The Third Type of Diabetes?

Many people know there are 2 types of diabetes.  Type 1, formerly called juvenile-onset diabetes and type 2 or adult-onset diabetes.  Gestational diabetes or pregnancy-induced diabetes resembles type 2.  

But did you know there is a third type of diabetes known as LADA (latent autoimmune diabetes in adults) or type 1.5 diabetes?

What are the differences?  Type 1 diabetes usually occurs in babies to young adulthood.  Those that have some type of genetic pre-disposition to diabetes get a virus such as mononucleosis or the flu bug which triggers the pancreas to stop producing insulin. This type of diabetes requires life-long insulin therapy.

Although Type 2 diabetes used to occur later in life we are now seeing young children and adolescents develop type 2.  It is brought on by a combination of genetics, weight, poor diet choices, and inactivity.  Insulin resistance precedes adult onset diabetes and occurs when your insulin becomes almost “sleepy” or sluggish, which increases carbohydrate cravings, weight issues and fatigue.  This type of diabetes can usually be controlled with lifestyle and oral medications.

The third type of diabetes is not as well known or understood.  Rather than the insulin being resistant, with LADA or type 1.5, an individual’s insulin becomes deficient.  The cells of their pancreas stop producing as much insulin as they once did - like a slowly developing type I diabetes.

This individual is usually thin, has slowly increasing blood sugars and develops diabetes over many months or years.  This type of diabetes is caused by the person’s immune system which develops antibodies that attack the pancreas hence lowering the amount of insulin produced over time.

Many times this type of diabetes is misdiagnosed or treated as type 2.  What do you do if you suspect you have LADA?  Ask your doctor to check a blood test called the c-peptide and measure over time.  C-peptide is a simple blood test which measures how much insulin your pancreas is producing.  Knowing the value can determine whether your antibody levels need to be checked.

What can you do in terms of your lifestyle?  Diet balance is essential and eating plenty of protein, healthy fats and moderating your carbohydrate intake with non-starchy sources such as fruits and vegetables can help give the pancreas a rest and keep your blood sugars normalized. 

Exercise helps the insulin you do make much more effective and efficient - up to 50%.  Besides diet and exercise, sleep and stress management are invaluable in keeping your system healthy.

If you suspect you may have LADA lifestyle and self-monitoring are of utmost importance.  Knowing what to do and what parameters to check can keep your system in good health.

Obesity, Insulin Levels and Cancer?

Last week’s LA Times article on Obesity’s Role in Cancer was timely.  We know excess weight is critical in the development of diabetes and heart disease.  But now a correlation between increased weight and cancer?

About ten years’ back one of my clients brought in an article linking high insulin levels to cancer.  Since one of my specialties is diabetes I follow all the research on diet affecting insulin levels.  Now cancer was in the mix as well?

Research over the last few years has linked high insulin levels to development of certain types of cancers and its reoccurrence.  A diet high in processed carbohydrates increases production of insulin, which in turn can increase cell growth of tumors in the body.  When insulin levels are high, tumor cells are fed, thus dividing and multiplying.

So is there a connection between carbohydrates and cancer?  Hmm…let me rethink that plate of pasta.

A group of researchers examined the records of 89,000 women participating in the Nurses’ Health study in 2002.  The women who were overweight, did not get much exercise, and ate a lot of starchy foods were 2.5 times more likely to develop pancreatic cancer than those who ate healthy carbohydrates.

One of the co-authors of the study, Charles S. Fuchs, discussed how replacing starchy foods that increase insulin levels with healthy carbohydrates from fruits and vegetables can improve your health by not only lowering risk of cancer, but diabetes and cardiovascular disease as well.

In 2007, a major report called Food, Nutrition, Physical Activity, and the Prevention of Cancer:  A Global Perspective was published linking cancer to diet, physical activity, and weight.  The most profound finding of the report linked excess body fat to six types of cancer, including colon, kidney, pancreas, and adenocarcinoma of the esophagus and endometrium and post-menopausal breast cancer. 

So let’s break it down.  Excess weight and eating starchy carbs increase insulin levels which can increase growth of tumors and cancer risk.  Our romance with the taste and feel of comfort food - starchy carbohydrates - may not be achieving the health we so desire. 

To keep your insulin levels normal try eating some protein at each meal or snack along with a healthy source of carbohydrate like fruits, veggies, nuts/seeds, and add some healthy fats.  I’ve recently used spaghetti squash in place of pasta with meatballs and it was a pleasant surprise.

Imagine a salad with greens, goat cheese, pine nuts, avocado, tomatoes and some extra virgin olive oil and balsamic vinegar.  Healthy CAN be tasty and enjoyable AND help you prevent cancer!

Harvard researcher Walter Willett, M.D. states “Obesity is approaching smoking as a cancer risk.”  Perhaps now is the time to tackle the problem of food with the same vengeance as the anti-smoking campaigns.  Remember it’s prevention, not prescription.