Published 16 March 2014
Updated 14 January 2015
Updated 9 April 2015
If you cruise around the internet, engaging with the antivaccination cult (not recommended), you will pick up on their standard tropes, lies, and other anti-science commentary. One that has always bothered me, not because that it was a lie, but because I had enough evidence floating in my brain that I was wondering if it were true–that vaccines cause diabetes, especially the Type 1 version.
A lot of the vaccine deniers believe that vaccines cause a lot of everything, and several claim that vaccines cause Type 1 diabetes (or here), based on little evidence. As far as I can tell, this myth is based on the “research” from J. Barthelow Classen, M.D., who has pushed the idea that vaccines causes type 1 diabetes, through some magical process that has never been supported by other independent evidence.
In another example of the antivaccination world’s cherry picking evidence to support their a priori conclusions, they ignore the utter lack of plausibility supporting any link between vaccines and Type 1 diabetes.
Moreover, Classen seems to come to his beliefs based on population-wide correlations that rely on post hoc fallacies, rather than actually showing causality between vaccines and diabetes. It’s like finding that a 5% increase in consumption of Big Macs is correlated with Republican wins in elections. They may happen at the same time, but it would take a laughable series events to show any relationship.
Type 1 diabetes
What is Type 1 diabetes? The basic power source of our body is glucose, which is produced from almost anything we eat (carbohydrates, proteins, sugars, and fats). It is usually tightly regulated by the body, so that when you have excess glucose in the blood, it is taken out of the blood and stored–but when the blood glucose drops, it is then released from storage to be used for energy.
The key hormone, insulin, which regulates the level of glucose in the body is released by the Beta cells of the Islets of Langerhans in the pancreas when blood sugar goes up–insulin induces storage cells to remove and store glucose from the blood. In a complex interaction, the hormone glucagon, produced by other cells in the pancreas when the blood glucose level is too low, which then induces release of that stored glucose. (This once again goes to show how complex living systems are, and simple explanations are laughable and should be dismissed.) It’s a fascinating system of the body, and it’s remarkable that it works so well in 99% of people.
Type 1 diabetes is an autoimmune disease where the body’s own antibodies attack the Islets of Langerhans, causing the production of insulin to drop or even to be halted. As of today, there are no cures, and the only way to treat someone is to regularly inject human insulin, which is produced by bioengineered E. coli. Ironically, the human insulin gene has been inserted in GM safflower, to be used as another method of mass-producing human insulin. Before the wide availability of insulin in the 1920’s (usually pig insulin whose structure is similar to human insulin, but still caused a lot of allergic reactions), children simply died of the disease. Nothing could be done.
Type 1 diabetes should not be confused with two other types of diabetes, one called latent autoimmune diabetes of adults (sometimes called LADA or Type 1.5 diabetes), but really has no practical difference with Type 1 diabetes except age of commence of symptoms. Instead of showing symptoms as a child, it appears in late adulthood, typically 30’s and early 40’s. Like the typical Type 1 diabetes, the only treatment for LADA is insulin injections.
The other form is Type 2 diabetes, which is probably caused by a combination of genetics, obesity, eating behavior, and several other factors. Usually, the pancreas produces sufficient insulin, but the body’s cells and organs become “resistant” to the insulin, meaning that they ignore the signal to store glucose, and thus the blood glucose remains high. Oral medications, behavioral changes, such as improved diet and exercise, can often help manage if not reverse Type 2 diabetes. And “natural supplements” probably won’t help at all.
Type 1 and Type 2 diabetes are truly two different kinds of diseases with one common symptom, excess blood glucose levels.
So what causes the autoimmune disorder that leads to Type 1 diabetes?
Although a scientific consensus has not been fully developed, it is clear that some sort of infection induces the autoimmune disease that causes the destruction of the insulin-producing cells in the pancreas.
Two recent publications providing exciting and compelling evidence that the Coxsackievirus B1, a pathogenic enterovirus that cannot be treated, and as of today, cannot be prevented, may induce the autoimmune disease. In a lot of children, the Coxsackievirus infection is non-symptomatic, but may still induce the autoimmune disease. Coxsackievirus B1 is not associated with any vaccines currently administered, so going down that path is only for those who invent conspiracies.
Enter Markus Heinze
Probably the biggest champion of this “vaccines cause diabetes” trope is Markus Heinze, an antivaccine author, whose daughter contracted Type 1 diabetes when she was young, and he blamed a vaccination as the cause.
In a long-winded rant, Heinze brings up the old ad hominem argument about not trusting research paid off by pharmaceutical companies, because they’re hiding all the evil about vaccines. That doctors are clueless, because Heinze’s 2 hours of Google research is more valuable.
