New research suggests increasing Vitamin D intake may help prevent type 1 diabetes. First-year NICBC student Leslie Johnson breaks down the essentials.
What is Diabetes?
In 2017, the CDC reported that there are 23.1 million people living with diagnosed diabetes and another 7.2 million people living with undiagnosed diabetes. This number includes people with both type 1 diabetes and type 2 diabetes, however, it is estimated that only 5 to 10% of people with diabetes have type 1.
Though they share a common name, the pathogenesis and treatment is drastically different between the two diseases. Type 2 diabetes is the most common form and typically develops slowly whereas type 1 diabetes develops quickly and is diagnosed within weeks of its onset. Both types of diabetes involve a disruption in the body’s ability to utilize or produce the proper amount of insulin- a hormone that allows glucose to move into cells where it is eventually converted into energy to be utilized for normal body processes.
Type 2 diabetes is characterized by insulin resistance–meaning fat, liver, and muscle cells do not properly respond to insulin. This unresponsiveness ultimately results in the body’s inability to metabolize glucose which can lead to high levels of glucose in the blood. If left untreated, type 2 diabetes can lead to complications such as blindness, nerve damage, and death so it is important that people receive the proper treatment. For many, the disease can be managed and potentially reversed with lifestyle changes such as increased physical activity, decreased consumption of foods high in refined sugar, and increased consumption of foods high in fiber. For others, the disease may not go away but can be managed with medication and–if necessary–insulin injections.
Type 1 diabetes is an autoimmune disease in which the insulin producing cells in the pancreas are destroyed by the body’s own immune system. This lack of insulin leads to high glucose levels and, if left untreated, can result in death in a matter of days. There is no confirmed cause of the disease, however, many believe that there are both genetic and environmental factors that result in the onset of type 1 diabetes. It is often diagnosed in childhood and there is no cure or preventative measure for the disease. Treatment for type 1 diabetes requires blood glucose monitoring, insulin injections, carbohydrate counting, and regular medical checkups with an endocrinologist.
Type 1 Diabetes Pathogenesis
Every year in the United States, 40,000 people are diagnosed with type 1 diabetes and, to manage it properly, it requires high-tech devices, monthly orders of medical supplies, and frequent healthcare visits equating to over $14 billion in annual medical expenses. As of today, there is no confirmed explanation for what causes a person to develop type 1 diabetes.
Some research has shown certain triggers, such as viral infections, may be associated with the onset of the disease. Because of this, developing a viral vaccine may be one way to prevent type 1 diabetes. Furthermore, the incidence of type 1 diabetes is on the rise and researchers speculate that it is likely due to some changes in the environment, though no specifics have been confirmed.
However, there are many research studies focusing on both genetic and environmental components of the disease’s progression. One area of research is an examination of Vitamin D and the role it plays in type 1 diabetes prevention. There have been multiple studies that link a lower incidence of type 1 diabetes to populations with higher levels of Vitamin D–derived from both the diet and the sun.
What is Vitamin D?
Vitamin D is a micronutrient that plays an essential role in bone formation, cell growth, immune function, and numerous other life sustaining functions. While it can be found naturally occurring in certain foods (salmon, mushrooms, cod, etc.) and fortified in others (milk, orange juice, cereals, etc.), the majority of vitamin D comes from the skin when it is exposed to sunlight.
Once the skin is exposed to sunlight, the body undergoes a multitude of chemical processes that convert it to a form that the body can use. Vitamin D both from the sun and ingested from food gets sent to the liver so that it can be changed into a substance called 25(OH)D, which is what the body ultimately sends to different tissues to turn it into a form of vitamin D that the body can use to perform necessary tasks and functions.
How Does Vitamin D Relate to Type 1 Diabetes?
In a large observational cohort study, called TEDDY (The Environmental Determinants of Diabetes in the Young), childhood Vitamin D levels were shown to have a significant association with the risk of diabetes autoimmunity. Diabetes autoimmunity is a preclinical outcome (the stage in a disease before the appearance of symptoms that make a diagnosis possible) that can be measured in the blood and consists of antibodies that are “diabetes related.”
These antibodies appear prior to the actual physical signs of type 1 diabetes. In this study, the researchers looked for the appearance of the antibodies in blood samples from children with and without type 1 diabetes. The presence of these antibodies does not mean that a person will develop type 1 diabetes. However, people with the antibodies have been shown to have a one in 20 chance of developing the disease while the general population without the antibodies only has a one in 300 chance. Children with higher vitamin D levels had significantly fewer antibodies than those with lower Vitamin D levels.
There is no confirmed correlation between type 1 diabetes and the role of Vitamin D in its prevention. However, there are multiple studies that produced results pointing towards the speculated conclusion that higher childhood Vitamin D does have a role in preventing it. This research is still in the early stages, but shows promising evidence that could lead to early intervention in the prevention of type 1 diabetes.
Leslie Johnson is a first year NICBC student who recently moved to Boston from Lexington, KY. She is pursuing an RD while attempting to learn Russian in her “spare time.” She also loves to walk, read, and look at vegetable themed clothing on Etsy.