Tag Archives: type 2 diabetes

Is it just me, or…is leptin a serious player in the overall equation of type 1 diabetes?

January 29 2017

January…thankfully nearly over! The long, dark nights and cold, dark mornings are almost unbearable. But there is a small way to capitalise on this cold, bitter weather to get fitter. As a health conscious t1d (Type 1 diabetic), I am always on the lookout for ways to stay healthy, eat well and keep my body moving.

Loads of new studies are telling us that being cold is actually good for us. Why? Because it enables our brown fat (yes, the other, good kind of fat in our bodies!) to help burn up our unwanted white fat. How do we do this? There are several ways. When we are cold, our brown fat kicks into action and heats up our white fat, essentially burning it off to keep our bodies warm. The colder it is outside, the more calories we will ultimately burn to stay warm. If we can stay outdoors a bit more in this bitterly cold time of year, even if only for a few extra minutes (try walking instead of taking the bus, plus it will warm you up even more), we can increase our fat-burning potential by essentially resetting our leptin resistance. Too good to be true? Maybe yes for the t1d.

Leptin is a blood-borne protein that is now seen as a revolutionary factor in a multitude of ways: most importantly for reducing food intake as it acts as an on/off switch for feeling satiated after eating. It is also critical for activating a second, back-up method to stop overeating. It sends a signal from the liver stimulated by insulin which is then sent to the brain to turn on the ‘off switch’.

However, it doesn’t work in t1ds because they don’t have the insulin to trigger the stimulus. For Type 2 diabetes, the overeating behaviour leading to diabetes can be modified through both motivational and behavioural change models, as it can be controlled by diet and lifestyle changes (however in extreme cases or frequently when people can’t commit to these, medication can be administered to control it). But as a Type 1 diabetic (not behaviourally related), I am curious to see where research might head on this ‘stimulated off switch’ issue as I am always hungry, but have been told for years it’s because I am on insulin (which makes a person hungrier). One might surmise that the insulin I am injecting should trigger the ‘off switch’, but in fact, the more insulin I take, the hungrier I feel.  Or is this problem due to the fact when I take insulin, I regularly hypo and then feel the need to ‘panic eat’ to correct the hypo? I’m not sure I recognise the difference anymore.

Could unlocking the key to leptin be revolutionary for Type 1 diabetics in a multitude of ways? Maybe in time with more research leptin will prove to be the new ‘off switch’ allowing Type 1s the ability to finally feel satiated.

Is it just me, or…press people, can we please specify which type when talking about Type 1 or Type 2 diabetes?

September 13, 2016

Dear Times Editor,

I cringe as I read articles written by Katie Gibbons coming out of the Times about type 2 diabetes lately. In the last 6 weeks there have been 2 articles that have an attention grabbing headline about the ‘fear of getting diabetes’. But what your journalist really means is: ‘getting type 2 diabetes’.

Please would you be so kind as to specify in all future articles that the fear is real for sedentary people with poor diet and exercise regimes, or those from certain ethnic groups, of getting type 2. And what strain the obesity epidemic is putting on the NHS – but not type 1 diabetes.

Diabetes UK has a press guide for distinguishing how to discuss the two very different diseases here: https://www.diabetes.org.uk/Documents/News/0399B_Journalists_GuidanceA5_V2_2016.pdf

It’s worth noting those of us living with the autoimmune disorder of type 1 shouldn’t be lumped into the fear mongering – we’re already managing what will be a lifetime with our chronic immune disorder and don’t need any additional stress to raise our cortisol levels. Type 1 is not, nor will it ever be, reversible through ‘diet or exercise’. When Katie Gibbons wrote this morning: “One in ten will have diabetes within 20 years”, what she really meant is 1 in 10 will have type 2 diabetes within 20 years. The underlying message in the article is clearly the problem with sedentary lifestyles and the rising obesity problem due to a hefty dietary reliance on sugar – both in the UK and globally.

But still, the headline should have read: 3.6 million people have type 2 diabetes to clarify the huge difference between the two diseases. The clarity is: #t1d is an autoimmune disease and should be discussed as such in the press when writing about #t2d. It is imperative that the press and general public understand the difference between the two. And that the strain on the NHS Katie references is most likely not coming from the ten percent (roughly 400,000) type 1s. In fact, many type1s I’m in communication with fund many of their own supplies, including the very expensive glucose monitoring flash systems (like the Abbot Freestyle Libre) so we can simply and constantly monitor our blood glucose levels because we’re tired of pricking our fingers 10 times a day and don’t appreciate the bulk of the CGM systems.

Katie’s sentence “People with type 1 diabetes usually develop the condition in childhood and it is not linked to diet, weight or lifestyle habits” really should have read: “People who have type 1 diabetes tend to develop this autoimmune disorder early in life, but very little is known about what environmental factors end up triggering the disease and one can develop it at any time”.

There are still too many unknown factors with regards to what causes a person’s immune system to turn on itself and kill those precious beta cells we need to stay alive. Some current thinking in the science is that antibiotics in our food and those taken for medical reasons directly influence t1d coming on which means to some degree one’s ‘diet’ could be an environmental influencer, obviously not in the same sense as a sedentary path, but specifically from eating meat, milk and eggs that are raised using antibiotics. General thinking still believes that a virus caught at some point brings out the type 1 in a person. The truth is no one knows.

I think we all appreciate the press diabetes is getting, as both types are killers, but and also now with our new PM coping every day with this constant disorder, it would be nice to make sure we’re getting the facts straight and not lumping the two together. Can’t imagine the same mistake would be made about cancer, for example, when discussing prostate versus breast cancer. While there may be similarities amongst the two, they are not the same thing at all.