More Type 1 Diabetes

As I’m sure you know, a diabetes epidemic is assaulting our children. The diabetes in this epidemic is type 2 diabetes, in an earlier era called adult onset or non-insulin dependent diabetes—because it showed up in adults and didn’t require insulin as a treatment. This is in contrast to type 1 diabetes, formerly juvenile or insulin dependent diabetes—because it showed up in children and required insulin as a treatment.

An important thing to know about type 1 and type 2 diabetes is that they are really very different illnesses. Type 2 is a slow collapse of a person’s energy metabolism, a body’s gradual decline in its ability to move energy in a healthy way. Type 1 is a rapid collapse of a person’s ability to produce insulin—a key player in his or her energy metabolism. Type 1 has been recognized for some time as an autoimmune disease—the insulin producing cells of the pancreas are attacked by the immune system.

You might be surprised to know that there is an epidemic of type 1 as well as type 2 diabetes. For example, at the 2012 meeting of the American Diabetes Association, researchers reported that over the last 10 years type 1 diabetes among children in the US increased by 23%. Type 2 among children increased by 20%. It’s worth mentioning that this acceleration in type 1 diabetes isn’t unique to the United States or to European countries: it’s worldwide.

I find it appalling that the researchers, the American Diabetes Association, and the media all report that no one really knows why the rise in type 1 diabetes in children is happening. It has the clear marks of an environmental disease—yet no one in officialdom seems to have the wit or courage to venture outside the favorite issues of bad food, lack of physical activity, and obesity (all of which have the scent of blame-the-victim and which divert our attention from systemic causes of disease).

Some people outside the mainstream recognize the problem as environmental. In 2010 Dan Hurley published Diabetes Rising, which describes the increase in type 1 diabetes over the last 100 years. He lists a number of theories that have been advanced to explain what triggers the autoimmune response that causes type 1 diabetes. Among these are the increasing exposure to manufactured chemicals (including endocrine disruptors), the decline in vitamin D (from the decline in exposure to sunlight), and the increased sensitivity of the immune system (which also shows up in the rise in asthma and food allergies among children).

Sarah Howard has also thought about the environmental causes of type 1 diabetes. She hosts a website on the topic and serves as moderator of a Collaborative on Health and the Environment’s Working Group on Diabetes-Obesity Spectrum. In particular, she introduces two important ideas.

One idea is that extremely low dose exposures can have profound effects. The other is that mixtures of exposures can have synergistic effects. So, for example, endocrine disruptors at low doses might increase the likelihood of a type 1 diabetes autoimmune response, but in combination with low vitamin D and a misguided immune system will increase the likelihood even more.

This failure to attend to the growing number of environmental illnesses is no surprise. The social and physical environments that cause type 1 diabetes (and type 2 as well) are oceanic in their force. Health institutions, even if they were aggressive about the science, would be… are overwhelmed.

We’re saturated with manufactured chemicals not just because the chemical industry is powerful but because disentangling those chemicals from the cornucopia of products and processes we associate with civilized life is virtually impossible. Yes, in principle it’s possible—a truth on which the hope of reform hangs—but practically speaking the current flows mightily against it.

The decline in vitamin D is not simply a result of an increasingly urbanized population in which people and their children choose to spend more time indoors. Although in the agricultural economy of 100 years ago, life outdoors was common, simply moving to the city is not explanation enough for reduced sunlight. Children’s lives have been structured around indoor activity—and not just by the aforementioned cornucopia of products. Schools have been designed as indoor enclosures that train children to be civilized.

Some years ago, I came across a book titled Diabetes as a Disease of Civilization (Joe & Young, 1993). It was written by a group of Native American health activists. Their perspective was that European civilization imposed a variety of conditions—such as foods foreign to the Native diet—that led to the incredibly high rates of diabetes among Native peoples.

Yet all of these critical thinkers fail to penetrate the scientism and reductionism that is the hallmark of the science that is a cornerstone of civilization. Dan Hurley concludes his book with a call to reform the food environment. Sarah Howard calls for the reform of the chemical environment. The contributors to Diabetes as a Disease of Civilization call for a return to a Native diet validated by conventional science.

If diabetes is a disease of civilization, then we won’t get anywhere until we accept that civilization is the cause, it’s what’s wrong—not the bad food, the inactivity, the chemicals, and all the rest. Those are just the downstream effects, not the cause. So the way to prevent diabetes and autoimmune diseases and many of the other plagues that assault us is to get out of civilization’s oceanic forces and find a current that will take us back to shore.