Type 1 diabetes mellitus is considered incurable. Nevertheless, there are many options and natural remedies that improve the quality of life in type 1 diabetes. The goals are: facilitate blood sugar control, avoid ketoacidosis and hypoglycemia, prevent consequential damage and increase overall well-being and performance.
Type 1 diabetes mellitus manifests as an autoimmune condition.
Type 1 diabetes mellitus (or type 1 diabetes) is a chronic metabolic disease that belongs to the autoimmune diseases. This means that due to a malfunction of the immune system, it suddenly attacks and destroys the insulin-producing cells in the pancreas. These cells are called islet cells or islets of Langerhans (after their discoverer Paul Langerhans). They are called islets because they are distributed in an insular manner in the tissue of the pancreas.
However, there are different islet cells. In type 1 diabetes, only the beta cells are attacked by the immune system. They produce insulin. The alpha cells, on the other hand, produce a different hormone (glucagon) and usually remain intact.
Type 1 diabetes often begins in childhood or adolescence, but can also develop later. Type 1 diabetics have an absolute lack of insulin because their pancreas can produce less and less insulin and ultimately no insulin at all as a result of the autoimmune processes mentioned above.
Insulin is a hormone that is needed to transport blood sugar (glucose) from the blood into the cells, where the sugar can be used for energy.
If insulin is missing, the cells remain closed. They do not allow glucose to enter and cannot gain energy. At the same time, however, more and more glucose accumulates in the blood. Blood sugar levels rise, which has a detrimental effect on blood vessels and is responsible for the complications of diabetes (kidney, eye and nerve damage).
People with type 1 diabetes need to monitor their blood glucose levels closely and inject themselves with insulin according to their needs. When insulin was not available, type 1 diabetes was almost always a fatal disease.
How to recognize type 1 diabetes: the symptoms
If you recognize type 1 diabetes by its typical symptoms, around 80 percent of your pancreas has already been destroyed, so the disease is already advanced:
- great thirst
- frequent urge to urinate
- Tiredness, lethargy
- Visual impairment
- sudden weight loss
- Bad breath of acetone (reminiscent of nail polish remover or rotting fruit)
The aforementioned bad breath occurs because ketone bodies form in the blood in type 1 diabetes. One of the three ketone bodies produced is acetone, which is noticeable through the breath. Ketone bodies are formed when body fats are broken down uncontrollably in the organism due to the glucose shortage in the cells. The other two ketone bodies are acetoacetate and β-hydroxybutyrate.
How does type 1 diabetes differ from type 2 diabetes?
Type 2 diabetes is also a chronic metabolic disease, but it is not an autoimmune disease. Type 2 diabetes usually develops as a result of an unfavorable lifestyle (obesity, unhealthy diet, lack of exercise) in middle or older age and was therefore long referred to as adult-onset diabetes. In the meantime, however, younger and younger people are becoming ill more and more frequently.
In type 2 diabetes, there is not an absolute but a relative insulin deficiency, which means that the pancreas would basically make enough insulin (at least at the beginning of the disease), but the insulin no longer works because some body cells (especially muscle, fat and liver cells) have become insulin-resistant.
What is insulin resistance?
Insulin resistance occurs when the cells no longer respond as well to insulin, so that the sugar cannot be absorbed into the cells or cannot be absorbed in full. The pancreas therefore tries to release more and more insulin and eventually tires.
However, insulin resistance is not always equally pronounced throughout the day. For example, it is particularly pronounced in the morning, which is why fasting blood glucose levels are an important marker in type 2 diabetes. Another spike in the insulin resistance curve may occur in the afternoon.
Treatment of type 2 diabetes
In type 2 diabetes, insulin is only prescribed when the disease is very advanced. First, medications are given (e.g. metformin, sulfonylureas, etc.) that are intended to lower the elevated blood sugar level via the following mechanisms of action:
- Inhibition of sugar production in the liver
- Inhibition of sugar absorption from the intestine
- Promoting insulin production in the pancreas
- Promotion of sugar excretion in the urine
What is double diabetes?
Anyone who has type 1 diabetes and gets type 2 diabetes in the course of their life has double diabetes. Type 2 diabetes tends to develop with obesity, lack of exercise and an unhealthy diet. For a long time, type 1 diabetics were considered “the thin ones”, but this has now changed and more and more type 1 diabetics are now struggling with obesity.
Type 2 diabetes in particular, however, can be avoided excellently with our holistic concept of the right, healthy diet, exercise, good stress management and individually appropriate dietary supplements.
What is LADA diabetes?
LADA stands for Latent Autoimmune Diabetes of Adults. It is type 1 diabetes that does not appear until adulthood (from the age of 30) and is therefore repeatedly misdiagnosed as type 2 diabetes.
LADA diabetes progresses more slowly than typical type 1 diabetes, which is seen in children. This means that the pancreas’ ability to produce insulin decreases only very slowly. Often, patients do not need to start injecting insulin until three to six years after diagnosis.
Not so many people have type 1 diabetes
Diabetes is a common disease, with type 2 diabetes being much more common, while type 1 diabetes is one of the more rare diseases. In Australia, about 135,000 people are affected by type 1 diabetes. Roughly speaking, the breakdown looks like this:
- 10 percent of the population suffers from diabetes (type 1 and type 2)
- 90 percent of diabetics have type 2 diabetes.
- 10 percent of diabetics have type 1 diabetes.
- However, it is consistently pointed out that 5 to 15 percent of adults who received a diagnosis of type 2 diabetes actually have undiagnosed type 1 diabetes (9). This is referred to as LADA diabetes.
