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Comment by bluemax | Hacker News Reader

4 years ago I got diagnosed with type 1 diabetes in my early forties. The hospital staff showed me how to manage my glucose with long acting and fast acting insuline.

As a programmer I'm good with numbers so everything was pretty much under control but I started noticing that I needed less and less insuline up to the point that I needed no insuline at all. This was about a year ago. At that same time I had some new physical health problems and it turned out I had celiac disease as well. Bummer :(

One side-effect of 'untreated' celiac is that carbohydrates are less well converted to glucose and so my glucose levels stayed normal without using insuline. Unfortunately it meant I was not cured from type 1 diabetes.

Now that I am on a gluten free diet my insuline usage is back to normal and I stopped farting as a bonus :)

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If the celiacs meant the carbs were less well converted to glucose and that's why your levels stayed normal, why not just eat less carbs now?

You sure it was Type 1?

Generally people are diagnosed with Type 1 at a very young age, since it is caused by your own immune system destroying beta cells in the pancreas, which if untreated results in eventual death.

Type 2 is more often associated with age and diet. It is the most common type in particular at later ages, but some people get it younger due to genetic predisposition.

This is really not the kind of thing that people with a diagnosis tend to be confused about.

There is early and late-onset T1D. About 25% of T1D is diagnosed as an adult [1]

[1] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925303/

The UK Prime Minister, Theresa May, was diagnosed with type 1 diabetes in her mid 50s, just a few years ago.

Type 1.5 is adult onset autoimmune diabetes

That's a bit of an oversimplification. T1 is auto-immune -- the body loses the ability to produce insulin, and you can detect autoantibodies in the blood. T2 is insulin resistance, and generally has no autoimmune component and no autoantibodies present.

Typically T1D comes on all at once; the autoantibodies destroy the insulin producing beta cells and the patient needs exogenous insulin starting immediately. A subset of adult onset T1D displays a much slower progression of the destruction of beta cells. This is called LADA (latent autoimmune diabetes of adults”) or slow-progressing T1D and more recently T1.5D.

Similarly, some T2D patients also show evidence of autoantibodies however their beta cells are still largely functioning.

So now we further split into groups; Type 1–LADA, Type 1.5 or “double” diabetes, and Type 2 diabetes with autoantibodies.

This is a good overview: https://www.diabetesselfmanagement.com/diabetes-resources/de...

Thanks! I'm a little rough on my diabetes pathology/immunology, this was a good review :)

The folks at the hospital were not sure at first. I'm neither young, nor old and overweight so there were different opinions before some specific blood test was done.

That's a really interesting story and congratulations on beating a pretty nasty disease. That must feel like a true accomplishment.

It appears, based on this, that carbohydrates drove your diabetes? I wonder if the problem is with refined carbohydrates or with gluten specifically?

Do you eat sugar, chocolate, etc?

I think you misunderstand.... Certainly congrats to bluemax for successfully managing concurrent celiac and T1D but nothing has been "beaten" here.

T1D is an autoimmune disease which destroys the pancreas' ability to produce insulin. Your body needs insulin to process sugar in the blood into energy, a large part of that sugar comes from carbs.

Celiac is an autoimmune disease which is a reaction in the gut to gluten. Exposure to gluten causes inflammation in the gut and ultimately damages the lining of the intestine to the point where your body cannot absorb nutrients (including the carbs) from the food you eat.

What bluemax observed is the damage from celiac was restricting his carb absorption which reduces the amount of insulin required to keep blood sugar in range.

It takes ~6 months abstaining from gluten for the intestine to heal and for carb absorption to return to normal, over which time insulin requirements would also return to normal. Going gluten free allows the intestine to heal (and you have to stay gluten free -- the celiac doesn't go away).

My daughter is T1D+Celiac so I'm quite familiar with it as well.

Interesting. Thank you for taking the time to fill a large hole in my understanding :)

Sorry to hear about your daughter's health issues too. It must be very difficult to have that anxiety on top of the usual anxieties that come with parenthood. I have 2 young girls and I can only imagine what it would be like if either of them had a lifelong health problem, never mind 2.

Exactly that.

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