!

I know it's ridiculous but I just thought I would put it out there! Lol


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.

I sort of understand what your Grandad was getting at here and it does make sense in regard to some anti-biotics for example. However, there are certain conditions this would not apply to. If I was asthmatic and short of breath, I would use an inhaler. If I had angina and were having an attack, I would take my nitro tab. If I were allergic to nuts and started going into shock, I would use my epinephrine pen. So, certain conditions give you no real choice without suffering or worse.
There is no real evidence to suggest taking small amounts of insulin will delay dependancy but most doctors ( not all ) suggest it may help. I'll take that gamble until told otherwise. As with everything though, it's personal choice.

 

[phoenix]

Sorry posted and changed my mind,

 

[smidge]

Hi Elaine!

I know exactly what your Grandad meant and what he said makes sense for many things - e.g. exercise and muscles, walking and flexibility in the elderly etc etc - a sort of 'use it or lose it' theory, but I don't think it applies to beta cells. I've read a lot about LADA, diabetes and beta cells over the last 4 years, but I haven't seen a single article that supports the idea that beta cells are killed by under-use - some say it makes no difference and others say that giving them a break and taking the stress off them by using insulin is helpful. In fact, many articles indicate that overworking them by using insulin-stimulating drugs like Gliclazide speed up the progression of the condition. Again,although I am persuaded by that argument, I haven't seen any real evidence quoted. I have seen articles stating that early insulin therapy in LADA slows progression, articles that state it makes no difference, but I have never seen anything that indicates early adoption of insulin causes any negative impact on the condition.

I often wonder why doctors are reluctant to put LADA patients straight onto insulin at diagnosis on the basis that it might do some good and is unlikely to do harm. I've come to the conclusion that most doctors are more used to dealing with Type 2 where there are often factors such as weight, insulin resistance and excess insulin already in the bloodstream to consider, so insulin therapy is a last resort and they then apply this to LADA patients as well when most of us do not have those factors that indicate against insulin therapy. That's just my thoughts on it, though.

In the end, you can only think through the options and make a decision that you are comfortable with.

Smidge

 

[mo1905]

Sorry posted and changed my mind,

Well that's got me intrigued lol ! Sometimes, less is more I guess ;-)


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[Sunshine_Kisses]

Sorry posted and changed my mind,

Well that's got me intrigued lol ! Sometimes, less is more I guess ;-)


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Me too!! C'mon Phoenix, spill the (low carb) beans! ;-)

 

[Sunshine_Kisses]

Some really, really interesting replies here from Smidge & Phoenix, thanks so much guys... I seriously think some of us on here know way more than the doctors! Definitely some of you know more than my GP who outright said 'I've no idea what GAD antibodies are so can't help you' - which was reassuring... ;-)

One thing you said Smidge:

It is known that in children with Type 1, the beta cells are all but destroyed within weeks of Type 1 triggering. However, in adults with LADA that isn't the case. We also know that out of 3 GAD tests for example, the antibodies might only be present once. I guess this means that our beta-cells are not under constant attack, but that something triggers an attack under certain conditions - but that is just a guess on my part, I have never seen any sensible/plausible description of how that happens.

To me, this just adds to the weight that the something that triggers an attack under certain conditions could very well be something that we're eating...?

I'm not saying it definitely is that - but surely it's worth cutting out dairy if there's a suspected association between the antibodies and dairy consumption, which can mysteriously cause our GAD antibodies to flare up too...? It may seem overly simplistic, but has to be worth a shot in my book...

... She says cautiously, as currently don't exactly know *what* I'm dealing with after ridiculous convo's with GP and Endo secretaries yesterday - posted about it in my original GAD thread but all very distressing... :-(

 

[catherinecherub]

Hi,

Have you read Dan Hurley's book, Diabetes Rising?

He has 5 hypotheses as to why diabetes is rising.
Too much pollution.
Too much cow's milk.
Growing too big too fast.
Not enough sunshine.
Too clean.
http://health.usnews.com/health-news/fa ... n-the-rise
http://diabetes.diabetesjournals.org/co ... /3353.full

 

[elaine77]

I've read about the lack of sunshine!!!! I wonder if diabetes is higher in colder countries and lower in hotter ones? Defo read somewhere that lack of vit D from the sun is thought to be a potential trigger though....


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 23 currently controlled by only Metformin, 500mg twice a day.

 

[Sunshine_Kisses]

Catherine, I haven't read it, but looks supremely interesting so will defo look into it, thank you!!

I've also read about the vit D deficiency - though in my case I think it's more likely to be dairy as I've been supplementing Vit D at pretty high levels for about 18months now after discovering my levels were on the low side... But who knows, could easily be a combination of factors - which is why I'm happy to throw anything at it..!

 

[Sunshine_Kisses]

I've read about the lack of sunshine!!!! I wonder if diabetes is higher in colder countries and lower in hotter ones?

Elaine, I don't know about the vit D vs type 1 and less sunny countries association, but I do know that there's a lower incidence of type 1 in counties that don't eat dairy, and higher incidence of type 1 in countries that do...

 

[smidge]

Hi Sunshine!

Sorry, I've only just remembered this thread, so I've come back to your points a little late. I have read several theories about what triggers LADA. Of the food theories, wheat or gluten is the most commonly accused intolerance. I am prepared to believe there is something in these theories, but I think I am more persuaded by the theory that a virus closely resembles the beta cells, and in attacking the virus, the body is fooled into attacking its own beta cells too. To me, this would also explain why you seem to get outbreaks of LADA in geographical areas at certain times and then it dies down for a while. I guess no-one really knows at the moment so we all just latch onto what seems to make sense to us.

Smidge

 

[Sunshine_Kisses]

Hmmm... Interesting stuff, thanks Smidge - I didn't know there were geographical outbreaks...

 

[Anonymous]

I can't have dairy. If 1.5 is autoimmune it would make sense some of us will have Ibs issues or other conditions where our turns against us.


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