Is type 1 diabetes dangerous?
Life expectancy in type 1 diabetics is still 8 to 13 years shorter than in people without diabetes ( 19 ). However, since insulin has been available as a drug, type 1 diabetes is no longer an acutely fatal disease. Nevertheless, the disease is dangerous in that it is not always easy to keep blood sugar levels under control. Blood sugar fluctuations (hypoglycemia and hyperglycemia) occur again and again.
1. Hypoglycemia: If blood sugar drops, hypoglycemic shock can occur.
2. Hyperglycemia: If blood sugar rises too high, ketoacidosis with diabetic coma can result. For details on ketoacidosis, see 2 below. Hyperglycemia (hyperglycemia).
Both can lead to death if left untreated. However, many type 1 diabetics are equipped with modern aids (e.g. insulin pump) or check their blood sugar and ketone levels in time, so that the extremes described only occur in rare cases.
1. Hypoglycemia (low blood sugar)
A blood sugar level below 60 mg/dl is referred to as hypoglycemia, and values below 40 mg/dl are referred to as severe hypoglycemia. Hypoglycemia can occur if you have injected too much insulin, eaten fewer carbohydrates than planned or than usual, exercised more, drank alcohol, or have gastrointestinal infections with diarrhea and vomiting.
Drinking alcohol in the evening in particular can lead to dangerous hypoglycemia at night. This is because alcohol has to be broken down by the liver, so the liver is busy for the time being and cannot take care of regulating blood sugar levels. Alcohol inhibits the release of sugar from the liver, so the liver also does not respond to glucagon, the hormone that activates the liver to release sugar into the blood (22).
Hypoglycemia is recognized as:
- Food cravings
- Palpitations, trembling and restlessness
- Lack of concentration
- Pallor and sweating
- Nausea and dizziness
- Signs of confusion with speech and vision disorders
What to do in case of hypoglycemia?
If you observe the above symptoms of hypoglycemia, follow these steps:
- Measure your blood sugar.
- At levels below 60 to 70 mg/dl, consume about 10 – 20 g (1 – 2 KE) of easily digestible carbohydrates that quickly pass into the blood.
- After 15 minutes, your blood sugar should be back to 100 mg/dl.
- If this is not the case, consume another 10 – 20 g of carbohydrates.
In the case of mild hypoglycemia, you can consume the following healthy carbohydrate sources (the indicated amounts correspond to 1.5 KE, i.e. 15 g of carbohydrates):
- 150 ml apple or orange juice (from direct juice, unsweetened or orange juice freshly squeezed)
- Fruit, e.g. 1 banana (70 g), apple or pear (140 g)
- 2 tbsp sultanas (25 g) or 4 to 5 pitted dates (20 – 25 g)
In the case of more threatening hypoglycemia, you should immediately consume quickly digestible carbohydrates, e.g. pure glucose (10 g/1 KE) dissolved in a glass of water or suck 2 tablets of dextrose (= 1 KE). Once the hypoglycemia is resolved, you can eat something “normal”, such as fruit or a whole meal bread with a spread.
In the worst case, hypoglycemia can lead to hypoglycemic shock. It manifests itself through the above symptoms plus loss of consciousness and a certain tendency to convulsion. Hypoglycemic shock is a case for the emergency physician who administers an infusion of glucose.
Until the emergency doctor arrives, the patient can be placed in the stable lateral position. Under no circumstances should sugar solutions or anything else be infused into it. He will receive this when he regains consciousness. Otherwise, there is a risk of suffocation.
If the patient has glucagon injections in the house, they can receive one (in the muscle of the thigh) until the emergency doctor arrives. Glucagon works in the exact opposite direction to insulin and promotes the release of sugar from the liver, which causes blood sugar levels to rise. As explained above, the glucagon shot would not work if alcohol was drunk beforehand. In this case, only the sugar infusion from the doctor will help.
Hyperglycemia is a blood sugar level that is too high, which means that the level exceeds the limit of 180 mg/dl and can reach values of 250 to 500 mg/dl and more. The body now tries to excrete the excess sugar through the urine, which leads to an increased urge to urinate. Not only is a lot of water drained out of the urine. Vital minerals (electrolytes) are also flushed out, so that the affected person suffers from a lack of fluids and minerals. Dehydration occurs.
The symptoms of hyperglycemia are those of diabetes mentioned above (urination, thirst, fatigue, nausea, etc.). If hyperglycemia is not treated, i.e. insulin is not injected, it can develop into diabetic ketoacidosis.
Diabetic ketoacidosis is also known as an acute derailment of metabolism. It is a serious complication of diabetes that can occur not only in type 1, but also in type 2 diabetes. Here, however, it is much rarer. Ketoacidosis occurs in 20 to 40 percent of new diabetics, i.e. those people who do not yet know about their type 1 diabetes and only find out that they have it through ketoacidosis. However, 5 to 8 percent of those diabetics who have been injecting insulin for a long time are also affected by ketoacidosis every year.
Ketoacidosis occurs in the following way: If there is a lack of insulin in the body, blood sugar cannot be transported to the body’s cells. Blood sugar levels rise. At the same time, sugar as fuel is missing in the cells. In this emergency, fats are now being broken down. During the process, substances known as ketone bodies are generated. Ketone bodies are a kind of sugar alternative. They can be used by the cells to produce energy.
