Diabetes Self-Management Blog

Donna Jackson Nakazawa Did toxins cause your diabetes? Could they be causing other diseases, and is there anything you can do to reduce that risk? Many people have never considered these questions — autoimmune diseases, in which the body’s immune system mistakenly attacks healthy tissue, remain largely under the nation’s radar even though they affect nearly 24 million Americans.

That may soon change thanks to The Autoimmune Epidemic: Bodies Gone Haywire in a World Out of Balance and the Cutting-Edge Science That Promises Hope, by Donna Jackson Nakazawa. Diabetes Self-Management’s Quinn Phillips talked with Nakazawa about how autoimmune diseases — which include Type 1 diabetes — occur and what, in her view, should be done about them.

Quinn Phillips: Why should people, especially those with diabetes, be concerned about autoimmune diseases?

Donna Jackson Nakazawa: People with one autoimmune disease have a higher risk of developing others. Type 1 diabetes is, of course, an autoimmune disease, and it has been studied more thoroughly than other autoimmune diseases, so it’s sort of a litmus test of what might be happening to our immune systems in general. And the news is frightening: The number of people with Type 1 diabetes is going up exponentially, increasing 6% a year for children four and under, and 4% for children ages 10-14. We’re also starting to understand the triggers of Type 1 diabetes better. Studies have shown that eliminating milk protein from the diet and adding essential fatty acids can reduce the rate of Type 1 diabetes for infants who are considered high-risk because of family members with diabetes. We know that long-term pesticide exposure can increase the risk of Type 1 diabetes, lupus, and other autoimmune diseases. The research is coming together so that we now know not only that the numbers are going up, but what to do about it.

COMMENT: Do you think chemicals — or certain foods — played a role in your developing diabetes?

QP: How does exposure to certain substances lead to an autoimmune response?

DJN: The immune system’s job is to protect us all of the time, and to do this it has to decide whether a substance it comes across is safe or is a foreign substance, an antigen, that needs to be attacked. That might be a bacterium, a chemical, a food, a virus. In autoimmune disease, what happens is that the immune system goes on, after attacking the antigen, to attack the body’s own tissues and systems. All of our body’s tissues and systems have a sort of “bar code,” a protein sequence, that identifies it to the body, and the theory is that autoimmune disease happens when a foreign substance has a “bar code” that is very similar to one in our body. So we’ve outpaced our evolutionary ability to handle exposure to so many foreign substances — there are just too many chemicals and pollutants in the world around us. Genetics plays a role, but exposure to antigens is what ends up triggering autoimmune disease.

QP: You mention in your book that U.S. policy tends to require solid proof of harm to regulate a substance, whereas Europe uses the “precautionary principle.” Is their system better?

DJN: The latest European law, REACH, was put in place in June of 2007. It basically says we need proof that a chemical is safe before we allow it to reach the public, and if something is suspected to be bad, we’ll take it off the market until it’s proven to be safe, and if it’s not, then we need to find an alternative. And guess who pays for the testing? The company that makes the chemical. In the United States, we need “the tobacco story” before we take something off the market — we need to see a large number of people becoming very ill. We don’t want to make companies pay for testing, and we don’t want the government to pay for testing. So around 1,700 new chemicals a year are approved with almost no testing. We have it all twisted. And the precautionary principle is really so commonsense: You need to prove it’s safe before you put it into baby bottles, nail polish, bug spray. I think following the European model would be a great first step in protecting our immune systems.

COMMENT: What do you think of the “precautionary principle”?

QP: Many people claim that requiring extensive testing of chemicals would stifle innovation and make industries under the regulations less competitive. How do you respond to this?

DJN: REACH has been implemented very successfully in Europe, so we already have a working model. Companies can and do adapt to new rules, just as the auto industry is adapting to fuel efficiency standards. Meanwhile, the only alternative to the precautionary principle is to wait and see how many people fall ill, which is more or less our policy right now. We do nothing because we say we have to “prove” that a chemical causes disease in a significant number of people first. Yet proving conclusively that a chemical is harmful based on its effects in a human population is not a simple task, especially with autoimmune diseases. Because the exposure that leads to disease is so often chronic — and from multiple sources — it is difficult, if not impossible, to single out the cause after the fact. And there are other hurdles, as well.

