Exploring the Connection Between Gut Health and Type 1 Diabetes: The Basics

“What factors might influence type 1 diabetes?!”

“How come it’s so hard to maintain normal blood
sugars?!”

(Cue hair-pulling and/or anxiety-fueled annoyance.)

What if I told you one big answer to these questions has a strong association with a type 1 diabetic’s gut health?

Are you ready to make sense of how a compromised gut may not only influence immune dysfunction but may provoke type 1 diabetes development and blood sugar mismanagement, as well?

If so, buckle up because in Part 1 of this series you’re going to learn:

The two vital functions of a healthy gut
How the immune system is influenced by your gut health
Your gut’s association with type 1 diabetes

Ready?

Hop in and let’s go!

Gut Health 101

Gut Stats

Before we start talking about how the gut should be working, let’s go over a few basic gut statistics to put a few things into perspective.

There’s a darn good chance that you know someone suffering from a gut illness.

Approximately 61% of Americans experience some kind of digestive issue (1).

Among diabetics, research suggests more than 50% will experience some sort of gastrointestinal (GI) problem, which may be linked to abnormal blood sugar control (2).

Another study found associations among type 1 diabetics suffering from more numerous and severe GI symptoms than those of the same age and sex without the disease (3).

These gut symptoms usually present as diarrhea or constipation while feeling bloated, among other reactions, especially after the consumption of certain triggering foods.

It is well known among medical researchers and functional medicine practitioners that one’s gut status is vital to overall health and longevity.

In other words, gut illness isn’t limited to just gut problems.

There are cases where gut illness doesn’t even cause any GI symptoms, but may contribute to a host of other conditions such as type 1 diabetes, multiple sclerosis, autism, psoriasis, rheumatoid arthritis, hypothyroidism, depression, and celiac disease (4, 5, 6, 7, 8, 9, 10, 1 1).

Now that we have an idea of how common gut problems can be, especially among type 1 diabetics, let’s go over the two primary gut functions and how their compromise may affect more than just immunity!

What Does a Healthy Gut Do?

The main functions of the gut are pretty simple:

This is where the gut and immune system complement each other incredibly.

They both heavily rely on each other for optimal performance (12, 13).

I’ll address this relationship soon but when our bodies detect any foreign substance that doesn’t belong in our bodies, it triggers an immune response.

If this immune response becomes chronic, this may become the foundation of where all hell can potentially break loose, especially if gut dysfunction is present.

The reason why is because it is likely to promote compromises in absorbing essential nutrients and minerals while also impairing the body’s ability to protect itself.

The astonishing thing about both of these problems (gut and immune dysfunction) is that once they’re detected, it can be a vicious circle attempting to determine which came first.

⚠️ Vicious Circle Example ⚠️

One example of this is vitamin B₁₂ deficiency in elderly patients.

Vitamin B₁₂ plays important neurological roles in the body, helps make DNA, and assists with producing energy and blood cells.

It’s a very common condition that’s not just a concern with vegans and vegetarians, either.

Many omnivores (eating both meat and plants) are plagued with this condition, as well, and aren’t even aware of it until symptoms arise much later.

It’s been suggested that 40% of people between the ages of 26 to 83 have low-normal B₁₂ levels (14).

Low-normal levels are still able to increase the risk of diagnosis and symptoms of B₁₂ deficiency, as well.

This deficiency can imitate typical conditions seen in the elderly that present as simple forgetfulness but may also present with more severe characteristics similar to dementia, Alzheimer’s, multiple sclerosis, Parkinson’s, cardiovascular disease, and more.

Once there is a full-blown case of vitamin B₁₂ deficiency, it has a higher likelihood of appearing in conditions like pernicious anemia, as well.

This anemia is an autoimmune disease of decreased red blood cell production, not allowing B₁₂ to be absorbed adequately in the body.

Now, the altered functions of nutrient absorption and gut barrier protection both feed into one another and can make these conditions persistently worse.

On top of that, given that the gut and immunity are compromised, a protein that helps bind B₁₂ for better absorption may now become altered, as well.

This protein is called intrinsic factor and its produced in the GI tract.

This decreased absorption of B₁₂ could have influenced pernicious anemia, while the latter could be making it even harder to absorb B₁₂…

…but then…

…the reduced intrinsic factor may be influencing all of this, as well?