Ketone bodies are also produced in a fasting state or on the ketogenic diet. Because if nothing is eaten or if no carbohydrates/sugar are eaten, the body uses the fat reserves or the fats of the food and breaks them down into ketone bodies, which can now serve as fuel for the cells – similar to blood sugar. Ketone bodies include:
- Acetoacetate (also called acetic acid)
- β-hydroxybutyrate (also called beta-hydroxybutyric acid)
However, in diabetic ketoacidosis (compared to fasting and also compared to the metabolic state in the ketogenic diet), excessive amounts of ketone bodies are produced – especially from the ketone body β-hydroxybutyrate, which can now lead to hyperacidity (acidosis) of the blood, which is called ketoacidosis. The ketone body acetoacetate is broken down into acetone, which is now partially excreted in the urine and breath. Therefore, urine and breath smell like acetone and thus a little like nail polish remover (which can contain acetone as a solvent).
Since the blood sugar level is very high at the same time, the body tries to excrete the excess sugar through the urine, which manifests itself in an excessive urge to urinate. However, not only water, sugar and acetone are expelled from the urine, but also vital minerals (electrolytes), so that dehydration (lack of water) and an acute mineral deficiency threaten the body.
Ketoacidosis can lead to circulatory failure (loss of consciousness), a life-threatening state of shock called diabetic coma, which should not be confused with latent hyperacidity of the tissues, which from a naturopathic point of view is the consequence of an unhealthy lifestyle and diet.
The later ketoacidosis is detected, the higher the risk of mortality. The older the patient and the more severe the comorbidities, the more likely ketoacidosis is to be fatal. However, this is rarely the case in young diabetics (less than 1 percent) (8).
How do I recognize diabetic ketoacidosis?
You can recognize diabetic ketoacidosis by these symptoms:
- Abdominal pain (painfully tense abdominal wall)
- Weakness and fatigue
- Headache and loss of appetite
- Increased urge to urinate
Ketoacidosis in infants and young children
Especially in infants and young children, parents easily overlook the first signs of diabetes, such as increased thirst and increased urge to urinate. Ketoacidosis is then a real shock. The children are pale, barely responsive, breathing quickly but deeply. Your eyes may be sunken due to dehydration, lips may turn blue. This is a case for the emergency doctor or emergency room in a hospital.
A complication of ketoacidosis is cerebral edema, which can lead to diabetic coma (loss of consciousness). Even though it is rare for a child to die from cerebral edema today, studies have shown that it can lead to damage to the brain. Affected children show slightly worse cognitive function than children who did not have edema.
What blood values indicate ketoacidosis?
Ketoacidosis is caused by:
- Hyperglycemia (blood glucose levels reaching levels above 250 to 500 mg/dl and above)
- Hyperketonemia (excessive concentration of ketone bodies in the blood; Concentration of β-hydroxybutyrate rises to more than 3.0 mmol/l in the blood)
- Acidosis (hyperacidity) of the blood, which now has a pH well below the healthy 7.4, often between 7.1 and 7.2.
What to do in case of ketoacidosis?
If you are already diabetic, be sure to discuss the question of what you should do if you have ketoacidosis with your doctor – during a routine visit, not just when ketoacidosis is present.
At least as important is the question of how to prevent ketoacidosis. If you measure blood sugar levels that are too high, then also take a ketone measurement.
If elevated ketone body concentrations are detected in the blood or urine and the patient is still conscious and does not yet show any other serious symptoms (vomiting), the following measures are generally important:
- As a precaution, call a doctor and only in consultation with the doctor, inject insulin, which inhibits fat breakdown, lowers the concentration of ketone bodies and thus increases the blood pH. If the condition and the subsequent tests (blood sugar and ketone body urine strips) do not improve and vomiting may be added, then it’s time to go to the hospital!
- Consume 15 – 30 g of carbohydrates, e.g. glucose, to avoid hypoglycemia due to increased insulin administration.
- Consume 300 – 600 ml of water to compensate for the increased fluid loss and lower blood sugar at the same time.
- Ketone bodies and blood glucose must be checked hourly.
The diagnosis of type 1 diabetes
The diagnosis of type 1 diabetes can be made quite easily by the doctor (GP or diabetologist) on the basis of a blood test. Of course, the doctor will also ask about relevant symptoms.
Since it is an autoimmune disease in which the immune system considers the islet cells of the pancreas or even insulin to be foreign to the body and produces antibodies against these structures, these antibodies can also be found in the blood of many type 1 diabetics (but not in all patients).
In addition, the sugar levels in the blood are examined – both in the fasting and non-fasting state. The so-called long-term glucose level (HbA1c), which indicates the average blood sugar in the last two months, is also checked.
These laboratory values indicate diabetes mellitus
For the diagnosis of diabetes mellitus (type 1 and type 2), the following blood glucose levels are checked in the laboratory. The figures show the levels at which diabetes could be present:
- Fasting blood glucose higher than 126 mg/dl (7.0 mmol/l)
- Occasional blood glucose higher than 200 mg/dl (11.1 mmol/L) – blood glucose level measured at any time
- Oral glucose tolerance test (OGT) higher than 200 mg/dl (11.1 mmol/l) – This is how the OGT is performed: First the fasting blood glucose is determined, then you drink 300 ml of water with 75 g glucose, wait 2 hours and now take blood again for another blood sugar check.
- Long-term sugars (HbA1c) higher than 6.5% (48 mmol/mol Hb)
- Antibodies (only for type 1 diabetes – see under “Early detection”)
Early detection: Can type 1 diabetes be predicted?
Some laboratory values can be used to predict type 1 diabetes. So even if the disease is not yet there and the patient has no symptoms, these values can be used to say with relative certainty whether and when type 1 diabetes will occur.