In my book, I write about a stunning incidence of lupus in a neighborhood surrounding a toxic waste site in Buffalo, New York. Because stress is a factor in autoimmune diseases, the Buffalo cluster might also have been blamed on the low-income neighborhood being a highly stressful place to live — which it no doubt was. Epidemiologists working on the cluster also found it difficult to track patients in an underprivileged neighborhood where people frequently moved away or died without having had a proper diagnosis. You can see when we look at clusters why proving a solid link is so difficult. If we don’t start to test chemicals for their effects on the immune system and instead wait for proof of harm, that day of proof may never come. And we will pay far too high a price for sitting idle in the face of a gathering storm.

COMMENT: Do you think we regulate chemicals enough? Too much?

QP: You note that autoimmune diseases are more common in the U.S. than cancer, yet most people aren’t as aware of them, and there are far fewer efforts to track, study, and fight autoimmune diseases. Why is this?

DJN: We’re really “late out of the gate” with these diseases. They weren’t even widely taught in medical schools until the 1980’s. Once they were identified, we passed them on to specialists: Rheumatologists got lupus, neurologists got multiple sclerosis, and so on. We’ve never had much oversight regarding how prevalent these diseases are. We have no national autoimmune disease center the way we do for cancer and heart disease. We do have a diabetes clearinghouse, but for autoimmune disease in general, we’re going to need these diseases to “band together” so that we get a real sense of these numbers. A lot of scientists think that the estimate of 24 million people affected is probably too low.

Autoimmune diseases affect more than twice as many people as cancer yet get one-tenth the funding. Historical reasons help explain this, but I think there’s also something else: that the
se are largely women’s diseases. Almost 80% of people afflicted are women, and I think that has something to do with it. These are difficult-to-diagnose diseases, and for a long time people who were diagnosed with them were considered to be malingerers or hypochondriacs because the diagnoses were difficult to confirm. The average woman sees six doctors over four years before she gets a diagnosis. What’s happened in the last decade to change this is that we now have much better autoantibody tests [autoantibodies are proteins present in an autoimmune attack]. Although it can still take several years — doctors who aren’t well versed in these diseases dismiss patients to this day — with specific autoantibody counts, you can’t say to someone, “It’s just in your head.”

COMMENT: Do you think women are taken less seriously as patients?

QP: A recent study found that exposure to certain pesticides increases the risk of Type 2 diabetes, and separate studies have shown that about 10% of people with Type 2 diabetes have autoantibodies usually associated with Type 1 diabetes. Do you think we will find autoimmune connections to conditions that we don’t recognize now as autoimmune diseases?

DJN: That is happening right now with atherosclerosis. We know that in atherosclerosis, when the plaque breaks off the artery wall, there is an autoimmune response involved. Imagine if we took everyone with atherosclerosis and included them in autoimmune disease numbers — it would be huge. We haven’t done that yet, but we probably will within 10 years, or at least recognize that there is an autoimmune reaction involved. Certain reactions to viruses also turn out to be autoimmune in nature. So I think that we’re going to see the “autoimmune umbrella” include more diseases.

QP: What do you think are the top two or three ways for people to protect themselves from environmental triggers of autoimmunity?

DJN: First, for any autoimmune disease, having a good diet is hugely important. You can look into any “anti-autoimmune diet” — I have one in my book. They’re basically whole-foods diets that are gluten-, dairy-, additive-, yeast-, sugar-, and alcohol-free. Second, look around at things you come into contact with every day. What are you cleaning with? There are so many “green” cleaning products now, there’s no reason not to “clean green.” You can avoid cosmetics with parabens and phthalates in them. You can avoid drinking coffee in plastic-coated paper cups. You can unclog a drain with vinegar and baking soda. You can go to an organic dry cleaner. Little choices like these don’t seem like a lot, but over time they add up.

I’ll introduce an analogy: Think of the immune system as a barrel that gets filled with potential environmental triggers. You can fill that barrel pretty high, but as long as it doesn’t overflow, you’re fine. You just have to take enough out of the barrel so that it doesn’t overflow. Stress is also an important autoimmune trigger, so don’t let eliminating potential triggers create more stress — it’s not worth it. Try to develop some sort of antistress routine, such as yoga, meditation, a daily walk, visualization, or prayer. So I think limiting risk takes a three-prong approach: managing diet, chemical exposure, and stress.

COMMENT: Do you take precautions to limit your autoimmune disease risk? Will you?

The Autoimmune Epidemic For more information about Donna Jackson Nakazawa and The Autoimmune Epidemic, visit www.donnajacksonnakazawa.com.

Related links:
Diabetes Definitions: Autoimmunity
EPA EnviroMapper
Blog: Eating fruits and vegetables

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Comments
  1. I agree with the autor about the precautionary method. It just makes sense! It’s good logic.

