What is Type 1 Diabetes?: Diet, Lifestyle, and Supplementation

Type 1 diabetes is an autoimmune disease that causes the destruction of insulin-producing cells in the pancreas, known as beta-cells, resulting in a lifelong dependence on exogenous insulin via injection, insulin pump, or inhalation device. (21)(30) Insulin is necessary for the transport and conversion of glucose within the cells. The pancreas also produces glucagon, a hormone responsible for raising blood glucose levels when they’re too low. (20) When insulin production and glucose uptake is impaired, cells lack the energy they need, and blood glucose (sugar) can rise to dangerous levels. (32)

Often referred to as juvenile diabetes, type 1 diabetes most commonly presents in childhood. However, 25% of people with type 1 diabetes are diagnosed in adulthood. (15)(22) As of 2020, approximately 1.6 million people in the United States and over 300,000 people in Canada live with type 1 diabetes. (15)(16)(21)

Did you know? Type 1 diabetes affects 1 in 300 people over age 18 in the United States. (21)

Type 1 diabetes risk factors include young age and having a family history of the condition. Additionally, specific populations are considered to be at increased risk of developing type 1 diabetes. For example, Caucasians are more likely to develop type 1 diabetes than African Americans and Hispanic or Latino Americans. (11)

A simple blood test, which measures hemoglobin A1c (HbA1c), a measure of long-term average blood sugar, and fasting or random blood sugar (glucose) levels, can help your practitioner determine whether you have type 1 diabetes. (9) Your practitioner may also test you for autoantibodies, which are antibodies that target the body’s healthy tissue, and are indicative of type 1 diabetes but not seen in type 2 diabetes. (10)

Diagnosis of type 1 diabetes in children is more common than in adults.

Signs, symptoms, and complications of type 1 diabetes

Being able to identify type 1 diabetes symptoms is essential as symptoms can often present suddenly. Poorly managed or undiagnosed type 1 diabetes may lead to serious health complications and can be fatal.

Type 1 diabetes symptoms include:

• Blurred vision
• Excessive thirst (polydipsia)
• Fatigue
• Frequent urination (polyuria)
• Fruity-smelling breath
• High blood sugar (hyperglycemia)
• Tingling or loss of feeling in the hands and feet
• Weight loss (4)(21)

Type 1 diabetes complications include:

• Eye conditions (e.g., glaucoma, cataracts)
• High blood pressure
• Ketoacidosis (dangerously high levels of ketones)
• Kidney disease
• Neuropathy (nerve damage)
• Skin infections
• Stroke (2)(4)

Symptoms of type 1 diabetes in children, adolescents, and adults include blurred vision, excessive thirst, fatigue, and high blood sugar.

Managing type 1 diabetes

There is no known cure for type 1 diabetes, however, certain lifestyle modifications, including regular exercise, proper diet, and stress management, coupled with insulin administration and other medications, may help. (10)

Exercise

The American Diabetes Association (ADA) recommends that adults with type 1 diabetes engage in at least 150 minutes of moderate-intensity exercise per week. (12) Adults are also encouraged to participate in two to three resistance training sessions per week on non-consecutive days. Furthermore, individuals with sedentary lifestyles, such as those who sit for long periods of time at a desk, should aim to stand up, walk around, or stretch your arms and legs every 30 minutes. (5)

It’s important to monitor your blood sugar before, during, and after an exercise session to determine how different physical activity types affect your blood sugar levels. (5) Blood sugar levels can become dangerously high or low both during or after exercise, especially following high-intensity activity. If your blood sugar is low before exercise, a pre-workout snack containing approximately 15 grams of carbohydrates can help raise your blood sugar levels and prevent hypoglycemia. (5) Alternatively, if your blood sugar is too high before exercising, your healthcare practitioner may advise you to check your blood or urine for ketones using reactive strips or meters. Ketones are produced by your liver when you don’t have adequate amounts of insulin to convert glucose into energy. (5) Ketones in your blood or urine may indicate that you’re not getting enough insulin, and in severe cases, high ketone levels may indicate a condition known as diabetic ketoacidosis, which may lead to coma or death. (29)

Regular exercise is essential for overall health. Particularly important for individuals with diabetes, exercise can help you maintain a healthy weight and keep your blood sugar levels balanced. Regular exercise also helps maintain proper blood circulation and nerve function, to avoid some of the possible complications from diabetes later in life. Before beginning an exercise routine, consult a healthcare practitioner for recommendations and tips for monitoring your blood sugar levels.