Such early detection is very important in type 1 diabetes for at least two reasons:
- Early detection can be life-saving. This is because if diabetes occurs suddenly, ketoacidosis can occur, which in the worst case (if you are not prepared) can be fatal – which you can find more information about above under “Ketoacidosis”.
- Early detection can help to delay the onset of the disease with appropriate measures (perhaps even prevent it altogether) and prevent it from developing so quickly.
Early detection with antibody tests
Antibodies against insulin can be detected years before the disease; Later, when the disease has broken out, antibodies against the insulin-producing beta cells of the pancreas can also be detected in 90 percent of patients. The antibodies are responsible for the destruction of these cells. If the disease has existed for a few years, other antibodies can be found again – the so-called GAD antibodies.
Antibody tests are particularly important in early detection, i.e. when there are no symptoms at all. If a child has 2 or more of the typical diabetes antibodies (without having the disease), it can be assumed that they will become type 1 diabetic at some point in the coming years:
- 50 percent of children with 2 or more antibodies develop the disease within 5 years
- 75 percent develop the disease within 10 years, the rest at a later date
Researchers from the Institute of Diabetes Research recommend that appropriate tests be carried out on all children in early infancy in order to be able to take action in time to delay diabetes, but also to prepare the family accordingly.
Early detection based on symptoms
If you notice the above symptoms in yourself or your loved one, get a check-up with your doctor. Be vigilant, especially with infants and young children, if your child suddenly drinks more than usual and is constantly tired and listless, have it examined immediately to prevent ketoacidosis in case of diabetes.
In adults, early detection based on symptoms is easier because, unlike children, they can express themselves if they suddenly feel noticeably unwell. We have listed the relevant symptoms above under “How to recognize type 1 diabetes: the symptoms”.
However, this is not really an early detection, because by the time symptoms occur, diabetes has already broken out – as explained above – and 80 percent of the beta cells are destroyed.
Early detection with urine test strips
Urine test strips, which can be used to detect sugar in the urine, are easy to use, but are of no use, especially for early detection, because they only change color when you already have really high blood sugar levels, i.e. the diabetes is already far advanced and could then have already caused further damage to the organism.
Urine test strips, which can be used to measure ketones, are helpful for the timely detection of ketoacidosis. The strips are used to measure the amount of ketone bodies (acetone) in the urine. The darker the color of the test result, the more ketone bodies are in the urine, which may indicate ketoacidosis.
The ketone test strips are not suitable for the early detection of type 1 diabetes, because ketoacidosis only occurs when the diabetes has already completely broken out and reached a critical stage. A ketone measurement, on the other hand, makes sense if a diabetic detects a blood sugar level that is too high (over 250 mg/dl) during daily blood sugar control and wants to rule out the threat of ketoacidosis.
Ketone measurement can be done in the urine or in the blood. In the blood, the ketone body β-hydroxybutyrate (BHB) is measured. Acetone is measured in the urine. Before acetone can be measured in urine, BHB can be measured in the blood, which is why ketone measurement in the blood is the recommended way.
The ketone level in non-diabetics is about 0.6 mmol/l. If the value rises significantly, possibly to more than 3.0 mmol/l, diabetic ketoacidosis is suspected.
Is type 1 diabetes inherited?
The risk of type 1 diabetes is increased for children if family members are already diabetics. However, diabetes is not a disease that children always get if one parent or sibling is diabetic.
Even in identical twins, only 25 to 50 percent of the cases involve both children. In fraternal twins, just like other siblings, only 6 percent of children develop the disease if their twin or brother or sister is type 1 diabetic.
If the father is type 1 diabetic, 6 to 9 percent of the children develop the disease, and if the mother is diabetic, it is up to 4 percent of the children. If both parents are type 1 diabetics, the risk for the child to become diabetic increases to 10 to 25 percent. Thus, the majority of children remain healthy, even if family members are type 1 diabetics ( 11 ).
Can type 1 diabetes be prevented?
Several studies in children are underway to prevent type 1 diabetes. Currently an oral vaccination is tested, as well as the preventive effect of probiotics:
Vaccination against type 1 diabetes
There is no vaccine against type 1 diabetes yet. However, a placebo-controlled study by Helmholtz Zentrum München – the so-called POInt Study – is currently investigating an oral vaccination that attempts to delay or completely prevent the onset of type 1 diabetes in children with hereditary predispositions ( 12 ). The study has not yet been evaluated.
The oral vaccination against type 1 diabetes is an insulin powder that is taken mixed with liquid, baby porridge or yogurt. The insulin powder does not affect blood sugar levels in this way. The idea is to train the immune system. This is because, at the beginning of type 1 diabetes, it first turns against insulin, and only later against the insulin-producing cells of the pancreas.
The study participants were 18 months old when they started taking insulin and took the powder daily for another 18 months, until the end of their third year of life.
Probiotics for the prevention of type 1 diabetes in children
Following their POInt study, Helmholtz Zentrum München has initiated another placebo-controlled double-blind study (SINT1A Study), which aims to test the extent to which a specific probiotic bacterial strain (Bifidobacterium longum subspecies infantis) can prevent or delay type 1 diabetes in children.
In the first months of life, the development of the immune system is significantly influenced by the intestinal flora. It is known from previous studies that children with type 1 diabetes suffer from a disorder of the intestinal flora at an early age. Therefore, the SINT1A study is trying to preventively influence the intestinal flora in such a way that it can in turn prevent the immune system from suddenly turning against the body’s own insulin or against the pancreas.