Currently, conventional medicine doesn’t proactively manage B₁₂ levels rigorously unless blood biomarkers are conclusive of a particular condition.

And by the time blood work does confirm a diagnosis, it may be too late to adequately treat and resolve.

Meanwhile, many could very well argue that this particular group of elders may have been able to age more gracefully should their B₁₂ absorption capacity have been one of the factors better monitored during their check-ups*.

Either way, all of these conditions have an origin in the gut.

And it can be like a dog chasing its tail in trying to determine which one came first.

The best thing we can do to prevent vicious circles like these from occurring is to know our next topic of what determines gut health.

Diabetic Side note: B₁₂ deficiency is also commonly seen among those with diabetic neuropathy (15).

Now, that we know the gut’s primary functions, let’s see what factors help it perform optimally.

What Makes a Healthy Gut?

Over the recent 20+ years, medical research has been thriving with discoveries that demonstrate the gut’s connections with different systems, organs, tissues, and cells in our bodies.

The reason for these connections is that the GI system hosts an enormously diverse community of gut microorganisms, or microbes, that play an immense role in human health throughout the body (16).

Microbes is a word used to collectively group gut microorganisms, such as bacteria, viruses, and fungi, among others.

And yes, some of these microbes are, both, good and bad to have.

As long as there is plentiful diversity among the beneficial microbes (good gut bugs) and a lower number of pathological microbes (bad gut bugs) in the GI system, one should be able to:

But what supports these microbes?

And can whatever helps these microbes also potentially help a type 1 diabetic?

Two components strongly influence the integrity of gut health that are the foundation behind a great many illnesses and diseases when they are compromised:

The gut microbiome and the gut barrier.

1. The Gut Microbiome

The gut has over 100 trillion microorganisms spread among 1,000s of different species within them (17).

These microbes are known to have 100 times more genes than our human genome.

As a result, you could say we are more microbe cells than we are human cells.

Pretty cool, right?

These plentiful microbes all have enormous importance in the body and collectively make up the gut microbiome (18).

The gut microbiome is the total amount of microbial and genetic material present in the GI tract at a given time.

Gut Dysbiosis: The Root of Many Illnesses

One of the most important factors promoting superior gut function is the balance of microbes.

The commensal microbes are neither good nor bad in the right amounts but they can become problematic if they overpopulate in the gut.

When there is an imbalance among all these microbes, it is a condition called gut dysbiosis.

Gut dysbiosis decreases healthy microbe composition, and reduces optimal gut function, which in turn, typically compromises immunity.

Studies have shown gut dysbiosis may increase the risk of conditions such as type 1 diabetes, IBS, diverticulitis, IBD, infections, hypothyroidism, rheumatoid arthritis, and hypertension and is also believed to influence some cancers, among many other conditions (1 9, 2 0, 21, 22, 23, 2 4, 2 5, 26).

Currently, the type 1 diabetic incidence rate is approximately 15 cases per 100,000 people and steadily increasing (27).

And with strong associations between a compromised microbiome and type 1 diabetes, this is something worth having a conversation about (28).

Now, while the abundance of good gut bugs is one important variable in promoting optimal gut health, the other factor to consider is how diverse these microbes should be.

Think of it this way:

Ya…I’d go with option #2, as well!

The same reasoning goes behind having as many different beneficial microbes in your gut for when certain antigens, ranging from mild to severe, care to test your immune system.

And pathogens are routinely doing this!

This concept is so crazy-important to understand because this lack of microbial diversity has been strongly suggested to influence type 1 diabetes development (29)!

Now, let’s look at the gut barrier’s role in optimal gut function.

2. The Gut Barrier

Everything that enters your mouth to be consumed is either absorbed and distributed throughout your body accordingly or piled up with other waste your body doesn’t need and is urinated out, with the help of your kidneys, or pooped out.

To keep things simple, it’s a helpful reminder to consider anything you’re consuming as either promoting health or illness.

Nutrient and mineral absorption is made possible because the gut is naturally permeable.

Meaning that the gut normally allows beneficial substances to pass through it, like nutrients and minerals.

