A few days ago Hannah* (18) came back to my practice. Originally, only her mother Regina* (46) was a patient of mine, but when Hannah came to me three years ago, I had to take care of her Diabetes type-1 When Hannah was diagnosed with diabetes mellitus, her mother insisted that she come to my practice. Hannah has been a loyal patient ever since.
When the two first visited together, Regina had reported that Hannah had always been slim, but that she had recently become more and more Weight lost without any major changes in their life circumstances. Also from frequent Dizzy spells was the talk, but most importantly, her daughter would have a much greater thirst than ever before. At first, she thought it might be related to Hannah's puberty, but eventually she took Hannah to the doctor. The Diagnosis diabetes was quickly determined, only: which type?
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Type-1 or type-2 – the origin is crucial
diabetes mellitus designates a group of metabolic diseases, which is increased amount of glucose in the blood (also known as Hyperglycemia known). Among the various manifestations, the two most important are Diabetes type-1 and type-2. These two forms have a very different history of development, which is why I will limit myself to type 1 for now.
First of all: Diabetes type-1 is the rarer variant of diabetes and innate. In Germany, approximately. 200.000 people among them. Symptoms usually appear in childhood or adolescence, sometimes also in early adulthood.
– Fatigue – listlessness – intense thirst (polydipsia) – increased urination (polyuria) – weight loss – weakness – dizziness
Unlike type-2 diabetes, people with type-1 diabetes (like Hannah) are usually very slim:
"I never had any problems as a child"
Here's how it played out in Hannah's memory: "I always felt healthy, and even at the U exams (pediatric checkups) there were never suspected of having diabetes. The problems only started at the age of 14."
At Diabetes type-1 it concerns a autoimmune disease, in which antibodies triggered by an autoimmune reaction cause the insulin-producing beta cells in the so-called islets of Langerhans of the pancreas destroy (not to be confused with the "Langerhans cells" in the skin). As soon as about 80% of the beta cells are destroyed, the blood sugar rises and the first symptoms can no longer be overlooked.
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What do we actually need insulin for?
The hormone insulin is responsible for various Metabolic processes central: it ensures that the glucose circulating in the blood gets into our cells and gives them provides energy. Insulin is also responsible for creating energy reserves. Sugar content in the blood increases -. decreases in the cells. The energy supply of the cells is disturbed.
In addition to type 1 diabetes, Hannah unfortunately had Gluten intolerance (celiac disease) developed. Strikingly often, other autoimmune diseases such as the Hashimoto's thyroiditis , celiac disease or autoimmune gastritis Type A gastritis associated with type 1 diabetes. You can learn more about the connection between type-1 diabetes and celiac disease here:
Science has yet to figure out what exactly causes the immune system to attack beta cells. However, one ames genetic disposition out, and of course the Microbiome or. the specific colonization of our intestine plays an important role. So what does a diabetes type 1 therapy look like?
The microbiome is always involved
As with many other diseases, the human microbiome is an important influencing factor in the development of type-1 diabetes. Our body possesses a large variety of bacteria strains, of which the "friendly" bacteria normally predominate in a ratio of 80:20. What is striking (and a real alarm sign) is that often approx. one year before the onset of type-1 diabetes the number of good intestinal bacteria is reduced by ca. 25 % shrinks. As a result, potentially harmful bacteria can multiply accordingly and cause increased inflammatory processes in the intestine lead.
The mucosal damage can result in leaky gut:
Increased permeability of the intestinal barrier leads to interaction between genes and bacteria. This has a particularly fatal effect when we are dealing with advanced dysbiosis (faulty colonization of the intestine). The physiological bacteria that are important for our health are no longer able to prevent potentially pathogenic germs from entering the body. The immune system runs amok – and reacts over.
It is also known that a reduced number of butyrate- and lactate-forming bacterial strains can have a direct effect on the development of type 1 diabetes. These fatty acids promote combustion processes in the body. Prevent an overgrowth of pathogenic germs.
The inglorious role of antibiotics
In fact, antibiotics also play an alarming role here: namely, those who use the genetically more susceptible is a type 1 diabetic and at the same time had to take antibiotics more frequently as a child, apparently has "good chances" of developing the disease sooner! Also a Antibiotics intake of the mother during the breastfeeding period can be the cause of the outbreak of the disease. (Incidentally, a similar situation applies to other autoimmune diseases!) In fact, Hannah's mother had been administered antibiotics shortly after birth due to severe bacterial cystitis. (For more details see my blog:)
Two developments seem interesting to me here: on the one hand, the number of people suffering from Autoimmune diseases suffer, smoothly doubled. At the same time, antibiotics were prescribed more and more frequently for children. To ame a connection here is at least not completely far-fetched.
antibiotics kill known harmful bacteria Unfortunately, this also means that many of the body's own cells are lost fundamentally important intestinal bacteria underlying. A functioning immune system depends on a healthy amount of intestinal bacteria, but woe betide us if these are no longer present: Then it can easily happen that our immune cells suddenly start attacking the body's own cells!