Children under 6 weeks of age can participate. As soon as the children are 6 weeks old, they are given the probiotic or a placebo for the first time. The probiotic is given daily until the age of 12 months. ( 13 ).
Of course, you can also discuss the use of a children’s probiotic with your pediatrician or diabetologist in advance.
Treatment of type 1 diabetes mellitus
In the case of type 1 diabetes mellitus, conventional medical therapy consists in particular of injecting the required amounts of insulin according to one’s own needs. In the meantime, there are aids (pen, patches, insulin pump) that greatly simplify therapy, so that in most cases type 1 diabetics can lead an almost normal life with leisure activities, sports, spontaneous dining, swimming pool, etc. For information on the exact use or the advantages and disadvantages of the individual aids, please contact your doctor or diabetologist.
Transplantation of a new pancreas
In exceptional cases, conventional medicine offers the possibility of pancreas or islet cell transplantation. That sounds great at first. After all, what could be better with a defective pancreas than a new, healthy pancreas? However, transplantation is only a possible solution for a few diabetics.
The first requirement is that you must be under 50 years old. Other prerequisites are a blood sugar level, which is difficult to control even with insulin administration and thus causes strong blood sugar fluctuations with frequent hypoglycaemia phases. In most cases, patients who already have to undergo dialysis, i.e. whose kidneys are already so damaged due to diabetes that renal insufficiency, are preferred for transplantation. The kidneys are then transplanted along with the pancreas.
The transplantation of a healthy pancreas can result in the person no longer needing insulin. But now, as with all organ transplants, he has to take immunosuppressants, i.e. drugs that suppress the immune system so that the foreign pancreas is not rejected. These medications can have serious side effects.
The Federal Center for Health Education also states that out of 100 transplanted pancreases, only about 80 function as desired one year after surgery and only 68 after five years – according to a study for which data from 1990 to 2019 was collected and analyzed.
A pancreas transplant is therefore not necessarily an unproblematic solution. And even if it were, there aren’t nearly as many pancreas as there are type 1 diabetics in need.
Another option is the transplantation of only the islet cells, i.e. the pancreatic cells that normally produce insulin. The cells are directed into the portal vein of the liver, settle in the liver and release insulin from then on.
However, the amount of insulin produced in this way is often not sufficient. But at least it helps to reduce the amount of insulin to be injected and also the risk of hypoglycemia episodes. But here, too, immunosuppressants must be taken, so it is necessary to carefully consider whether the benefits outweigh the risks.
What are the consequences of type 1 diabetes?
The consequences of type 1 diabetes and the associated blood sugar fluctuations are:
- Eye problems and visual disturbances (diabetic retinopathy)
- Cardiovascular diseases, especially coronary artery disease (atherosclerosis in the blood vessels that supply the heart)
- Kidney damage
- Nerve damage (diabetic polyneuropathy)
- Circulatory disorders and resulting poorly healing wounds (e.g. diabetic foot; in diabetics, the risk of foot amputation is increased by 10 to 22 times compared to non-diabetics).
- Increased risk of stroke and heart attack
- Mineral deficiencies (and corresponding secondary diseases), because the increased urine output increases the excretion of vital minerals that can often no longer be absorbed through diet alone.
These symptoms are caused by chronically elevated blood sugar levels. Many diabetics fear hypoglycemia, which often leads to them preferring to accept a slightly elevated blood sugar level. This, however, leads to oxidative stress and leads to cell damage, especially in the blood vessels, but also on the nerves, so that over time the above-mentioned consequential damage occurs, which are also referred to as complications of diabetes.
Which sugar substitute for type 1 diabetes?
With type 1 diabetes, it is officially said that you can basically eat anything you want, including sugar.
We recommend avoiding sugar as much as possible – and using a healthy sugar substitute that requires little or no insulin, such as the sugar substitutes erythritol and xylitol (although erythritol has almost no calories, while xylitol has about half as many as regular sugar). Products made from stevia, a natural sweetener, also do not require insulin.
Also highly recommended for diabetes is a sugar substitute consisting of a combination of erythritol and stevia.
What natural remedies help with type 1 diabetes?
Holistic and natural remedies and measures for type 1 diabetes consist of an overall healthy lifestyle (exercise, sufficient sleep, good stress management), the individually correct diet and dietary supplements in the form of vital substances and plant extracts. All these measures will be used with the following objectives:
- the onset of type 1 diabetes should be prevented as far as possible (e.g. in the case of genetic predisposition)
- the progression of the disease should be slowed down in the case of pre-existing diabetes, but in the case of residual function of the islet cells
- the course of the disease should be positively influenced, which means that blood sugar fluctuations – hypoglycemia and hyperglycemia including ketoacidosis – should be avoided as far as possible, blood sugar is stabilized, the general condition improves, the overall constitution is strengthened (e.g. defense against infections, organ functions, performance, etc.).
- the occurrence of complications and consequential damage should be prevented or delayed
Proper nutrition for type 1 diabetes
A conscious diet can significantly protect against blood sugar fluctuations. In the past, when insulin was not yet available (the first treatment with insulin was in 1922), patients were put on a strict low-carbohydrate diet (less than 10 g of carbohydrates per day) and could thus extend the lives of those affected.
However, since the pharmaceutical industry has been able to produce insulin almost limitlessly, corresponding dietary recommendations have moved into the background, but could also increase the life expectancy of those affected today, because a conscious diet in diabetes can reduce the risk of the main causes of death in diabetes: blood sugar extremes and the typical consequential damage to the kidneys and cardiovascular system.
