Type 1 Diabetes: Early Exposure to Cow's Milk Protein

[Guest guest]

Type 1 Diabetes

 

Type 1 diabetes (T1D) or insulin-dependent diabetes is a classic

example of a multifactorial disease. What this term reflects is that

many factors appear to contribute to its development.

 

Ultimately the insulin producing cells of the pancreas are

destroyed in most cases by the body's own immune system, but what

triggers this destruction is related more to " dietary " and

environmental factors than " genetics " .

 

Basic facts of type 1 diabetes

 

The result of damage of the beta-cells of the pancreas that produce

insulin

Dependence upon daily insulin injections to maintain blood sugar

control

 

Accounts for somewhere between 5 to 10 percent of all cases of

diabetes in the United States

 

Peak incidence occurs during puberty, around 10 to 12 years of age

in girls and 12 to 14 years of age in boys.

 

There is a higher incidence of T1D in Caucasians than in other

racial groups.

 

I find it interesting that most medical texts, diabetes

organizations, and doctors tend to consider T1D primarily as a

genetic disorder. The point that I want to make is that dietary and

other environmental factors are the chief factors that ultimately

determine if the disease will develop.

 

The entire set of genetic factors linked to T1D have been

termed 'susceptibility genes' as they are neither necessary nor

sufficient for disease to develop.

 

Just like a parched forest may be predisposed to a forest fire, if

there is a big rain, or no match or spark, then there is no fire.

But, if there is something that ignites the fire it may burn out of

control.

 

Here is a statistic that is very important to consider: less than

10% of those with increased genetic susceptibility for T1D actually

develop the disease.

 

Additional evidence

 

If you are still not convinced that dietary and environmental

factors are the areas that we need to focus on with prevention,

consider the following:

 

If developing T1D were governed only by genes, then every time one

identical twin developed diabetes, the other should develop it, too.

 

In other words, the " concordance rate " should be near 100%.

However, the concordance rate for developing T1D in identical twins

is only 23% to 38%. If one twin develops T1D after age 24 years,

then the concordance rates drops all the way down to 6%.

 

There has been a three to tenfold increase in the number of people

with T1D throughout the world over the last 40 years or so. Such a

rise is simply cannot be explained by an increased number of people

genetically predisposed to T1D. Changes to the human genetic code

across large populations take more than one generation.

 

The rate of T1D can increase dramatically when children in areas

where T1D is relatively rare move to developed countries. For

example the rate of T1D increased by nearly 4-fold in one ten-year

period in children of Asian origin moving to Great Britain and the

rate increased over 7-fold when Polynesians migrating to New

Zealand.

 

It is ridiculous to think that genetic factors could explain such a

rapid change.

 

Factors that increase the risk for type 1 diabetes

 

Most of the recent information indicates that the function of the

gut immune system is central in the development in type 1 diabetes.

 

The lack of breast-feeding is strongly implicated as it is a very

important factor in establishing proper gut immune function.

 

The key dietary factors that have received the most attention are

early exposure to cow's milk proteins and intolerance to gluten (a

protein in grains).

 

These dietary factors can trigger the formation of antibodies that

can destroy the insulin-producing beta-cells in the pancreas.

 

One of the most important determinants of gut immune function is the

intestinal microflora. In researching the scientific literature I am

shocked that I could not find a single research study that has tried

to determine the status of the intestinal microflora in type 1

diabetics.

 

Gut bacteria, especially the Bifidobacteria, are very

important in protecting against infections due to enterovirus,

coxsackievirus, and rotavirus - common causes of intestinal

infection especially in children.

 

All of these viruses replicate in

the gut and cause stimulation of the gut immune system that may

activate the autoimmune process in T1D.

 

These viruses and others are

also capable of infecting pancreatic beta cells causing the white

blood cells to attack them.

 

Vitamin D protects against type 1 diabetes

 

There is emerging evidence that vitamin D supplementation during

early childhood can prevent type 1 diabetes. One study found that

the use of cod liver oil during pregnancy significantly reduced the

frequency of type 1 diabetes in their children.

In the most

extensive of studies, all pregnant women in northern Finland who

were due to give birth in 1966 were enrolled (over 12,000 women) and

their children were monitored until December 1997. Final analysis

demonstrated that children who regularly took vitamin D had an 80%

reduced risk of developing type 1 diabetes while those that had

vitamin deficiency actually had a 300% increased risk of developing

the disease.

 

Avoid Nitrates

 

Another causative factor explaining the rise in the rate of T1D is

the parallel increased levels of nitrate from dietary sources and

water. Nitrates are produced by agricultural run-off from

fertilizers as well as found in cured or smoked meats such as ham,

hot dogs, bacon, and jerky to keep the food from spoiling. Nitrates

react within the body to form compounds known as nitrosamines.

Nitrates and nitrosamines are known to cause diabetes in animals.

Infants and young children are believed to be particularly

vulnerable to the harmful effects of nitrate exposure.

 

One of the most alarming features of type 1 diabetes is the fact

that is becoming much more prevalent with a current growth rate of

3% per year worldwide. Some areas are hit particularly hard, such as

Finland, Great Britain, Canada, and the United States. Increased

nitrate exposure may be a key factor as the nitrate levels in ground

and surface waters of agricultural regions have increased over the

past 40 years as a result of increases in the use of nitrogen

fertilizers. Nitrate contamination occurs in geographic patterns

related to the amount of nitrogen contributed by fertilizers,

manure, and airborne sources, such as automobile and industrial

emissions

 

Final Comment

 

Although genetics plays a role in virtually all chronic diseases

like diabetes, cancer, and heart disease, they generally play second

fiddle to dietary, lifestyle, and environmental factors.

 

Disease and

good health are not pre-ordained in most cases, but rather a result

of making the right choices.

 

 

 

Key References:

 

Kelly MA, Mijovic CH, Barnett AH. Genetics of type 1 diabetes. Best

Pract Res Clin Endocrinol Metab 2001;15:279-91.

Knip M, Akerblom HK. Environmental factors in the pathogenesis of

type 1 diabetes mellitus. Exp Clin Endocrinol Diabetes 1999;107

(Suppl 3):S93-100.

Redondo MJ, Yu L, Hawa M, et al. Heterogeneity of Type I diabetes:

analysis of mono-zygotic twins in Great Britain and the United

States. Diabetologia 2001;44:354-62.

Hypponen E, Kenward MG, Virtanen SM, et al. Infant feeding, early

weight gain, and risk of type 1 diabetes. Childhood Diabetes in

Finland (DiMe) Study Group. Diabetes Care 1999;22:1961-5.

The EURODIAB Substudy 2 Study Group. Vitamin D supplement in early

childhood and risk for Type I (insulin-dependent) diabetes mellitus.

Diabetologia 1999;42:51-54.

Stene LC, Ulriksen J, Magnus P, Joner G. Use of cod liver oil during

pregnancy associated with lower risk of Type 1 diabetes in the

offspring. Diabetologia 2000;43:1093-1098.

 

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