Type 1 diabetes and autoimmune conditions

Type 1 diabetes is an autoimmune condition. People who develop type 1 diabetes have the genes for type 1 diabetes and then a prompt, such as an illness or stress, triggers those genes to turn on. This causes the body to develop antibodies that attack its own beta cells in the pancreas.

If you live with type 1 diabetes you are also at higher risk of developing other autoimmune conditions such as inflammatory bowel disease (Crohn’s disease or ulcerative colitis) and coeliac disease. People who have already developed autoimmune conditions are also at higher risk of developing type 1 diabetes.

Why are we interested? The more we can understand about the genetics of type 1 diabetes and autoimmune conditions, the closer we get to new treatments and potential cure or prevention methods.

But what about type 2 diabetes?

Type 2 diabetes also has a genetic aspect. If you have family with type 2 diabetes you are at a greater risk of also developing type 2 diabetes. Lifestyle factors such as poor diet, lack of exercise and being overweight can also increase the risk.

Type 2 diabetes and connection with gut issues

Research shows chronic intestinal inflammation common in inflammatory bowel disease (Crohn’s disease and ulcerative colitis) appears to increase the risk of a person developing type 2 diabetes.

The gut plays a big part in regulating glucose levels. Studies are now looking at how inflammatory bowel disease might impact the development of diabetes.

Besides digestion and nutrient absorption, the gut is involved in modulating the immune system, secreting hormones and signalling nerves. It is also home to billions of microbes and microflora (the microbiome).

Researchers have explored the long-term risk for people living with type 2 diabetes developing inflammatory bowel disease, or vice versa, by looking at population-based studies.

While there is still a large amount of debate surrounding the basic relationship between inflammatory bowel disease and diabetes, it is thought the mechanism of chronic inflammation and genetic factors common to type 1 and type 2 diabetes and inflammatory bowel disease may play a role in this. One explanation for the relationship between inflammatory bowel disease and diabetes is that inflammatory bowel disease is associated with diabetes due to chronic inflammation and dysbiosis – an abnormal gut microbiome.

It has been suggested that products from the gut microbiome may interact with the immune system inducing a tissue metabolic modification, which feeds the low-grade inflammation that occurs in the onset of both overweight and type 2 diabetes.

What can we do about this?

The current medications for both type 1 and type 2 diabetes have anti-inflammatory properties in addition to their major modes of action. Lifestyle changes also appear to reduce inflammation and improve cardiovascular health.

Improve your gut microbiome by:

• Eating plenty of fibre: wholegrains, fruit, vegetables including legumes, nuts
• Including probiotics (good bacteria) in your diet: probiotic yoghurt or probiotic yoghurt drinks

As well as:

• Exercising regularly
• Taking medications, as prescribed.

See an Accredited Practising Dietitian for food and nutrition advice specific to you. If you have diabetes, your GP can provide you with a care plan so you can receive up to five visits to allied health professionals, such as a dietitian, subsidised by Medicare each calendar year.

By Dale Cooke APD