Insulin dependent diabetes mellitus (IDDM) is an autoimmune disorder triggered and influenced by environmental and lifestyle factors.
Environmental triggers and lifestyle factors influence the disease course of the autoimmune disorder insulin dependent diabetes mellitus (IDDM). Like other autoimmune diseases, IDDM occurs in people with certain immune system genes, particularly HLA-DR3, when they're exposed to certain environmental triggers. When they persist, these environmental triggers, as well as certain lifestyle factors, are known to influence the development of autoantibodies that destroy the insulin-producing cells of the pancreas, and consequently, the disease course.
Environmental triggers associated with the development of IDDM include medications and viruses, including childhood vaccines. Medications associated with the development of IDDM include streptozocin, pentamidine, interferons and interleukins. Viruses associated with IDDM include mumps, coxasckie virus, rubella, enterovirus, echovirus, hepatitis B vaccines and MMR vaccines.
Smoking has a profound effect on the clinical course of IDDM particularly because of its constricting effects on blood vessels. These effects contribute to neuropathy iand kidney disease in IDDM. The effects of smoking contribute to morbidity more than any other lifestyle factor studied. Assessments of morbidity included hospitalizations, sick days, and days of limited activity. The combination of IDDM and smoking was more than multiplicative for all morbidity measures. That is, the interaction of these two factors caused morbidity much higher than expected from the addition of each independent factor.
In patients with eating disorders and IDDM, levels of hemoglobin A1C and serum triglycerides were significantly higher than levels of patients without eating disorders. In women who intentionally omitted or reduced insulin, these levels were the highest. Women with IDDM and bulimic eating disorders consumed significantly more energy, total fat and cholesterol compared to women with IDDM and eating disorders characterized by restrained eating.
Although improvements in prevention, treatment, and monitoring of blood glucose levels in IDDM have led to better management of patients with IDDM, the incidence of IDDM has increased dramatically in the last two decades. Furthermore, lifestyle influences such as smoking and eating disorders contribute to poor outcomes. Long-term, complications of IDDM include visual impairment, vascular disease, neuropathy (nerve damage), skin ulcerations and infections, feet problems, blindness, renal failure, stroke, amputation and myocardial infarction.
Goals for healing in IDDM include balancing diet, exercise, and insulin in an effort to control blood glucose levels; preventing dehydration; maintaining a normal body weight; leading an active life; avoiding environmental chemicals and toxins; and reducing oxidative stress through solid nutrition and antioxidant vitamins.
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