These helpful sources are picked up by the intestinal villi, with hair-like structures attached to them, called microvilli.

These villi and microvilli initiate what’s needed for nutrients and minerals to be picked up and passed through the gut and into the blood so they may reach the body’s tissues and cells that need them (30).

However, when the gut malfunctions and starts to permit larger proteins and other foreign substances that are not normally passed through, this is called intestinal permeability (aka leaky gut).

Leaky Gut

Gluten is a good example of a protein capable of disrupting GI function by increasing leaky gut risk.

I go into greater detail on gluten, the gut, and its further association with type 1 diabetes here.

A quick summary is that zonulin is a stomach protein that regulates the tight junctions in the intestine, which allow the right nutrients and minerals to pass through the gut.

You can see the status of both tight junction cases in the picture above.

To those susceptible, gluten has a strong connection to increased gut permeability by significantly increasing zonulin levels in the body.

Gluten will also cause damage to the intestinal villi and microvilli in those with celiac disease.

This makes it harder to absorb nutrients and can lead to further nutrient deficiency problems.

And the chaos doesn’t stop here!

Altered tight junctions also makes it easier for antigens and foreign substances to pass through the gut and enter the blood due to the tight junctions becoming looser and less restrictive.

The GI system and the body can then become overwhelmed by toxins and other pathogens in the bloodstream leading to tissue cells.

These foreign substances then reach bodily tissues that trigger an immune response to attack these invaders.

Assuming it’s an isolated incident, the immune system typically has no problem eliminating these pathogens.

However, should these inflammatory triggers be a consistent, abundant, and daily routine, antigens passing through the gut in greater numbers are likely to increase.

(Psssst!…a “consistent, abundant and daily routine” example could easily be the diet!)

Given how diverse these antigens can be, let alone how creative some are in protecting themselves, the immune system may get tricked into attacking itself.

Along with the body cells being wrongfully attacked, the beneficial microbes also typically decrease in number, diversity, and potency, leaving the gut and body more vulnerable to prolonged inflammation and ill conditions until the gut is treated back to normal function.

Beneficial gut microbes are observed to heavily influence proper immune functions. This has been observed to dramatically improve common autoimmune symptoms and conditions as a result. (31, 32).

The reason this info is good to know is that a leaky gut can also have a profound effect on chronic illnesses.

There are consistencies among the research suggesting a leaky gut can be seen well before autoimmune diseases spring up (33).

This implies that as long as healthcare providers know how to test and treat the gut proactively, many of these autoimmune conditions may very well be avoided.

With all this being said, it should come to no surprise that a leaky gut does have an association with type 1 diabetes development (34).

And it’s not alone!

Metabolic disorders (which are very common symptoms among diabetics), obesity, chronic illnesses, depression, skin conditions, and ADHD are just a small list of other potential conditions that may also occur with gut permeability (35, 36, 37, 38).

Body’s Response to Leaky Gut

Cartoon by KC Green, www.kcgreendotcom.com
Used by permission;
Gif source: https://tenor.com/wfui.gif

You now know the foundation of gut health and its impact on our immune system and its general association with type 1 diabetes.

There’s a strong argument for gut dysbiosis being a possible root cause behind type 1 diabetes development.

But what causes gut dysbiosis?

Because of this likely connection, this series of posts will be focusing on not only the gut dysbiosis triggers but how they all correlate to type 1 diabetes and its management hurdles.

Continue reading in part 2 to learn how diet may influence gut dysfunction and type 1 diabetes.

Until then, share this post with someone you feel may benefit with this information.

Summary

Your gut has two functions:
1. To break down and absorb nutrients
2. To protect your body alongside your immune system from foreign invaders (aka pathogens)
A diverse group of beneficial gut microbes that outnumber the bad ones are ideally needed to promote a healthy gut.
- When there are more bad gut bugs than good ones, it causes a condition known as gut dysbiosis, which can impair quite a few functions in your body. It’s been suggested that it can also be seen years before autoimmunity makes itself present for diagnosis.
Leaky gut is a condition that makes the absorption region in your gut less reliable and allows more things to pass through it and into the blood that normally wouldn’t. This can cause a variety of problems relating to gut and immune health.
- Eating gluten has been shown to increase the risk of getting leaky gut

References

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