Diet

Before the introduction of exogenous insulin in the 1920s, a very low carbohydrate diet was the only option to manage type 1 diabetes. (6) Today, biosynthetic or animal-derived insulin are used in the treatment of type 1 diabetes, although diet still plays an important role in the management of diabetes. The ADA has not established specific recommendations for a type 1 diabetes diet, however, they recommend minimizing the consumption of processed foods, added sugars, refined grains, and starchy vegetables, such as potatoes and corn, as they can raise your blood sugar levels quickly. Choose whole foods instead of highly processed and pre-packaged foods as often as possible and consider following a Mediterranean diet, which emphasizes the consumption of vegetables, fruit, whole grains, legumes, nuts, seeds, and lean proteins. Eating small, frequent meals throughout the day can also help keep your blood sugar levels in check. (13)

Download a handout on the foundations of a healthy diet.

Recent research has also indicated the potential effectiveness of the ketogenic (keto) diet and low carb diet in the therapeutic management of metabolic diseases, including type 1 diabetes. (18) The ketogenic diet, which promotes a very low-carbohydrate, high-fat, and moderate-protein dietary pattern, shifts the body’s metabolic state in ketosis, allowing the body to use fatty acids for energy instead of glucose. (17) Individuals considering a ketogenic or low-carbohydrate diet should first consult a healthcare practitioner as insulin or other medications may need to be adjusted to prevent low blood sugar levels (hypoglycemia). (19)

Some research has identified the benefits of a high fat, low carbohydrate keto diet and type 1 diabetes.

Stress management

Extensive research has identified an association between stress and impaired glycemic control. (14) Acute stress has been shown to increase glucose production and reduce glucose utilization, meaning it stays elevated in the blood for too long. Further, sudden changes in blood sugar levels can contribute to changes in mood or increased feelings of stress. It is also common for patients to experience diabetes-related stress, which describes the emotional stress related to the management and pathophysiology of type 1 diabetes. Research has demonstrated that managing diabetes-related stress may improve HbA1c levels. (14) Furthermore, a systematic review found that children of single-parent homes or low socioeconomic status are more susceptible to diabetes-related stress and, consequently, poorer glycemic control. (27)

Stress can be managed in numerous ways, including:

• Finding a hobby or activity you enjoy
• Joining a support group
• Practicing mindfulness and meditation
• Regularly exercising
• Seeking professional help
• Spending time with supportive friends and family (3)

Supplement ingredients for type 1 diabetes

In addition to exogenous insulin and other practitioner-recommended medications, certain dietary supplements may be beneficial to a type 1 diabetes treatment plan.

Vanadium

Vanadium is a trace element found in a variety of foods, including milk, lobster, vegetables, and grains, that has demonstrated some therapeutic potential for patients with type 1 diabetes. (7) In a long-term study of 14 patients with type 1 diabetes, daily vanadium supplementation for 30 months significantly decreased fasting blood sugar levels and lowered insulin requirements. (26)

Gymnema (Gymnema sylvestre)

Gymnema is a medicinal herb commonly used in Ayurvedic medicine to control blood sugar levels. (23) A study of 27 type 1 diabetic patients supplementing with twice-daily doses of gymnema achieved an average reduction in A1c of 12.8 to 9.5% after six to eight months. In the same study, 22 individuals continued to supplement with gymnema for up to 20 to 24 months, resulting in a significant reduction of average fasting blood sugar levels. (24)

Vitamin D

Vitamin D deficiency affects up to 90.6% of type 1 diabetes patients. (8) Supplemental vitamin D has been shown to improve glycemic control in type 1 diabetics with low vitamin D status. One study found that participants who achieved a higher vitamin D status after 12 weeks of supplementation had significantly lower A1c levels. (1) Further research has demonstrated that oral vitamin D intake may support insulin therapy by enhancing beta-cell function, thus improving insulin secretion in children with type 1 diabetes. (25)

Alpha-lipoic acid

Clinical trials have demonstrated that the anti-oxidant alpha-lipoic acid (ALA) may improve diabetic peripheral neuropathy, a type of nerve damage that results in pain and numbness in the legs. (31) A meta-analysis of four trials concluded that ALA significantly improves neuropathic symptoms, including pain, burning, and numbness, compared to a placebo. (33)

Bottom line

While dietary supplements can help individuals manage type 1 diabetes, diet and lifestyle are the most important factors to be addressed. The best diet for type 1 diabetes involves avoiding processed and sugary foods, while focusing on whole foods such as vegetables and lean protein. It can be overwhelming to deal with a lifelong disease, but with the assistance of a qualified healthcare practitioner, type 1 diabetes can be very well managed, and optimal overall health can be achieved.