Type 1 diabetes management: balancing blood sugar with functional medicine

Type 1 diabetes symptoms

Type 1 diabetes can develop slowly over months or years, and symptoms can seem to appear very quickly. Medical attention should be sought quickly if these symptoms appear.

The most common symptoms of early-stage type 1 diabetes are:

• Excessive thirst
• Extreme urination, passing urine more frequently, especially at night which interrupts sleep
• Extreme hunger
• Unintended weight loss
• Bedwetting in children (who don’t usually wet the bed)
• Fatigue
• Weakness
• Blurred vision
• Mood swings
• Headaches
• Dizziness
• Leg cramps
• Skin infections, slow healing wounds
• Itching, tingling hands or feet
• Nausea, vomiting
• Stomach pain

What causes type 1 diabetes?

There are a few different types of diabetes, all with different causes. Type 1 is an autoimmune condition affecting 10-15% of people with diabetes in Australia. Type 2 and gestational diabetes make up the remaining 85-90% and are more related to lifestyle factors, although gestational diabetes may be related to a person’s kidney glucose threshold.

Other subtypes of diabetes are:

• MODY diabetes – maturity-onset diabetes of the young, a result of a chromosomal mutation affecting insulin production. Usually diagnosed before age 25
• LADA diabetes – late-onset type 1 diabetes in adulthood
• Direct injury to the pancreas-induced diabetes, caused by trauma, surgery, or the conditions hemochromatosis, cystic fibrosis and gallstones
• Medication-induced diabetes, from corticosteroid and some antipsychotic medications
• Genetic syndrome conditions induced diabetes, in Down syndrome and Turner syndrome

Research has found that a complex interplay between genetic predisposition and environmental triggers underlies all autoimmune conditions, such as type 1 diabetes. First generation relatives of someone with type 1 diabetes are 10 times more likely to develop type 1 diabetes. In those people (often with the presence of HLA DR3 / DR4 gene haplotypes), a variety of suspected triggers are risk factors for developing the disease. This is thought to occur via a process called molecular mimicry, where molecules entering the body look the same as beta cells of the pancreas, and the immune system mistakenly attacks both the ‘intruder’ and beta cells over months or years, eventually destroying all functioning beta cells.

These triggers include:

• Gut microbiome dysbiosis – type 1 diabetics often have higher levels of Streptococcus mitis, Streptococcus oralis, Streptococcus pneumoniae, Candida albicans and lower levels of Lactobacillus rhamnosus and Bifidobacterium dentium species, and species related to fermentation/production of short-chain fatty acids
• Viruses – enteroviruses (affecting the gut), such as polio and hepatitis A, coxsackievirus, echovirus, rubella
• Respiratory infections
• Rotavirus infection
• Early introduction of cow’s milk protein
• High dairy and gluten consumption
• Intestinal hyperpermeability
• Low Omega-3 fatty acid status
• Having another autoimmune disease, such as coeliac disease, Hashimoto’s thyroiditis
• Stress/trauma

Particularly for juvenile-onset:

• Maternal vitamin D deficiency
• Maternal high gluten consumption
• Pollution exposure during pregnancy – especially ozone exposure of 25ppb
• Pre-pregnancy obesity

Complications of type 1 diabetes

Poor blood glucose management can cause damage to small blood vessels in the kidneys, eyes, heart, gums, liver, feet and legs. These tiny vessels can be easily damaged by too much glucose which is a large molecule.

Whilst frequent insulin injections are often required, they can never exactly replicate a healthy body’s own insulin production in response to food, and other bodily processes can make it hard to manage blood glucose levels consistently, such as carbohydrate cravings.

In addition to this, it is common for people with type 1 diabetes to develop non-alcoholic fatty liver disease and other autoimmune conditions, especially Hashimoto’s thyroiditis and coeliac disease, further complicating health and metabolism. Other autoimmune conditions associated with type 1 diabetes are Sjogren’s syndrome and Lupus.

Other conditions that commonly appear alongside type 1 diabetes are periodontal disease and heart disease, which are connected to the depletion of coenzyme Q10. CoQ10 is related to the energy metabolism and antioxidant capacity, however there are also implications with endocarditis, systemic vascular inflammation, and progressive dyslipidaemia, which all form a complex comorbidity.

Heart attack, stroke, kidney failure and amputations of toes, feet and legs are associated with poor blood glucose management, and subsequent nerve damage that leaves people unable to feel damage to feet and toes. Candida overgrowth can also be common. There is growing awareness of the link between poor blood glucose regulation and Alzheimer’s disease, which is now being referred to as type 3 diabetes.

