“All disease begins in the gut”. This is one of the most famous quotes from Hippocrates. It may seem like a bit of a stretch to say that all disease originates from one place, but here we are again with yet another study linking a common disease to the gut. Perhaps Hippocrates was known as the father of modern medicine for a good reason. A study from January 2017 in The Journal of Clinical Endocrinology and Metabolism shows that patients with Type 1 diabetes have distinct microbiota and inflammatory profiles compared to patients without diabetes or even patients with celiac disease.1
Type 1 diabetes… is that the kind my friend/cousin/coworker has?
Let’s start with a brief overview of the two major kinds of diabetes. While it’s likely you know someone with diabetes, the odds are good that person has Type 2 diabetes, commonly known as “adult-onset diabetes”. Type 2 diabetes is a chronic condition in which the body has difficulty using insulin due to the development of insulin resistance. 90-95% of diabetics have Type 2. On the other hand, Type 1 diabetes is an autoimmune condition that causes the immune system to attack the beta cells of the pancreas. These are the cells that produce insulin, so the pancreas is only able to produce small amounts of insulin, if any at all.
What is the significance of this study?
The results of the study indicate that individuals with Type 1 diabetes have microbiomes and inflammatory signatures that differ from individuals without diabetes and individuals with other kinds of autoimmune conditions. “Some researchers have theorized that the gut may contribute to the development of Type 1 diabetes, so it is important to understand how the disease affects the digestive system and microbiome” said the study’s senior author, Lorenzo Piemonti, MD, of the Diabetes Research Institute at San Raffaele Hospital in Milan, Italy. Piemonti also added that, “We don’t know if Type 1 diabetes’ signature effect on the gut is caused by or the result of the body’s own attacks on the pancreas. By exploring this, we may be able to find new ways to treat the disease by targeting the unique gastrointestinal characteristics of individuals with Type 1 diabetes.”
Piemonti’s comments suggest that further research is necessary to determine which came first, the diabetes or the egg…er, microbiome. Which is the cause, and which is the effect? Imagine the possibilities that this knowledge could provide us. If it is determined that a dominance of particular strains of bacteria in the microbiome is more likely to cause Type 1 diabetes, entirely new avenues of screening for, diagnosing, and treating Type 1 diabetes could surface. It could also mean that positively altering microbial composition in the gut through proper diet and probiotics might be able to effectively combat the onset of Type 1 diabetes.
1Pellegrini S., Sordi V., Bolla, A. M., Saita D., Ferrarese, R., Canducci F., Clementi M., Invernizzi F., Mariani A., Bonfanti R., Barera G., Testoni P. A., Doglioni C., Bosi E., Piemonti L., Duodenal Mucosa of Patients With Type 1 Diabetes Shows Distinctive Inflammatory Profile and Microbiota, The Journal of Clinical Endocrinology & Metabolism, Volume 102, Issue 5, 1 May 2017, Pages 1468–1477, https://doi.org/10.1210/jc.2016-3222
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