    Posted by specsis |
  2. Absolutely, women are taken less seriously by the medical community! I’ve gone to the ER with severe chest pain and had to wait in the lobby until they were ready for me. You can’t tell me a man would have that experience.

    Posted by specsis |
  3. Hi,

    I found out I was a type 2 diabetic in July 2000. At that time I had sore and burning toes for about ten years, which doctors said was because of Neuropathy. This being a fact, then I had Diabetes long before it became evident by eratic vision.

    None of my family as far back as any member had ever had Diabetes.

    Then I found out that there was a study of us who were in VietNam during the spraying of Agent Orange and it was suspected that this was the cause of mine and many others.

    I imagine that Aent Orange could be claimed to be a Toxin. So I believe its true.

    Thanks

    Ed

    Posted by buzzbird |
  4. I was sprayed with a defoliate while in the Army in 1973. Within 2 months I started showing signs of type 1 diabetes and was diagnosed within 9 months, by which time I was out of the Army. Since there is no history of diabetes in either side of my family, I strongly feel the defoliate caused my diabetes.

    Posted by hakker |
  5. In the summer of 1964 I was taken from California
    by my Mom to visit my Aunt and her family in rural Illinois at the home in which she and her sister had been raised.
    While there, I was exposed to a variety of animals which was a real treat for a kid from California but which also exposed me to a variety of farm animal wastes. This fact unfortunately led to my contracting a serious case of empitigo(sp) which was treated with a course of antibiotics upon my return to California. This was followed within 6 weeks by the rapid onset of Type 1 diabetes the symptoms of which were not readily apparent to my Mother or Father for approximately 8 more months.
    While it took awhile for medical science to reach the autoimmune trigger causation my family has always believed that my contraction of empitigo was the causal factor underlying my disease,
    I have two second cousins on the maternal side who have also developed autoimmune diseases (Lupus and Type 1 Diabetes)so it seems apparent there is a strong genetic correlation to these and other autoimmune diseases. My belief is that certain autoimmune diseases can be triggered by a variety of stressors which would certainly include
    pesticides and chemicals to which we are regularly exposed.
    My hope is that continuing research such as that presented in Ms.Nakazawa’s book along with increasingly more detailed genetic research will allow the biological trigger that many of us carry to be permanently locked in the “off” position.

    Posted by J.D.Taylor |
  6. I have thought for quite q while that we would eventually see researchers looking at environmental toxins as triggers for diabetes. The prevalence of type 2 diabetes rose very sharply from the early 1990’s to the present. In general, most people blame it on overeating and under-exercising. But it seemed to me the increase grew much faster that could be accounted for by lifestyle change. Lifestyle change in large populations generally happens more gradually.

    We know there are studies linking diabetes with more pollution, with plastics residues, and with certain pesticides. Those do get introduced suddenly. For example, isn’t the early 1990’s the time that bottled water in flexible plastic bottles appeared?

    Posted by Beth |
  7. Agent orange is said to cause diabetes shouldn’t all viet nam vets be checked for diabetes

    Posted by postman |
  8. When I hear about long term exposure to pesticides, it makes me wonder… I developed Type 1 diabetes when I was 30. I have always spent a lot of time sunning and gardening outdoors. I remember the smell of pesticides as my dad would spray the house/yard while I was laying in the sun. Plus, I have always sprayed myself with OFF when gardening. Also, less than a year from when I was diagnosed with diabetes, my husband and I both got this strange illness (virus). We were both in bed with nausea for a week. I always wonder if that illness may have caused my diabetes.

    Posted by PAS |
  9. I think the precautionary principle is definitely a good idea. I also think it is more important in the USA for a corporation to make a buck rather than be concerned about the health risks for 100s of people.

    Posted by PAS |
  10. I believe I got diabetes from standing next to barrels of chimicals when I was in the military. They never owned up to it. I have never been obese in my life.

    Posted by mrberrie |
  11. Agent orange is said to cause diabetes shouldn’t all viet nam vets be checked for diabetes

    How can that be done when the military won’t even admit where all the Agent Orange was? As a Security Policeman in the military during the Vietnam Era, I was guarding (standing next to) the barrels of chemicals in the Phillipines and standing under the airplanes that spayed Agent Orange in Vietnam. This was during the heavy rains in the Philippines. The chemical dripped on me off of the planes but the US Military will never admit to Agent Orange in the Philippines. Because of that I never did file a claim for disability.

    Posted by mrberrie |
  12. I stay away from sugar and I stay away from carbs. If it is white then it ain’t right. Leave bread alone, leave rice alone, leave potatos alone, etc. Don’t forget to add the fiber with medimucial. Check out the Atkins Diet.

