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Home > Living Well > Health Library > Type 1 Diabetes (Holistic)
Under a doctor's supervision, stabilize your blood sugar by eating fiber from whole grains, beans (legumes), vegetables, and fruit, and consider using a fiber supplement such as psyllium or guar gum
Under the supervision of a doctor, take 200 mcg a day of this essential trace mineral to improve glucose tolerance
Protect against diabetic complications, such as nerve and kidney damage, by taking 600 to 1,200 mg of this supplement per day
Diabetes mellitus is the reduced ability, or inability, to metabolize carbohydrates resulting from inadequate insulin production or utilization. Several types of diabetes exist: type 1, type 2, and gestational. This article concerns type 1 diabetes, in which autoimmune destruction of the beta cells of the pancreas results in insulin deficiency.
People with all forms of diabetes face increased risks of an array of complications due to chronically elevated blood glucose levels (hyperglycemia). Long-term hyperglycemia related to type 1 diabetes increases the risk of cardiovascular disease, stroke, kidney and nerve damage, Alzheimer's disease, poor wound healing, infections, and eye problems including retinopathy and cataracts.1, 2, 3
People with type 1 diabetes need insulin replacement and should work with the doctor prescribing their insulin before using any of the lifestyle or dietary changes mentioned in this article. Any change that makes the body more responsive to insulin could require adjustments in insulin dosage that the treating physician must supervise.4
It is recommended that everyone with diabetes aged 6 months and older, as well as their close household contacts and out-of-home caregivers, should be vaccinated against the flu each year.
People with type 1 diabetes who engage in regular exercise have better blood sugar control and require less insulin. They also enjoy better overall health, and may have a lower risk of cardiovascular complications.5 However, in the short term, exercise can induce low blood sugar or, if performed first thing in the morning before eating, high blood sugar.6 Therefore, people with type 1 diabetes should never begin a new exercise program without consulting a healthcare professional.
The American Diabetes Association (ADA) recommends that people with diabetes limit their per day alcohol consumption to one drink for women and two drinks for men.7 The Centers for Disease Control defines one drink as equivalent to a 12 ounce can of beer, 8 ounces of malt liquor, 5 ounces of wine, and 1.5 ounces of hard liquor (spirits). In higher amounts, alcohol is likely to be more harmful than beneficial. Drinking alcohol can make it more difficult to regulate blood glucose levels in people with type 1 diabetes.8 Although the evidence is far from conclusive, it appears different types of alcohol have different effects on health for people with type 1 diabetes: regular consumption of spirits was reported to increase risk of microvascular complications such as kidney and eye diseases, while moderate consumption of wine was reported to be protective.9, 10 Since no benefits have been clearly established, it is not advised that people who do not drink alcohol begin doing so simply for its possible health effects. Ask your doctor what is best for you, taking into account your personal medical history.
People with diabetes who smoke are at higher risk for kidney damage, nerve damage, heart disease, and other diabetes-related health problems.11 Therefore, it's important for people with diabetes who smoke to quit.
Most healthcare providers agree on the necessity of self-monitoring of blood glucose (SMBG) by people with type 1 diabetes. Advocates of SMBG, such as the ADA, have observed that SMBG by people with diabetes has revolutionized management of the disease, enabling them to achieve and maintain specific blood glucose and laboratory value goals. Now, technological advances have brought continuous glucose monitoring devices along with continuous subcutaneous insulin infusion pumps that can replace SMBG and insulin injections in order to further refine regulation of blood sugar and insulin levels.12, 13, 14, 15 In the context of rapidly changing technologies for monitoring blood glucose control, it is important to talk with your doctor about what form of glucose monitoring is right for you.
Acupuncture may be helpful in the management of diabetes, or complications associated with the disease. In a preliminary trial, 77% of people suffering from diabetic nerve damage (neuropathy) experienced significant reduction in pain following up to six acupuncture treatments over a ten-week period. Many also were able to reduce pain medications, but no long-term change in blood-sugar control was observed.16 Bladder control problems, a complication of long-term diabetes, responded to acupuncture treatment, with a significant reduction in symptoms in both controlled and uncontrolled trials.17, 18
Should children avoid dairy foods, especially early in life, to prevent type 1 diabetes? The relationship between dairy foods and type 1 diabetes risk remains unclear, although there is some evidence that milk consumption might increase the risk of developing type 1 diabetes in children who are genetically susceptible to developing the disease. Researchers noted some time ago that worldwide, in places with higher dairy consumption, children have a significantly higher chance of developing type 1 diabetes compared with areas where less dairy is consumed. Some research indicates that drinking milk may cause susceptible children to make antibodies that attack the pancreas (autoantibodies), causing type 1 diabetes to develop. One long-running double-blind, randomized controlled study has been following infants with a higher than average risk of developing type 1 diabetes due to the presence of genetic factors for the disease. Infants who were unable to consume breast milk for the first six to eight months of life were assigned to receive either regular cow's milk infant formula or a casein hydrolysate formula. While casein is found in milk, this second formula is considered more digestible and may be less likely to elicit an immune response, because the casein proteins are hydrolyzed or broken down in this product. Although initial findings from this study were promising, the hydrolyzed infant formula was ultimately not been found to reduce the risk of type 1 diabetes autoantibodies after an 11.5 years of follow up. Newer research examining whether a cow's milk formula that is free of bovine insulin is less likely to trigger autoantibody production in children has reported encouraging findings after three years, but longer observation is needed before conclusions can be reached.