All this supports the amption that a pre- or. probiotic therapy should also be used to accompany conventional medicine in the case of autoimmune diseases such as type 1 diabetes. Especially children who have genetic predisposition for type 1 diabetes benefit from probiotics right after birth. Among other things, probiotics protect against islet cell antibody which are essential for the development of diabetes Development of diabetes type-1 are responsible! Therefore, this is essential for a diabetes type 1 therapy.
I've written about this many times, but it's always important information: every antibiotic should be accompanied by a probiotic, from the start of therapy until 14 days afterward! I recommend OMNi-BiOTiC® 10 to my patients here, it contains 5 billion intestinal bacteria per serving from 10 different strains that naturally occur in the human gut. Scientific studies have shown that the bacteria contained in OMNi-BiOTiC® 10 can settle in the intestine and multiply.
Hannah has been taking OMNi-BiOTiC® SR-9 with vitamins B2, B6 and B12 in the morning on an empty stomach for 1 year. She says it makes her perk up and her more robust nervous system. In my experience, the nine strains of bacteria naturally occurring in the human intestine contained in OMNi-BiOTiC® SR-9 have a positive effect on the immune system, Anti-inflammatory on the intestinal mucosa and promote the colonization of butyrate-forming germs. In my opinion, this is especially for diabetics an important process. In addition, vitamin B2 in particular contributes to the Maintenance of normal mucous membranes as the intestinal mucosa with.
In the evening, Hannah takes the multispecies probiotic OMNi-BiOTiC® HETOX light, right before sleeping. From a number of studies and from experience with many patients, I can well assess the regulating effect of the bacteria it contains on the metabolism. This applies to both type 1 and type 2 diabetes, which I will report on shortly.
Let the sun shine!
Today we know that apparently amount of sunlight and the thereby in the first ten years of life produced amount of vitamin D have great influence on the probability whether someone develops diabetes type-1 or not. This could explain the phenomenon that more people in northern Europe suffer from type 1 diabetes than in southern Europe. The administration of Vitamin D in infancy can have a preventive effect.
In fact, a normal amount of vitamin D – compared to a vitamin D deficiency – improves the Insulin sensitivity considerably. In addition – this is of course quite decisive with regard to diabetes mellitus – vitamin D stimulates the insulin-producing cells and the to increased production of. **Recent studies show: Vitamin D can also positively change the composition of the intestinal flora and balance the immune system!
Orthodox medicine and probiotic diabetes type-1 therapy – a good connection
For type 1 diabetics, it is important to eat more often Insulin therapy indispensable. The better a diabetic is adjusted, the more likely it is that possible acute complications and consequential damage can be avoided. If the Blood sugar levels If a person's insulin level is poorly adjusted over a long period of time, this can damage small blood vessels over time, which in turn can affect the kidneys, retina or nervous system. The amount of insulin that has to be injected depends on the remaining production of insulin in the liver Pancreas From.
At first, Hannah was completely disturbed by the prospect of always having to inject insulin in the future Attach needle to have to, but in the meantime she has integrated it quite naturally into her everyday life. Recently she has been carrying a Sensor on the upper arm, that reliably measures her glucose level every five minutes and sends it to her cell phone via a transmitter. This way she can always judge what she can eat and when she needs to inject herself with insulin.
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Diet is the key
Indeed, a conscious diet is particularly important for diabetes patients and indispensable for type 1 diabetes therapy. The Carbohydrate intake and insulin supply should be optimally coordinated. It is therefore advisable to eat more often, but smaller meals. What one eats must also be taken into account, of course: The intake of simple sugars such as Glucose and Sucrose should be reduced to a Minimum limited its. They are absorbed more slowly. Therefore, do not let the blood sugar level rise so quickly. Hannah has long since internalized these relationships.
Among the foods with complex carbohydrates count u. a. Whole grain products, Legumes, high-fiber vegetables and – more acidic – fruit, the latter in small quantities. Products made from white flour should be avoided, because wheat is quickly converted into sugar! I had advised Hannah right at the beginning, before a carbohydrate-containing meal best something Protein to take in, for example, a low-fat natural organic yogurt. At first she shuddered at the thought, but the reasons made sense to her: The blood sugar does not rise so abruptly as a result.
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"Low fat? Does it really have to be?"