Various diets have proven to be extremely successful in type 1 diabetes and can often lead to the first insulin injection being delayed after years.
A healthy diet that is as natural as possible and rich in vital substances also has a very positive effect on the intestinal flora, which is disturbed in type 1 diabetes, and can therefore also bring advantages in this way (more on this below under “Probiotics and intestinal cleansing”).
Dietary supplement for type 1 diabetes
Specifically selected dietary supplements can significantly improve the well-being of type 1 diabetes and reduce the risk of consequential damage.
In type 1 diabetes, hypoglycemia (just like hyperglycemia) is associated with severe oxidative stress, which can lead to inflammatory processes and dysfunction of the blood vessels. In a 2013 study, type 1 diabetics in a hypoglycemia phase were given vitamin C by infusion, which was better than GLP-1 (a diabetes drug) at inhibiting inflammation and vascular damage. When the vitamin was given together with GLP-1, the processes mentioned above were almost completely prevented. The infusion took place over a period of 2 hours at a dose of 30 mg of vitamin C per minute during the hypoglycemia phase (6).
Of course, if you take vitamin C orally, you won’t get as much of it into your blood as you would with an infusion. Nevertheless, a good supply of vitamin C in type 1 diabetes – as with any chronic disease – is enormously important to reduce constant oxidative stress.
When children are diagnosed with diabetes, the first insulin doses can lead to a so-called honeymoon, a phase in which the child seems to be cured. Suddenly, insulin is no longer needed, so you think your pancreas is healthy again. The honeymoon phase can last for many months before the disease returns.
In a 2006 study, it was investigated whether the administration of vitamin B3 (nicotinamide) can prolong the honeymoon phase and/or reduce the required insulin dose. Within 24 hours of the diabetes diagnosis, vitamin B3 was started to be administered daily at 1 – 2 mg per kilogram of body weight (but no more than 50 mg).
The normal daily requirement of children under 1 year of age is 5 mg of vitamin B3, and of children from 1 to 4 years of age it is 8 mg of vitamin B3, so the dose administered was not excessive.
The children in the vitamin group had a lower insulin requirement than the control group at each examination appointment (every 3 months over a period of 2 years), the honeymoon phase could be prolonged, and the function of the remaining beta cells could be maintained for up to 24 months ( 14 ).
While vitamin D clearly shows positive effects in type 2 diabetes, this is not so clear in type 1 diabetes. In various observational studies, it was discovered that type 1 diabetics are more likely to have a vitamin D deficiency than people without diabetes, e.g. in a 2009 study of 340 children under 16 years of age.
This study also showed that diabetes was more likely to occur in families where relatives were already vitamin D deficient. Vitamin D deficiency in early childhood also increased the risk of type 1 diabetes in the following years.
The diabetic children were less likely to have received vitamin D supplements and also less likely to receive multivitamin supplements than children without diabetes. Children who were breastfed for more than 6 months, who played outside in the sun more often and who were generally more active/athletic were better protected against diabetes. In their conclusion, the researchers wrote that vitamin D supplementation is a safe and effective way to reduce the risk of type 1 diabetes (5).
But what effect does the vitamin have on pre-existing diabetes? A small study from 2018 looked at how blood sugar fluctuations and insulin requirements changed in 22 type 1 diabetics when they took vitamin D. 12 weeks of vitamin D supplementation of 4,000 or 10,000 IU of vitamin D reduced blood sugar fluctuations, frequency of hypoglycemia episodes, and also insulin requirements (4).
A 2021 analysis, on the other hand, concludes that the influence of vitamin D on the risk of type 1 diabetes is not too high (3). Vitamin D alone cannot protect you from type 1 diabetes and cannot cure this form of diabetes. However, a good vitamin D supply, i.e. a healthy vitamin D level, is always part of a holistic therapy concept for type 1 diabetes. We explain here how to take vitamin D correctly.
Omega-3 Fatty Acids
Omega-3 fatty acids are vital fatty acids that the organism cannot produce itself. Everyone must therefore make sure that they have a good supply of omega-3 fatty acids – whether they are diabetic or not. Especially in the case of chronic diseases, however, it is the case that some nutrients are needed in higher quantities that cannot be consumed through a conventional diet. In the same way, there are nutrients that have a therapeutic effect in high doses, i.e. they are used more like natural medicine.
In a 2017 study, 40 type 1 diabetics were given omega-3 fatty acids for 12 months to observe their effects on a typical secondary disease of type 1 diabetes – polyneuropathy. Polyneuropathy is damage to the nerves caused by chronically elevated blood sugar levels. The participants had their diabetes for between 9 and 45 years. They were given an omega-3 (seal oil) product that provided 750 mg of EPA, 560 mg of DPA, and 1020 mg of DHA per daily dose.
A simple way to observe the progression of polyneuropathy or to detect the disease before it spreads in the body is to examine the nerve fiber length of the cornea of the eye. By taking the omega-3 fatty acids, the nerve fiber length increased by an average of 29 percent – which is a good success and speaks very well for the purely prophylactic intake of high-quality omega-3 fatty acids ( 15 ).
In an article published in May 2017 in The Journal of Clinical Investigation, it was read that it was known that the long-term consumption of omega-3 fatty acids suppressed inflammatory processes, which is why these fatty acids are considered promising candidates for the prevention and therapy of autoimmune diseases, such as type 1 diabetes.