    Posted by mrberrie |
  13. It took many years for my Type II diabetes to be diagnosed (Syndrome X is what I believe they call it now). Women are not taken as seriously as men in in matters concerning their health simply because they go to their doctors more frequently as they are more in tune with their bodies and seek resolution to their problems.

    Have been following the recommended diabetic diet for some time, but have not lost the weight I would have liked.

    Posted by Betty |
  14. In 1991 I was 41 years old. I weighed 115 and was health and very active. I had been working at RCA Integrated Circuit manufacturing. Many CHEMICALS in that manufacturing. I had 2 laporoscopy SURGERIES and one laporotomy for cleaning my fallopian tubes in 1990. Big mistake!! After that my failing marriage disolved into DIVORCE, the company had a major LAY OFF, I had NO HEALTH INSURANC. In the mean time I had also had bleeding and possible a MISCARRIAGE. All of these things made me DEPRESSED. Then in the spring of 1992 I found that I had elevated blood sugars while attending food fair that had a health clinic testing for cholestorel and blood sugar. I disregared it as due to the food I had eaten. In the fall I had full blown type I diabetes. As I review the previous incidents before diagnosis I have capitalized the items that may have had influence on becoming diabetic. In my mind the SURGERY was the item I blame for being diabetic

    Posted by sharon |
  15. Yes I do think women are not listened to and thought of as not able to help in solving health care for themselves or other. Being a type I diabeic has made my blood sugars very sensitive to certain foods and drinks. In the AM I drink coffee (with non-dairy powder creamer, no sugar) my blood sugars soar to 250. I had no food. I had explained this to my doctor for 3 years. Finally last year he tells me that it has been discovered in some people coffee will stimulate the liver to secret stored glocose, there by increasing my blood sugars. Imagine that!! I have switched to instant coffe and find I am not as sensitive. Popcorn, which has been listed as a health snack of 3 cups, is very bad for me. 1 cup sends my sugar level to over 300. Each person has their own sensitivity to even so called healthy food that increase their blood sugar dramatically. If I eat at restaurants I usually eat vegetables and meat and 2 carb servings.

    Posted by sharon |
  16. I recently spoke to a number of people who all had a similar experience. All developed type 2 diabetes shortly after being placed on prescriptions to lower cholesterol. It did not seem to be a gradual onset or worsening of a pre-diabetic condition, they all went from normal glucose to diabetes within a few weeks of starting statins.

    Posted by RWoodward |
  17. I was in Viet Nam in 1967-68 and again in 1970-71 and in 2000 I was diagnosed with Type 2 diabetes.
    I am now 100% service connected disabled.
    Any one who was in Viet Nam and has Type 2 is automatically service connected. All Veit Nam veterans should apply for disability, and get on the Agent Orange register.

    Posted by VietNam Vet |
  18. My husband contracted Diabetes Type II in 1955 and was put on Diabenese. Doctor said for him to stop using an insecticide spray on the flowers so he stopped. After one year his diabetes disappeared. The old doctor predicted that there would be a world-wide epidemic of diabetes in the future because of the insecticides being used on fruits, vegetables, and flowers. Apparently he was right!!!

    Posted by A Lady |
  19. This was an excellent article; it gives me something to think about as how I might have contracted type 1 diabetes at 60 years old.

    Posted by excellent |
  20. Dear Sharon.

    In my case also I can start in the morning with a reasonable BG and drink a mug of real coffee of course without sugar only some 1% milk and watch the BG go to the moon and will have dificulty in controlling it even with a lot of insulin.

    As a Chemical Engineer I wonder about the 1,000,000 or so chemicals that we have released into our world since the last war. Food for thought I caught a fish in our river that had both male and female fully developped sexual organs. I looked on Wikipedia and yes even my favorite green detergent may have estrogen mimicking chemicals.

    As for the autoimmune diseases it would be reasonable to assume the 1,000,000 have something to do with this. Not that the crooks from Wall Street have made it clear that Laissez faire capitalism does not work the FDA and the EPA will decades of work to clean up this mess and in 100 years the incidence of auto-immune disease may start to decline.

    I am wondering if this so called insulin resistance is some autoimmune response, any thoughts?

    Posted by CalgaryDiabetic |
  21. What would it take for the US to follow the Euopean example right now? Why haven’t started to do this way before now? i think we absolutely should adopt this approach.