Because the evidence is conflicting, there are no official guidelines recommending the avoidance of dairy foods (made from cow's milk) for children at higher than average risk of developing type 1 diabetes. However, if you have concerns about type 1 diabetes, or have a family history of the disease or other autoimmune conditions, such as rheumatoid arthritis or celiac disease, ask your pediatrician about the pros and cons of keeping dairy foods out of your child's diet for the first few years of life. Dairy can provide valuable nutrients to a child's diet, including protein, calcium, and vitamin D, so if you decide to avoid it, work with a registered dietitian who can guide you on how best to replace important nutrients with non-dairy options.
Our proprietary "Star-Rating" system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by some in the medical community, and whether studies have found them to be effective for other people.
For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.
3 StarsReliable and relatively consistent scientific data showing a substantial health benefit.
2 StarsContradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1 StarFor an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.
Vitamin D is needed to regulate immune activity and research has shown it has an important role in preventing autoimmune diseases, including type 1 diabetes. Vitamin D receptors have been found in the pancreas where insulin is made and some, but not all, preliminary evidence suggests that supplementation might reduce the risk of developing type 1 diabetes. Case reports even suggest a combination of high-dose vitamin D and omega-3 fatty acids may completely reverse the onset of type 1 diabetes.
Vitamin D deficiency is common in people with type 1 diabetes and associated with poor glucose control. Supplementation with cholecalciferol (vitamin D3), in doses ranging from 2,000 IU per day to about 6,000 IU per day, has been shown in randomized controlled trials to slow the decline of pancreatic function in people with newly diagnosed type 1 diabetes who have not yet suffered an extensive loss of pancreatic function. Furthermore, the majority of the research shows vitamin D3, in doses ranging from 2,000–10,000 IU per day, improves short and long term glycemic control in people with type 1 diabetes, particularly in those with low vitamin D status, possibly by preserving beta cell function and increasing insulin production.
Omega-3 fatty acids from fish are well known to reduce inflammatory immune activity and have beneficial effects in a range of autoimmune conditions. Observational research suggests higher levels during infancy and early childhood may be linked to lower risk of developing type 1 diabetes. One study done in Norway found that babies given cod liver oil regularly during the first year of life had a 26% lower risk of developing type 1 diabetes in childhood. However, not all studies have noted a connection between omega-3 fatty acids and type 1 diabetes risk, and some researchers have proposed the discrepancies may be explained by genetic factors affecting fatty acid metabolism.
Higher intake of EPA, an omega-3 fatty acids from fish, has been correlated with better preservation of pancreatic cells that produce insulin and long-term blood glucose control in youth with type 1 diabetes. A small pilot trial found that supplementation with 630 mg of EPA and 330 mg of DHA (another omega-3 fatty acid from fish oil) per day improved blood glucose control in subjects with type 1 diabetes. Furthermore, better omega-3 fatty acid status may be helpful in slowing the progression of diabetes-associated complications such as kidney dysfunction and nerve pain.
Although fish oil fatty acids generally have positive effects on triglyceride levels, some studies have found supplemental DHA can increase LDL- and total cholesterol, which may increase cardiac risk. For this reason, some doctors are wary of fish oil supplements for patients with type 1 diabetes and may recommend EPA-only supplements instead.
Blood levels of vitamin B1 (thiamine) have been found to be low in people with type 1 diabetes, and low levels are correlated with greater risk of diabetes-related anemia and other complications. Supplementing with B1, along with vitamins B6 and B12, was found to reduce high levels of homocysteine in children type 1 diabetes in one placebo-controlled trial. High homocysteine levels are generally correlated with blood vessel dysfunction and reducing high levels may help prevent vascular complications of diabetes. In this trial, improvement in markers of kidney function were also seen.
Several controlled trials have evaluated the effect of benfotiamine, a fat-soluble form of vitamin B1, on diabetic neuropathy in participants with type 1 and type 2 diabetes. In one of these trials, 600 mg per day of benfotiamine was more effective than 300 mg per day or placebo for reducing neuropathic pain after six weeks; in a three-week trial, those receiving 400 mg per day of benfotiamine had greater pain reduction than those receiving placebo. However, 300 mg of benfotiamine daily had no benefits on nerve function relative to placebo in people with type 1 diabetes after 24 months, suggesting this dose may be too low to be helpful.
High doses of niacin (a form of vitamin B3), such as 2 to 3 grams per day, are sometimes recommended to lower high triglyceride and cholesterol levels in people with type 1 diabetes. However, niacin's ability to reduce cardiovascular risk in the context of type 1 diabetes has not been established. It is important to note that niacin doses this high, particularly in extended release formulations, may cause flushing, stomach upset, and liver toxicity, and should be used by people with diabetes only with medical supervision.