If omega-3 fatty acids were given in early childhood (e.g. from the age of 1 year), this alleviates the autoimmune process associated with type 1 diabetes and even reduces the risk of developing type 1 diabetes in the first place in children with a family history of diabetes. It is ideal if the expectant mother takes omega-3 fatty acids during pregnancy and then also during breastfeeding.
When beta cells are well supplied with omega-3 fatty acids, it promotes their ability to produce insulin and may even protect the cells to some extent from destruction by the immune system (16).
Minerals in type 1 diabetes
A good mineral supplement should be taken for type 1 diabetes, especially if there are recurring problems with blood sugar control. This is because a chronically elevated blood sugar level ensures that minerals are also flushed out through the urine along with the sugar.
At the same time, minerals and trace elements are indispensable for a functioning insulin and sugar metabolism. In addition, they protect against oxidative stress, which can affect the cells enormously, especially when blood sugar levels are elevated, and promotes the dreaded secondary diseases of diabetes.
Studies show that magnesium, zinc, and chromium levels, for example, are lower in type 1 diabetics than in healthy individuals. In those diabetics who repeatedly suffer from blood sugar fluctuations, it is even lower than in well-controlled diabetics.
Conversely, animal studies show that taking chromium and magnesium helps control blood sugar and also reduces the risk of diabetes-related sequelae (17).
In a 2019 study, it was found that iron deficiency is also common in type 1 diabetes (almost a third of the participants had low ferritin levels) and 20 percent of the diabetics examined even already suffered from anemia. Depression, which is relatively common in type 1 diabetics, also appears to be associated with iron status. It is therefore recommended to keep an eye on the iron supply and to take well-tolerated iron supplements in case of deficiency (18).
Probiotics and intestinal cleansing
Autoimmune diseases, such as type 1 diabetes, lead to excessive immune reactions against the body’s own tissue, in the course of which this tissue (in diabetes, the beta cells of the pancreas) is destroyed.
In the course of type 1 diabetes, changes in the intestinal mucosa (decreasing expression of so-called cell adhesion molecules in the intestinal epithelium) lead to increased permeability of the intestinal mucosa. This leads to the so-called leaky gut syndrome. This, in turn, leads to an even stronger immune response and at the same time to higher levels of inflammation, which accelerates the destruction of beta cells in the pancreas.
Since probiotics work directly on the intestinal mucosa, protecting it and contributing to its regeneration and also have an anti-inflammatory effect and reduce oxidative stress (which is always associated with inflammation), it was suspected that probiotics could even be helpful in autoimmune diseases such as type 1 diabetes.
This assumption has now been confirmed in scientific studies (2 ). Specifically, it was shown that probiotics are able to positively influence the above-mentioned changes in the intestinal mucosa, so that the already overactive immune system is not further stimulated (triggered).
Probiotics increase the previously decreased expression of cell adhesion molecules in the intestinal epithelium. The permeability of the intestinal mucosa is thus reduced and autoimmune processes are reduced or (in the case of prevention) completely prevented.
The intestinal flora of type 1 diabetics
The importance of placing the intestine at the center of the therapy of autoimmune diseases is also shown by the following differences in the intestinal flora of type 1 diabetic children compared to the intestinal flora of healthy children:
- The intestinal flora of diabetic children shows less diversity (fewer bacterial species)
- It shows reduced stability (it changes more easily and is more susceptible to external influences (infections, antibiotics, stress)).
- The intestinal flora of diabetics is home to more harmful structures, e.g. viruses and so-called prophages (virus precursors).
- The intestinal flora of diabetics has a lower number of those bacteria that would produce the beneficial, anti-inflammatory, short-chain fatty acids (butyrates). These fatty acids also counteract leaky gut syndrome because, among other things, they stimulate the formation of mucin, a glycoprotein that seals the intestinal mucosa.
- The intestinal flora of diabetic children harbors significantly less bifidobacteria and lactobacteria than healthy children.
Therefore, discuss with your pediatrician or pediatric diabetologist which probiotic is suitable for your child. Even if you are an adult diabetic, you can raise this point with your doctor.
How quickly diet changes the intestinal flora
The intestinal flora can also be influenced very well by diet. It even changes within 24 hours with drastic changes in diet. If you go back to the previous diet, the intestinal flora soon returns to its original state (within 48 hours after returning to the old diet).
If the intestinal flora is involved in the development of a disease, not only the intestinal flora, but also the disease can be influenced relatively quickly with a consistent change in diet.
Plant compounds to protect beta cells
In a review from 2013, more than 20 plant substances and their effect on type 1 diabetes were presented – but mainly on the basis of animal or cell studies, so that the substances (not all, but possibly one or two) could be integrated into the prevention and treatment of diabetes in consultation with the doctor, but the actual effective dosages for humans are not yet known (1).
The root of Panax ginseng, usually referred to simply as ginseng, contains ginsenosides, plant compounds that (in the form of ginseng extracts) can save beta cells from perishing (apoptosis) in cell and animal studies.
EGCG from green tea
Green tea and oolong tea are among the naturopathic remedies for type 2 diabetes. In mice, EGCG – the key ingredient in green tea – was able to delay the onset of type 1 diabetes. In children, however, green tea showed a promoting effect on type 1 diabetes in a study and should not be used in children at risk, but could possibly be helpful in adult type 1 diabetics.
Silymarin is the active ingredient complex from milk thistle – a medicinal plant that is particularly known for its detoxifying and liver-regenerating effects. However, it also has anti-inflammatory, antioxidant and anti-diabetic effects and was therefore able to save beta cells from dying in diabetes rats.
