Gut Health May Be a Factor in Type 1 Diabetes in Children

One of the keys to reducing the risk of type 1 diabetes may be linked to the health of a child’s intestinal system.

A recent study comparing the gut microbiota in 15 children with type 1 diabetes to 13 children without diabetes as well as 15 children with maturity-onset diabetes of the young 2 (MODY2) is revealing significant differences.

“Compared with healthy control subjects,” explains the study published in the American Diabetes Association’s Diabetes Care Journal, “type 1 diabetes was associated with a significantly lower microbiota diversity.”

Researchers said children with type 1 diabetes also had higher levels of “proinflammatory” cytokines and lipopolysaccharides. Inflammation is a known contributor to the onset of autoimmune disease as well as to the development of diabetes-related complications.

The study also found that children with type 1 diabetes and the group of children with MODY2 had increased “gut permeability,” which is essentially “leaky gut syndrome.” A leaky gut means that foreign material from the gut is able to leak into other parts of the body.

This appears to happen more often to people who are “more prone to the potential of autoimmune dysfunction,” explains Jennifer Smith, registered dietician and diabetes educator with Integrated Diabetes Services.

“Their guts seem to be more permeable,” Smith told Healthline. “If they have environmental factors — in this case, it would be dietary — if there are inflammatory types of foods that cause irritation within the gut lining, it allows those things to move out of the digestive system and into our body, rather than being normally moved through your digestive system.”

Smith, co-author of the book “Pregnancy with Type 1 Diabetes,” adds that the irritants and allergens from the gut are then in circulation within the body.

An allergen is a type of antigen that triggers an especially aggressive response from the body’s immune system when it perceives an allergen as a threat even if it might actually be harmless to the body.

When there is a regular, consistent presence of those irritants and allergens resulting from the diet (gluten, for example), this can lead to an autoimmune response such as type 1 diabetes or celiac disease.

Smith says she’s seen similar research being presented in relation to celiac disease and type 1 diabetes.

The research is showing a consistent increase of certain bacteria and a decrease of other bacteria for people with these ailments.

Diet may play a role

The research also looks at the strong role that a person’s diet contributes to their gut biome.

“Gluten and dairy have proven in research to have a tremendous implication in the onset of type 1 diabetes,” explained Smith.

She points to another recent study linking high gluten consumption in a pregnant mother and a child’s risk of eventually developing type 1 diabetes.

Regarding dairy, Smith explains that the type of protein present in the United States’ commercial dairy products is the A1 protein. It is known to be allergenic with links in the development of type 1 diabetes.

Other countries use milk from cows that are not from this particular European descent, and instead contain the “A2 protein,” which has proven to be far less allergenic.

Populations that consume primarily A2 milk have fewer cases of type 1 diabetes compared to populations drinking primarily A1 milk.

For children with an increased risk of autoimmune disease due to a family history of autoimmune disease, Smith says avoiding or reducing gluten and commercial dairy products as well as potentially taking probiotic products could improve the issue of a “leaky gut.”

That, in turn, could help to delay or prevent autoimmune diseases such as type 1 diabetes.

Questions about the study

Some experts point out the long list of variables that complicate the results in a study like this.

“It was a small study and it was not randomized,” Dr. Stephen Ponder, a pediatric endocrinologist and 2018 Diabetes Educator of the Year, told Healthline. “I didn’t see a statement that the patients were not related, which could introduce some bias concerns, too.”

Ponder, co-author of the book “Sugar Surfing,” adds that participants also seemed to all live in the same general area, which means their food and water supply could also have an impact on their gut bacteria.

“It is intriguing to consider how microbiota varies from region to region, and even within different ethnic and racial populations, too. Which means the question about cause versus effect can’t be answered by a small study like this,” he said.

For Ponder, this research presents far more questions than answers concerning the role that our gut plays in the development of diseases such as type 1 diabetes and celiac disease.

“I hope they cast a wider net next time and look at populations in different regions, levels of glycemic control, and their ages,” he said. “As our gut microbiome is constantly churning, it must play a role in both protecting us and at times exposing us to risk.”

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