Type 1 Diabetes

Type 1 diabetes is characterised by the destruction of the insulin producing beta cells in the pancreas. Therefore someone with type 1 diabetes will always require an external source of insulin (unless medical technology can create new insulin producing cells and protect them from the same fate as the original cells).

Most often, type 1 diabetes is an autoimmune disease in which the immune system mistakenly targets proteins displayed on the beta cells. Many people carry immune system genes that make them susceptible to this autoimmune disease but most do not develop type 1 diabetes. Who gets it depends on exposure to environmental factors and a bit of bad luck. The consumption of cow’s milk has a strong association with type 1 diabetes. A proposed mechanism is that “foreign” cow’s milk proteins provoke the production of antibodies that are also a close match for a beta cell protein, and indeed there is a 17 amino acid sequence that is found in both. There is also a strong association between autoimmune diseases in general and eating a rich Western diet versus a plant based diet. Whilst there is nothing gained by ruminating over what caused type 1 diabetes in individuals who already have it, it is important to consider how the disease might be prevented, particularly in siblings and children who may share the same genetic risks as these individuals.

Most people eating the high fat, protein rich Western diet will develop atherosclerosis which may manifest as heart disease, stroke and peripheral vascular disease. People with diabetes are at even greater risk than the general population, particularly if the diabetes is not well controlled. In the past, well-meaning health professionals have advised to eat less carbohydrates and more fats and animal products, further increasing heart risk. These high fat, high protein diets also promote kidney disease and weight gain.

The same low fat plant-based diet that improves insulin sensitivity in type 2 diabetes can reduce insulin needs in type 1 diabetes.

A low fat high carbohydrate plant-based diet may make it easier to balance food intake with insulin needs. Carbohydrate content makes up most of the calories and the energy density of different starchy foods in their cooked, hydrated state is similar. Therefore the size of the meal will be a reasonable guide to its carbohydrate content. The PCRM plate and the McDougall starch-based plate are both mixes of vegetables and high starch grains, legumes and root vegetables. The low energy density of these foods means portions can be generous and between meal snacks can be included without causing weight gain.

The glycaemic index (GI) can be used to further refine the choice of carbohydrates. Low GI choices may help stabilise blood glucose levels. Use the GI to choose between different whole plant foods and avoid processed foods that use GI for marketing.

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