This limited insulin production is not enough to prevent the patients from having to use insulin injections, but it is very important because that residual insulin production is associated with a lower risk for hypoglycemic crises and diabetic complications. So anything that could be done to preserve that residual capacity to produce insulin as long as possible would be highly beneficial to these patients.
The authors of this study looked at a number of dietary factors that have been suggested to affect the onset of type I diabetes. They looked at vitamin D and long chain omega-3 fatty acids because previous studies had suggested that they may protect against the autoimmune process that leads to type I diabetes. They looked at the branched chain amino acid leucine because previous studies have shown that it stimulates insulin secretion. Finally, they looked at carbohydrate intake because high carbohydrate intake causes high blood sugar levels which also stimulate insulin secretion.
Their study enrolled 1,316 children, average age 11, who had been recently diagnosed with type I diabetes The authors did a comprehensive dietary analysis at the time of diagnosis and measured the residual capacity of these patients to produce insulin over the next 10 months. During that 10 month period 42% of the children retained at least some ability to produce insulin.
The results of the study were very interesting.
Leucine, total long chain omega-3 fatty acids (EPA + DHA), and EPA alone were all independently associated with retention of the ability to produce insulin over the 10 month follow-up. Vitamin E and carbohydrates in the diet had no effect on the retention of insulin producing capacity. Vitamin D was inversely associated with the retention of insulin producing capacity. That last result was unexpected and conflicts with previously reported studies of vitamin D in type I diabetes.
The strength of the study is that it suggests simple dietary interventions may help preserve residual insulin production and, therefore, lower the risk of complications in type I diabetic patients.
The weaknesses of the study are obvious. The study only measures associations, not cause-and-effect. Double- blind intervention studies will be needed to prove that these dietary changes actually benefit type I diabetic patients. Finally, this is a single study and several more studies will be needed before we know whether these effects are reproducible. The vitamin D effect, for example, is particularly questionable because it conflicts with previous studies suggesting that vitamin D helps prevent the onset of type 1 diabetes.
While this paper focused solely on type I diabetics, the same dietary interventions could potentially affect patients with type II diabetes as well. Type II diabetics eventually lose the ability to produce insulin, and there are some similarities in the inflammatory pathways that lead to the loss of the insulin producing cells in both type I and type II diabetics. This is, of course, is speculation on my part at present, but it is a promising area for future research.
The bottom Line
- This study suggests that diets enriched for the amino acid leucine and the omega-3 fatty acids EPA and DHA may help preserve residual insulin production in type I diabetics. If confirmed by subsequent studies, these simple dietary adjustments could significantly reduce the risk of complications in these patients.
- There is the potential that some of the same dietary changes could help preserve insulin production in type II diabetics as well. I will keep my eye on the emerging research in this field and keep you abreast of the latest developments.
To Your Health!
Dr. Stephen G Chaney
These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.