‍Type 1 diabetes management – the conventional approach

Management of type 1 diabetes requires lifetime insulin injections to ensure the transportation of glucose from the bloodstream into cells for energy production. The pancreas produces none, or very little, insulin in people with type 1 diabetes, and so without insulin, it is a life-threatening condition.

Once diagnosed, your doctor or diabetes educator will design a management plan that includes:

• Education on the importance and how to maintain optimal blood glucose levels
• Insulin replacement via injections, or a pump
• Monitoring blood glucose levels up to 6 times per day
• Following a healthy eating plan
• Regular exercise

Ideal fasting blood glucose levels are maintained at between 4-5.5 mmol /L, although this can vary from person to person. The optimal levels of blood glucose vary depending on a person’s age, weight, activity level and diet to avoid hyperglycaemia (too much glucose in the blood), hypoinsulinaemia (not enough insulin in the blood), or life-threatening ketoacidosis. Ketoacidosis is a condition where insufficient insulin over hours or days causes the body to burn an alternate source of fuel, ketones, which can alter blood biochemistry problematically, leaving dangerous chemical accumulation in the blood. Hypoglycaemia is when there is too much insulin, leaving very little blood glucose, causing dizziness and fainting.

Your doctor will monitor this with regular blood tests, in particular, HbA1c (glycosylated haemoglobin) test. Red blood cells have a lifespan of 90-120 days, and glucose naturally attaches itself to haemoglobin (a blood protein). The HbA1c is a measurement of this combination, meaning the more glucose in the blood over the last 90-120 days, the higher the HbA1c result.

While conventional medicine is very good at diagnosing chronic conditions, treatments often miss addressing the fundamentals of health that can make a big shift in someone’s overall health. This is why many people seek natural treatment for type 1 diabetes, to reduce the risk of complications and effectively manage blood glucose levels through dietary and lifestyle measures.

Type 1 diabetes management – the functional medicine approach

Functional medicine practitioners can support people with type 1 diabetes by developing natural management strategies aimed at reducing complications and improving quality of life. This process begins with an in-depth investigation into root causes and contributing factors, looking at your:

• Family history, birth story, childhood illnesses
• Personal medical history, including surgeries, medications, disease states, and viruses
• Environmental chemical exposures, including mould, pesticides, exhaust, heavy metals and other chemicals
• Life stressors/trauma
• Diet and lifestyle factors

Functional testing may identify gut microbiome disruptions, nutritional deficiencies and signs of poor nutrient absorption, food allergy and intolerances, and other factors contributing to complications.

Treatment strategies include dietary recommendations, lifestyle medicine, herbal medicines and supplementary medicines with the following aims:

• Improving insulin receptor sensitivity – to reduce the amount of insulin required for glucose uptake into cells
• Improving detoxification pathways – to reduce the load on the liver
• Reducing inflammation – a common cause of complications
• Improving blood vessel integrity – to reduce damage to cardiovascular system and reduce the likelihood of foot and leg damage that leads to amputations
• Increasing nutrient absorption and distribution – to ensure healthy cofactors for all processes
• Protecting heart, eye and kidney health
• Protecting dental health – strongly correlated with gut microbiome and heart health and a common issue for type 1 diabetics
• Improve digestion, microbiome species diversity/composition to improve digestion, reduce inflammation, and the impact on liver function
• Prevention for people who are first-generation relatives, who want to do all they can to avoid developing type 1 diabetes

Herbal medicines and supplementation of vitamins and minerals may include:

• Berberine-containing herbs, cinnamon, and gymnema to improve insulin receptor sensitivity
• Myo-inositol and chromium supplementation for glucose regulation
• St Mary’s thistle, globe artichoke for liver detoxification
• Ginkgo biloba, gotu kola, horse chestnut for blood vessel support
• Hawthorn, motherwort for heart support
• Anti-inflammatories and antioxidants to reduce inflammation and support organ function – turmeric, Vitamin C, Vitamin E (tocotrienols), NAC, Liposomal glutathione, green tea, resveratrol
• Eye health – Bilberry, eyebright, Vitamin A, Vitamin C, zinc
• Heart and oral health – CoQ10, magnesium citrate (plus regular dental checkups and xylitol mouthwash to address dental health)
• Magnesium for greater glucose uptake, energy, sleep and as a cofactor for over 300+ processes

Most importantly, when you choose functional medicine to support your type 1 diabetes management, you are choosing natural, holistic and evidence-based treatment strategies, delivered by skilled practitioners who are invested in seeing you succeed in making healthy changes.

At Melbourne Functional Medicine, we pride ourselves on providing a high-level service in our unique program that delivers results. Your healthcare team will include a type 1 diabetes functional medicine practitioner and a health coach, who are there to guide, support and empower you to be in the best health you can be.

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Our unique model of care was designed with you in mind. Find out how, then book a call today