In diabetes mice, the alcoholic extract of papaya leaves was able to reduce blood sugar levels that were too high – presumably because the extract led to the regeneration of beta cells. It is not yet known which substance in the papaya leaves is specifically responsible for this effect.
Plant compounds that regulate the immune system
Since type 1 diabetes is an autoimmune disease with misdirected immune cells, measures that help to steer the immune system back into order are also important.
Cannabinoids are plant substances from cannabis (marijuana), the medical hemp. In mice with a genetic predisposition to type 1 diabetes, cannabidiol, a substance from the cannabinoid group, was able to partially prevent the onset of the disease. So far, it is not exactly known how this works, but could be because cannabidiol causes the demise of overactive immune cells (T cells).
Another substance from cannabis – THC (tetrahydrocannabinol) – was even able to reverse type 1 diabetes because it activated certain cells, so-called myeloid suppressor cells, which can throttle the immune system.
These results do not mean that you should smoke a joint regularly. Cannabis is inhaled in a vaporizer for healing purposes, or cannabinoids are taken in pill/drop form. This is because individual studies also indicate that frequent pot smoking can increase the risk of ketoacidosis ( 23 ).
Wilford’s Three-Winged Fruit
Raw extracts from Wilford’s three-winged fruit (Tripterygium wilfordii) are said to be able to suppress the development of type 1 diabetes by throttling the activation of overactive T cells, accelerating their degradation and suppressing certain messenger substances (Th1 cytokines) that can initiate autoimmune processes.
Olive Leaf Extract
The extract from the leaves of the olive tree – olive leaf extract – was able to reduce the incidence of type 1 diabetes (in mice). In any case, olive leaf extract has an anti-inflammatory and antioxidant effect. It inhibits the activity of pro-inflammatory messenger substances that also play an important role in autoimmune processes (e.g. IL-17 or TNF-alpha).
Plant compounds for both: regulating the immune system and protecting beta cells
There are also plant compounds for which both mechanisms of action are known, i.e. they can regulate an overactive immune system as well as protect the endangered beta cells of the pancreas.
Resveratrol is a well-known plant substance from dark grapes and thus also from red wine. For example, the anti-aging substance has a neuroprotective effect, can alleviate osteoarthritis, improve hormonal imbalances, reduce the risk of dementia and be integrated into the treatment of cancer.
Resveratrol also has immunomodulatory properties, which means that the substance can help the immune system regain its healthy balance. As with the other plant compounds, it was mice with type 1 diabetes in which resveratrol improved the disease, prevented the cell death of the beta cells and thus led to better insulin secretion.
Of course, curcumin should not be missing from the list of helpful plant substances. The yellow pigment from turmeric initially delayed the onset of type 1 diabetes in mice with a correspondingly hereditary predisposition or prevented the disease altogether. This is because curcumin throttled autoimmune processes that would normally have led to the destruction of the pancreas.
In already diseased type 1 diabetic mice, curcumin lowers pro-inflammatory messenger substances (IL-6, IL-17, etc.) and at the same time increases insulin levels and messenger substances that dampen autoimmune processes ( 20 ) ( 21 ).
Capsaicin – an active ingredient found in chili – also shows anti-diabetic properties. In type 1 diabetic mice, the plant substance increased the number of certain immune cells that protect against type 1 diabetes and at the same time reduced the activity of autoimmune immune cells. In addition, capsaicin was able to improve the body’s insulin secretion, indicating that the plant compound can affect beta cells in some way.
Do type 1 diabetics need to inject insulin for life?
According to official knowledge, type 1 diabetes requires insulin until the end of the patient’s life, which means that type 1 diabetics have to inject insulin for life.
However, there are always reports on the net (the veracity of which unfortunately cannot be verified) that showed that some type 1 diabetics do not need insulin, which could indicate that the autoimmune process that destroys beta cells can be stopped under certain circumstances.
These circumstances could include mental techniques and/or a targeted change in diet. This is because those affected who report an insulin-free life had usually brought about drastic changes in their diet and lifestyle.
At this point, it is often said that these people are certainly dealing with the so-called honeymoon phase, a phase that can be observed in some type 1 diabetics and in which the pancreas can suddenly produce sufficient insulin again. The honeymoon phase can last from a few weeks to months, in rare cases a few years.
In the case of LADA diabetes, which is known to progress slowly, it can be several years in which diabetics can live very well without insulin administration. Sooner or later, however, it is said that every type 1 diabetic will have to inject insulin.
Is type 1 diabetes curable?
Officially, type 1 diabetes is considered incurable. Compared to some other autoimmune diseases (such as Hashimoto’s), we personally do not know of any type 1 diabetics who have been cured of their diabetes in any way (whether conventional medicine or naturopathic). However, the case studies and field reports mentioned in the previous section give hope that this might be possible after all, or that at least in the case of type 1 diabetes that is not yet insulin-dependent, the first insulin injection could be delayed for many years with the right measures – also depending on the type of type 1 diabetes (see above keyword LADA diabetes).
However, cases in which insulin has been injected for years or decades and then a cure would have occurred are rare and difficult to verify, such as the story of Ewald Schober, business coach, personality trainer and author, who claims to have his pancreas reactivated after decades of insulin injections, especially with mental techniques.
Admittedly, his path to healing (if healing has actually occurred) is not necessarily feasible for everyone. Nevertheless, it is also worthwhile to learn and apply mental techniques with regard to other areas of life, as they lead to more happiness, satisfaction and success – and a balanced psyche always has a positive influence on physical complaints.