Animal research suggests that niacinamide, a form of vitamin B3 with fewer side effects, may prevent toxic damage to the pancreatic cells that make insulin. Although one intriguing study found niacinamide supplementation was associated with a lower incidence of type 1 diabetes in children at high risk, more recent studies have not confirmed a protective effect.
A controlled clinical trial in subjects with recently diagnosed type 1 diabetes found the addition of niacinamide (25 mg per day per kg of body weight; approximately 2–3 grams per day) to intensive insulin treatment led to greater improvement in HgA1c over two years, but other clinical trials have found no benefit on glucose metabolism in similar subjects.
People with type 1 diabetes may be more likely to be zinc-deficient than their healthy counterparts. Low zinc status leads to impaired immune function and increased oxidative stress and has been linked to poorer glucose control. Zinc supplements have been found to increase antioxidant capacity and reduce lipid peroxidation in people with type 1 diabetes.
Despite evidence that zinc may be beneficial in people with type 1 diabetes, some doctors remain skeptical of high doses due to one 1994 study in which zinc supplementation, at a dose of 50 mg per day for 28 days, increased glycosylation (glucose-induced protein damage). This trial is hard to evaluate because zinc supplementation increases the life of blood cells and such an effect artificially increases the lab test results for glycosylation. In fact, laboratory studies suggest zinc can inhibit glycation. Until this issue is resolved, those with type 1 diabetes should consult a doctor before considering high-dose supplementation with zinc.
1. Barrett EJ, Liu Z, Khamaisi M, et al. Diabetic Microvascular Disease: An Endocrine Society Scientific Statement. J Clin Endocrinol Metab 2017;102:4343–410.
2. Kahanovitz L, Sluss PM, Russell SJ. Type 1 Diabetes - A Clinical Perspective. Point Care 2017;16:37–40.
3. Lee HJ, Seo HI, Cha HY, et al. Diabetes and Alzheimer's Disease: Mechanisms and Nutritional Aspects. Clin Nutr Res 2018;74:229–40.
4. Piłaciński S, Zozulińska-Ziółkiewicz DA. Influence of lifestyle on the course of type 1 diabetes mellitus. Arch Med Sci 2014;10:124–34.
5. Wu N, Bredin S, Guan Y, et al. Cardiovascular Health Benefits of Exercise Training in Persons Living with Type 1 Diabetes: A Systematic Review and Meta-Analysis. J Clin Med 2019;8.
6. Houlder S, Yardley J. Continuous Glucose Monitoring and Exercise in Type 1 Diabetes: Past, Present and Future. Biosensors (Basel) 2018;8.
7. Evert A, Dennison M, Gardner C, et al. Nutrition Therapy for Adults with Diabetes or Prediabetes: A Consensus Report. Diabetes Care 2019;42:731–54.
8. Tetzschner R, Norgaard K, Ranjan A. Effects of alcohol on plasma glucose and prevention of alcohol-induced hypoglycemia in type 1 diabetes-A systematic review with GRADE. Diabetes Metab Res Rev 2018;34.
9. Harjutsalo V, Feodoroff M, Forsblom C, Groop P. Patients with Type 1 diabetes consuming alcoholic spirits have an increased risk of microvascular complications. Diabet Med 2014;31:156–64.
10. Beulens J, Kruidhof J, Grobbee D, et al. Alcohol consumption and risk of microvascular complications in type 1 diabetes patients: the EURODIAB Prospective Complications Study. Diabetologia 2008;51:1631–8.
11. Zhu P, Pan X, Sheng L, et al. Cigarette Smoking, Diabetes, and Diabetes Complications: Call for Urgent Action. Curr Diab Rep 2017;17:78.
12. Heinemann L, Stuhr A, Brown A, et al. Self-measurement of Blood Glucose and Continuous Glucose Monitoring—Is There Only One Future? Eur Endocrinol 2018;14:24–9.
13. Bloomgarden Z. Beyond HbA1c. J Diabetes 2017;9:1052–3.
14. Galderisi A, Sherr J. A Technological Revolution: The Integration of New Treatments to Manage Type 1 Diabetes. Pediatr Ann 2019;48:e311–8.
15. Ruedy K, Parkin C, Riddlesworth T, Graham C. Continuous Glucose Monitoring in Older Adults with Type 1 and Type 2 Diabetes Using Multiple Per day Injections of Insulin: Results from the DIAMOND Trial. J Diabetes Sci Technol 2017;11:1138–46.
16. Abuaisha BB, Costanzi JB, Boulton AJ. Acupuncture for the treatment of chronic painful peripheral diabetic neuropathy: a long-term study. Diabetes Res Clin Pract 1998;39:115-21.
17. Zheg HT, Huang XM, Sun JH. Treatment of diabetic cystopathy by acupuncture and moxibustion. J Tradit Chin Med 1986;6:243-8.
18. Zhang W. Acupuncture for treatment of diabetic urinary bladder neural dysfunction—a report of 36 cases. J Tradit Chin Med 1997;17:211-3.
Last Review: 06-08-2015
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