Hannah's horror was familiar to me from many other patients to whom – for whatever reason – I had to give a Change of diet had put to the heart. I explained to her that, unfortunately, fats also have an influence on blood sugar … which, stupidly enough, also affects the exact determination of her own insulin status is made more difficult: Until the blood sugar level increases due to a fat or protein intake, some time is always.
The reason why this is not a trivial indication can be seen in another context: after eating fat, for example, many fatty acids in our blood, and that can Insulin resistance evoke! In addition, some protein building blocks be the reason that the pancreas Glucagon is released – with the effect that Sugar from the liver is released directly into the blood. With this knowledge, Hannah was able to develop a nutrition plan that includes both of these important nutritional components – fat and protein – optimally included. Above all, the so-called fat-protein ratio (FPE) is useful here because it indicates how long the effect of fat and protein lasts:
Duration of effect of FPE
1 FPE (100 kcal) over 3 hours 2 FPE (200 kcal) over 4 hours 3 FPE (300 kcal) over 5 hours 4 FPE and more over 7-8 hours Usually one unit of short-acting analog insulin or regular insulin is needed per FPE.
What diabetics unfortunately have to learn
"But how do I know how many FPEs I'm getting in me and when?" Hannah was initially understandably despondent in view of the abundance of information and measures with which it should suddenly deal. Not for nothing there are regular Introductory courses for diabetics! As a possible formula to calculate the FPE I gave her:
(Fat in g x 9) + (Protein in g x 4) = Total calories from fat and protein. If you divide these total calories by 100, you have the FPE quantity.
Helpful to determine Effect of carbohydrates on blood sugar is the so-called glycemic index (GI). It describes how much blood sugar rises after consumption of carbohydrate-containing foods compared to pure glucose. The GI of 50g glucose is 100%, from which the other values are derived: a GI of over 70% is considered to be high, a GI between 55% and 70% is called medium value and a value below 50% is considered to be low.
Hannah's head was spinning at the time, and she had my full sympathy. Her mother, however, promised her to fully immerse herself in this topic. And by learning to use the glycemic index as a guide, they were able to find a way to lower Hannah's blood sugar balanced diet ensure. Good to know: 700g of cooked carrots have the same GI as 5 slices of toast – without toppings! Even more accurate, of course, is the calculation of the Glycemic load, as this takes into account the weight of the food.
classificationGlycemic Index (GI)Glycemic load (GL)
low< 55< 10
high> 70> 20
Thank goodness the internet offers nowadays a lot of tables with food and their glycemic load or glycemic load. Index. In orthodox medicine are the GI resp. Although GL is still controversial, I always recommend to my diabetes patients to follow it – with good success.
With the Pope at my side
Dr. Nicolai Worm is generally considered the "pope of the GI" or the "pope of the GI". GL – he has written many books about it. "How does it look then actually with diabetic and dietary products from?", Hannah had interjected – probably in the hope of escaping all the arithmetic. But unfortunately I had to pull the tooth out of her right away: Many of these products contain Sugar substitutes such as fructose or sorbitol, for diabetics not necessarily suitable are. In natural quantities – z. B. in the form of fruit – fructose can be consumed relatively safely, but it is important to keep in mind that fructose a higher sweetening power has as z. B. Glucose.
At least in one respect I could give Hannah a Comfort to give her on the way: On their beloved Skateboards she does not have to do without, because exercise is a natural way of lowering blood sugar!
During her visit a few days ago Hannah made the impression of a cheerful, fun-loving young woman on me. You see: Even a diagnosis that is initially perceived as "devastating" doesn't have to mean the Life feeling impair. With a conscious diet, some things can be "buffered", without the Pleasure factor to completely neglect!
So I can only advise you again and again to always listen to your friendly intestinal bacteria – for the sake of your health.
Have a nice weekend! Yours sincerely, Dagmar Prabler
* All names changed
**Bashir M, Prietl B, Tauschmann M, Mautner SI, Kump PK, Treiber G, Wurm P, Gorkiewicz G, Hogenauer C, Pieber TR. Effects of high doses of vitamin D3 on mucosa-associated gut microbiome vary between regions of the human gastrointestinal tract. Eur J Nutr. 2016 June; 55(4): 1479-89
In my blogs I describe experiences from my practice, especially the course of some specific treatments. I would like to point out that the described courses are individual cases and no general conclusions can be drawn from them. Other people may react differently, even if they experience the same treatment. These are my subjective perceptions, there is no promise of a cure. If you have any complaints, you should consult a doctor or alternative practitioner. My blogs are exclusively editorial contributions. Besides the described products there are others from other manufacturers.