MarksDailyApple is one of my favorite blogs for diet and health topics, but I don't know if I remember Type 1 Diabetes ever being discussed as a main topic. Here it is.
I'm practicing many of the things that are mentioned as helpful for T1Ds. I think sleep is a factor that I didn't think mattered too much, but when I started sleeping the right amount, my insulin resistance really fell off.
I feel that his comments on the gluten free are bordering on dangerous (while there are two or three reports of diabetes going into remission with gluten free diets, there are also a zillion people out there who were diagnosed with diabetes after they'd already been eating gluten free for celiac that had been diagnosed years earlier! and other conditions also cause diabetes that goes into remission when treated, very occasionally- even hypothyroidism has).
ReplyDeleteFurthermore, every study on celiac diagnosed after type 1 diabetes has showed that the average A1c stayed roughly the same or increased significantly after adoption of a gluten free diet, presumably because the people's guts healed enough for their digestion to improve. Markers like reduced antibody levels mean a lot less in type 1 diabetes than it does for autoimmune diseases like lupus.
As for the studies on type 1 diabetes and a low carb diet- I don't think any of them has had an adequate control group, where the appropriate control/comparison would be giving patients an education in, say, carb counting, rather than low carb. I think the actual awareness and paying attention to the diabetes might matter a lot. The carb counting study that guy quotes as if it was about low carb wasn't; it was about teaching people how to measure their carbs to use for an I:C. And the A1c in that group did drop in a statistically significant way, but it was just barely statistically significant- looking at the graph in the study, I'm not impressed (12 weeks in the control and study group fell about the same amount, and at the 24 week mark the control group had gone back up, which suggests to me that if they had kept studying them longer they'd find the groups randomly moving closer and further apart).
I think it's also worth noticing that in the studies, it's meal time insulin that goes down a lot, not total insulin as implied by that guy's article. The bolus needs shift to basal needs, by and large; they don't disappear.
And I also think it's worth pointing out that in none of the low carb studies on type 1 diabetics do the A1cs fall into the nondiabetic range.
All of the dietary intervention studies to prevent type 1 diabetes- and that includes a couple of studies with supplementing vitamin D- have failed to show any statistically significant difference in terms of rates of developing type 1 diabetes.
While breastfeeding is a great thing, the studies on that topic haven't been as straightforward as I'd like. More than one study hasn't found any link, or found that breastfeeding was protective to some degree only if certain other criteria were met... individual studies showed big links that other studies haven't backed up.
Also, while it's certainly true that certain countries have higher type 1 diabetes risks and that the overall pattern has something to do with distance to the equator, that's definitely not the whole story. Different areas with the same distance to the equator have orders of magnitude of difference in their T1D rates.