Dietary strategies for management of Type 1 Diabetes – Part 1
by Rachel Fenske, BS
The team at YOUglycemia has noticed a deficiency in the attention we’ve paid to how our diet affects diabetes management in our series. In that spirit, we introduce Rachel Fenske, a nutritional science PhD student who is interested in the intersection of immunity, diet, and exercise.
Rachel was diagnosed with Type 1 Diabetes (T1D) senior year of high school and shortly after was additionally diagnosed with Celiac Disease. This fueled her interest in the complex relationship of diet and T1D and led her to pursue graduate school following completion of her bachelor’s degree at the University of Wisconsin – La Crosse. She entered the Interdepartmental Graduate Program in Nutritional Sciences at the University of Wisconsin – Madison in the fall of 2014 and has been working in Dr. Michelle Kimple’s lab on a variety of projects revolving around beta-cell signaling that is dysfunctional during T1D. Rachel’s interest in the interplay with exercise physiology stems from a passion for horseback riding she has had since the age of 6. It is also one of her short-term goals to complete a half marathon before she graduates with her PhD. Beyond her own interests, she hopes to share her journey with other Type 1 Diabetics so as a community they will have better understanding of the molecular pathways linking diet, exercise, and T1D and use this information to develop better strategies for management and care.
Current research on the causes of onset, progression, and exacerbation of type 1 diabetes and it’s associated co-morbidities are accelerating quickly and our understanding of many facets of the disease are growing profoundly. The development of the perfect diet for an individual with type 1 diabetes, however, has barely scratched the surface, let alone an ideal diet for a competitive athlete with T1D. The peer-reviewed research addressing these questions, have begun to shed light on the need for dietary interventional strategies to both best manage, and help enhance the efficacy of treatments for type 1 diabetes.
Extensive reviews evaluating the current research of dietary strategies for adults with type 1 diabetes, as well as in the position statement from the ADA regarding nutritional recommendations, state that due to insufficient evidence there is NO optimal balance of carbohydrates, fats, and protein that can be used to guide dietary habits, despite strong evidence that all three macronutrients can, and do, effect post-prandial blood glucose differently. Thus, there is no evidence-based recommendation that can be provided to promote the best blood glucose control and help minimize risk for complications.
What does that mean for individuals with T1D?
It means that on-going, cutting-edge research is crucially important for guiding the eating habits of type 1 diabetics and that both doctors and patients should be actively conversing about evidence-based dietary strategies. The lack of concrete evidence, in addition to the difficulty meeting blood glucose goals with current recommendations, has led people to turn to “fad” diet strategies that have gained popularity most notably due to celebrity and pop-culture influence. These diets, although sometimes extreme in nature, have shown some anecdotal potential and are, therefore, worth investigating. In a series of posts, I will evaluate the implications of these diets and their effects on T1D pathologies, as well as the biochemical and molecular signaling networks that connect dietary intake to T1D outcomes.