    Posted by daveincolorado |
  22. Yes, I definitely think women are taken less seriously by doctors. I am very proactive in my attitude toward my care of my type 1 diabetes. Before I was diagnosed in January of 1988, I had recently seen my OB-GYN. I told him of my symptoms: excessive thirst, a lot of urination and extreme fatigue (classic diabetes symptoms). He told me it was just because I was a working mom that I felt that way.

    Posted by Diane |
  23. I am a diabetic who recently developed lactose intolerance. Once I cut dairy from my diet, my blood glucose became easier to manage.

    No doctor suggested any connection existed between blood glucose and milk other than the calories in milk. But I found that eliminating dairy products had an across-the-board effect on my daily sugar readings.

    Posted by frensbar |
  24. Without more on the toxins i can’t say if toxins are the cause. I weas not exposed to any more toxins than my siblings and none of them are diabetic. The doctor felt my case was due the high stress of police work especially the area I worked. Most of the Officers I know that are diabetic also worked in high strees areas. As me they have no History in the family. Although My father is now diabetic and one sister border line and under control with diet only.

    Posted by Tim Gimeno |
  25. I believe that insulin resistance is like other things that our bodies refuse to use. Instead of using insulin it overloads our ability to use it.
    I was told by my doctor in one state to just keep adjusting the insulin dosage up until it controled the problem. Then I moved to another state and doctor; he said the amount that I was using would probably be the problem. He reduced the intake to less than 10% of what I had been taking and changed the type of insulin. My blood sugars came down. Then as my body got used to the new insulin it started the same problem of needing more and more to keep the sugars down. I am starting a diet of half cooked organic, vegetables and meats. No root vegetables, all vegetables they all must be grown above the ground. I am also avoidings many chemicals as is possible. My doctor told me that the only way I could really clear my system of chemicals is to live on top of the highest mountain in the world and even then something would make it’s way to the top. We are killing ourselves with then need to try to make this a picture perfect world.

    Posted by Brucetigertoes |
  26. I was diagnosed when I was 20. I had just gone on the birth control pill - 6 months later I was told I was a T1, and that I was lucky it was discovered ‘now’ while I was not actually pregnant. The doctor explained that the pill set up the same condition in my body as a pregnancy would have - and viola, say hello to the newest sugar baby. They also mentioned they were on the ‘cusp of a cure’ and not to be too upset. And I’m certain that is exactly what they are saying today, 25 years later. Knowing sodium is an issue for some, I still can’t stop myself from recommending more grains of salt be sprinkled about anytime someone with a Dr. in front of their name opens their mouth to speak. They only have a medical degree, not a magic wand.

    Posted by Paula |
  27. I was diagnosed as a type 2 diabetic after working for over ten years with very toxic chemicals in a research lab. There is no doubt of my exposure, and that of my colleagues, we were sent to hospital from time to time for emergency treatment for over-exposures! We are unable to sue for diabetes as there is no proof connecting the diabetes to the Hf, Pb, Cd, An, As Pt, Pd, Au, Ni, Fe, Rb, and various other dangerous compounds we were exposed to! The company continues today, under another name, and by deliberately, “Rotating” its workers by a corrupt but well taught Human Resources team who can get you fired at a moments notice, or make you want to quit just as fast! This privately owned outfit has poisoned many folk, who quit, and moved away in disbelief at their mistreatment, but before lawsuits for sicknesses were invoked! Timing by the owners/staff of this murderous treacherous and sick bunch of killers is the key, and they are now very rich for their abilities to eye-ball an employee before the health issues hit the fan, and screw him out of the job! Beware the vicious vulture capitalists in private companies, inside their walls, they have license, motive and means to kill you, through long term health problems, and they do it every day for a living!

    Posted by Uncle B |
  28. If the immune system recognises antigens by their protein sequence “barcode”, why do you say that antigens that are not made of complex proteins, such as chemical fertilizers, can cause autoimmune diseases in a similar way to viruses?

    Posted by Simon Perry |
  29. The EU is requiring proof that is putting many people out of their marketplace. Without room for innovation, we will not allow creativity anymore. Without creativity, we will not have cures or even adaptive devices to help those afflicted by diseases. While the US system may not be perfect, it is FAR better than that used by the EU.

    Posted by Lori Eckrich |
  30. We regulate chemicals effectively. I am very aware of a small business that makes adaptive devices that may soon exit the EU because of their very onerous reqjuirements. Adaptive speech devices, none of which contain the prohibited chemicals (phenols) will no longer be available in the EU because this small business cannot devote a person for six months to deal with their onerous regulations.

    Posted by Lori Eckrich |

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