(BlackDoctor.org) — Also known as childhood-onset diabetes,
type 1 diabetes requires regular blood sugar tests and medical intervention.
According to research or other evidence, the following self-care steps may be
helpful:
What You Need To Know:
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full diabetes
article for more in-depth, fully-referenced information on medicines, vitamins,
herbs, and dietary and lifestyle changes that may be helpful.
Dietary changes that may be
helpful
Eating carbohydrate-containing foods, whether high in
sugar or high in starch (such as bread, potatoes, processed breakfast cereals,
and rice), temporarily raises blood sugar and insulin levels. The blood
sugar–raising effect of a food, called its “glycemic index,” depends on how
rapidly its carbohydrate is absorbed. Many starchy foods have a glycemic index
similar to table sugar (sucrose). Beans, peas, fruit, and oats have low glycemic
indexes, despite their high carbohydrate content, due mostly to the
health-promoting effects of soluble fiber. Controlled studies have found that
people with type 1 diabetes who follow a low-glycemic-index diet have better
long-term control over their blood sugar levels compared with those following a
high-glycemic-index diet. However, other studies find similar benefits from
training patients to adjust their insulin doses according to the total
carbohydrate content of each meal or snack (“carbohydrate counting”). People
with type 1 diabetes should always discuss changes in their diet with their
treating physician.
Diabetes disrupts the mechanisms by which the body controls blood sugar.
Until recently, health professionals have recommended sugar restriction to
people with diabetes, even though short-term high-sugar diets have been shown,
in some studies, not to cause blood sugar problems in people with diabetes.
Currently, the American Diabetic Association (ADA) guidelines do not prohibit
the use of moderate amounts of sugar, as long as blood levels of glucose,
triglycerides, and cholesterol are maintained within normal levels.
Most doctors recommend that people with diabetes cut intake of sugar from
snacks and processed foods, and replace these foods with high-fiber, whole
foods. This tends to lower the glycemic index of the overall diet and has the
additional benefit of increasing vitamin, mineral, and fiber intake. Other
authorities also recommend lowering the glycemic index of the diet to improve
the control of diabetes.
Older studies suggested that including 30 grams per day or more of fiber
helps control blood sugar in type 1 diabetes. However, a more recent controlled
study of people with well-controlled type 1 diabetes on intensive insulin
regimens found no important benefits from consuming a high-fiber diet. In
another trial, a low-glycemic-index diet containing 50 grams per day of fiber
improved blood sugar control and helped prevent hypoglycemic episodes in a group
of people with type 1 diabetes taking two or more insulin injections per day.
Consuming more fiber may not be as helpful in type 1 diabetes when modern
intensive insulin regimens are used, but eating high-fiber foods is recommended
for its many other health benefits.
When taken with meals, high-fiber supplements such as guar gum reduced the
rise in blood sugar following meals in people with type 1 diabetes. More
research is needed to determine if regular use of fiber supplements benefits
long-term blood sugar control in type 1 diabetes.
When people with diabetic nerve damage (neuropathy) switch to a vegan diet
(no meat, dairy, or eggs), improvements have been reported after several days.
In one trial, pain completely disappeared in 17 of 21 people. Fats from meat and
dairy may also contribute to heart disease, the leading killer of people with
diabetes. Vegetarians also eat less protein than do meat eaters. Reducing
protein in the diet has lowered kidney damage caused by diabetes and may also
improve glucose tolerance in type 1 diabetes. Switching to either a high- or
low-protein diet should be discussed with a doctor.
Changing the overall percentage of calories from fat and carbohydrates in the
diets of people with type 1 diabetes is often difficult. However, it is possible
to modify the quality of the dietary fat. In adolescents with type 1 diabetes,
increasing monounsaturated fats relative to other dietary fats is associated
with better control over blood sugar and cholesterol levels. The best way to
incorporate monounsaturates into the diet is to use olive oil, especially extra
virgin olive oil, which has the highest antioxidant values.
Should children avoid milk to prevent type 1 diabetes? The relationship
between cows’ milk and type 1 diabetes remains unclear, although there is some
evidence that milk consumption might increase the risk of developing type 1
diabetes. Worldwide, children whose dietary energy comes primarily from dairy or
meat products have a significantly higher chance of developing type 1 diabetes
than do children whose dietary energy comes primarily from vegetable sources.
Countries with high milk consumption have a high risk of type 1 diabetes. Animal
research also indicates that avoiding milk affords protection from type 1
diabetes. Milk contains a protein related to a protein in the pancreas, the
organ that produces insulin. Some researchers believe that drinking milk may
cause children who are allergic to milk to make antibodies that attack the
pancreas, causing type 1 diabetes. Several studies have linked cows’ milk
consumption to the occurrence of type 1 diabetes in children. However, other
studies have failed to find such a link. One study even reported a protective
effect of higher intake of dairy products on diabetes risk in children. One
reason for the conflicting results of the research may be that different genetic
strains of cows’ milk protein (casein) are associated with different levels of
risk.
Immune-system problems in people with type 1 diabetes have been tied to other
allergies as well, and the importance of focusing only on the avoidance of dairy
products remains unclear. Preliminary studies have found that early introduction
of cows’ milk formula feeding increases the risk of developing type 1 diabetes,
although contradictory results have also been published. A study of Finnish
children (including children with diabetes) showed that early introduction of
cows’ milk formula feeding (before three months of age vs. after three months of
age) was associated with increased risk of type 1 diabetes. This research
supports abstaining from dairy products in infancy
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