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

Article Highlights

Gut Health’s Role in Type 1 Diabetes: The article emphasizes that gut dysfunction may not only impair immunity but also trigger type 1 diabetes development and blood glucose mismanagement.

Prevalence of Gut Issues: Approximately 61% of Americans experience some kind of digestive issue, and among diabetics, more than 50% will experience gastrointestinal problems linked to abnormal blood sugar control.

Gut-Immune System Connection: The gut and immune system complement each other, and their optimal performance is crucial. Compromises in gut function can impair nutrient absorption and the body’s ability to protect itself, which can lead to autoimmunity and other chronic illnesses, like type 1 diabetes.

Vicious Cycle of Deficiencies: The article discusses how nutrient deficiencies, can be both a cause and effect of gut dysfunction, leading to a challenging cycle to break.

“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?

Let’s make sense of how gut dysfunction may not only impair immunity but also trigger type 1 diabetes development, along with blood glucose mismanagement.

Let’s 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 your 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).

The image shows a symptomatic response to gut distress with a person holdong onto their stomach, which is an extremely common condition among the US population who have type 1 diabetes and troubled blood glucose levels.

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 providers 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, 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:

The image is a statement of the gut's primary functions, which are to absorb nutrients and block out foreign invaders or pathogens from entering our blood stream.

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 routine and consistent, this commonly leads to the foundation of where all hell can potentially break loose, especially if gut dysfunction is also present.

The reason why is because gut dysfunction triggers your body’s inability to absorb essential nutrients while also reducing your 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 is essential for nerve health, DNA, and energy, but many people, including meat eaters, have low-normal levels and don’t even know it.

The Tufts/Framingham Offspring Study found that 40% of people aged 26–83 have B12 in the low-normal range, and many of those people already showed symptoms (14).

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

In older adults, poor B12 absorption is commonly due to low stomach acid, inability to absorb as a result of gut damage, or lack of proteins that help bind B12 to where it’s needed.

This can then lead to general symptoms that “just getting old(er)” is typically blamed for.

The article argues conventional medicine tends to wait until lab values are clearly deficient before treating, but by then the present damage may be harder to reverse.

If low-normal levels were treated sooner, especially in those showing symptoms, they might have aged with more clarity and vitality.

Either way, most conditions like these 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 image is that of a dog biting its tail with the corresponding labels: Pernicious anemia (tail), B12 deficiency (dog's mouth), and the gut pathology (the dog).

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?

The image is a friendly picture of an animated stomach holding hands with the intestines as both are smiling when they're taken care of in type 1 diabetes and blood glucose management.

Over the past 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, called 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 a plentiful variety 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:

The image is a reminding statement of the gut's functions, which are to absorb nutrients, and keep foreign invaders out, along with the immune system.

But what supports these microbes?

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

Two factors strongly influence great gut health and are the foundation behind the variety of illness and disease.

These are 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?

The humorous gif has a person snyingly stating, "Nerd alert". — Gif source: https://tenor.com/blucG.gif

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 image states, "There are good, bad, and commensal gut microbes."

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

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

The image displays a clearer picture of gut dysbiosis commonly appearing with a low number good gut microbes, a high number of bad gut microbes, and/or a higher number of commensal gut microbes.

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 different these good gut bugs should be.

Think of it this way:

The statement paint a more clear picture of needing a numerous variety of beneficial gut microbes similar to a neighborhood (your body) benefiting fighting off a zombie invasion by having numerous firefigthers, cops, and ex-Navy seal vets that are better equipped for the attempted damage.

Ya…I’d go with option #2, as well!

The same reasoning goes behind having as many different and good gut bugs around for when foreign invaders care to test your immune system.

And these invaders 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

The image displays a picture of a buglar's hand cracking a door open & loosening a safety lock with their finger which is the comparison being made when bad gut microbes create an opening in the gut barrier, leaving the human body more vulnerable inflammation and illness in type 1 diabetes and blood glucose stability.

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 these nutrients, vitamins, and minerals.

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

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 in my post on gluten, the gut, and its further association with type 1 diabetes.

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 image above.

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

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

The image shows how gluten can impair intestinal villi by making them shorter & less capable of absorbing needed nutrients while allowing foreign pathogens to pass through and cause inflammation in type 1 diabetes & blood glucose stability.

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 can easily be your 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.

The image states why autoimmune disorders are unique in that triggering pathogens apply a molecular mimicry defense that fools your immune system into attacking itself when it thinks it's attacking a foreign invader.

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 longer inflammation and ill conditions until the gut is treated back to normal function…if ever.

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, as well (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 conditions that may also occur with leaky gut (35, 36, 37, 38).

Body’s Response to Leaky Gut

This popular gif is from KC Green that shows a dog casually calm & sitting down in a burning room of fire stating, "This is fine." Which is the comparison being made to gut dysfunction when indeed, not all is "fine". — 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.

The goal for optimal gut health is to have as many, diverse beneficial gut microbes that will support immune function, blood glucose levels, and further type 1 diabetes management.

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 are associated with type 1 diabetes development 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.