Oh and his 18 months studying psychology at a low level college in Kentucky somehow makes him an expert on anti-psychotics and depression medications. You know, because the four years of medical school, and another 8 years of post medical-school training to be a psychiatrist is irrelevant to him. Yes, he’s an arrogant man who probably worships at the Dunning-Kruger altar of cognitive bias.
Using a pretzel-like logic, the pseudoscientific methodology of those like Heinze who lack a rigorous scientific background (and he has no formal education or training in endocrinology, virology, immunology, or anything), Heinze has taken numerous peer-reviewed articles that certain infections may be related to diabetes, and manipulated the results to support his truly unsupportable hypotheses.
He claims, and it’s hard to write this while stifling laughter, he found a 25 year old article that showed that measles virus is found in the pancreatic tissue of someone with Type 1 diabetes. Heinze then blames the MMR vaccine for this infection, despite the fact that the MMR vaccines contains the live-attenuated (meaning non-pathogenic, it cannot spread in the body, nor incorporate itself into the RNA of any cells), and cannot infect pancreas cells.
Amusingly, Heinze actually thinks he’s got an “ah hah” moment, when all he has done is invent a conclusion, where the real researchers who did the real research made no such claim. Besides, since this was a cell culture, we know it was probably not immunized with MMR vaccine.
Why is Heinze so obsessive about vaccines and diabetes? Because his young daughter became diabetic, and at the time, typical of any parent, he lashed out at anything that he could blame for it.
I empathize with Heinze about his child, because I also have Type 1 diabetes. But I never blamed anyone or anything for it. I accepted it, and I use the most advanced science I can find to treat it. And because of that, I have little or no serious issues from the disease, and hope to live a long life. And so will Heinze’s daughter. But just because he’s going through this, he doesn’t have the right to invent bad science to scare people.
Back to reality–science finds no relationship to vaccines
Does an infection explain the 3-5% annual increase in Type 1 diabetes? First of all, it’s difficult to really determine the exact increase of diabetes in the modern era. Remember, before the 1920’s, kids simply died from diabetes, so it’s almost impossible to determine the prevalence of the diseases before then. Even after 1920, insulin was not exactly widely available, and the methods to inject it were expensive. It’s possible that up through the 1950’s, the diagnosis of Type 1 diabetes was lower than the actual number.
A lot of hypotheses have been offered by the scientific world (ignoring Heinze’s unscientific logic) regarding the increase in the rate of the disease.
Sure, some real scientists have actively sought out the possibility that vaccines are causal to Type 1 diabetes. But according to the best systemic reviews, the MMR vaccine is not linked to Type 1 diabetes. But don’t tell Heinze about this research, because using his vast scientific skills, he invented a link between MMR and diabetes, basically because the measles virus appeared in cell culture.
There is other evidence that clearly rejects a correlation between vaccines and diabetes. The haemophilus influenzae type B vaccine is not linked to diabetes. In a large, population controlled study, there was no link, none, between any of the common childhood vaccines and Type 1 diabetes. None.
OK, it’s not vaccines–what might be going on?
Another hypothesis for the increase in Type 1 diabetes is something that is actually kind of frightening. It’s possible that obesity, even at a very young age, might be the precursor to the autoimmune disease that causes the destruction of parts of the pancreas through some complicated but plausible physiological pathway.
And as the general weight of children across the world increases, it might potentially be the correlative factor that induces the disease. But still, it’s probably a complex interaction between a genetic defect, environmental factors, a virus, and weight.
The TL;DR version
In looking at this issue with a scientific and skeptical eye, here’s what I’ve found:
- Yes, the rate of childhood diabetes is rising rapidly.
- It is absolutely not associated with vaccines, although we all know that your typical antivaccination cultist will use the Argument from Ignorance to demand the one clinical trial to rule them all to “prove” that every singe vaccine in every single companion does not cause diabetes. Well, we have enough evidence to dismiss that belief, but if any pseudoscience pusher wants to provide a peer-reviewed article which shows a correlation, that also hasn’t been thoroughly dismissed by science, please show us. Because real science depends on real evidence.
- We don’t have a solid consensus as to what might be causing the rise in diabetes. There is some fascinating research that’s getting us close to the answer. That’s the great thing about science. Finding the answer to a question is all about the evidence, it’s not about inventing imaginary stuff.
- Just as bonus information, because when I do research, I try to be thorough, a systemic review concluded that gluten and cow’s milk are not associated with an increased risk of Type 1 diabetes autoimmune disorders. (But to be fair, the data did show longer breastfeeding might lower the risk.)
Ironically, researchers have found a potential method to reverse and/or prevent diabetes, and it might be available in the not too distant future. It’s a vaccine.
So Markus Heinze, I am sympathetic to what you’re experiencing with your daughter. But you have absolutely no, that would be zero, evidence that vaccines had anything to do with it. Get over it, because soon there will be a vaccine to reverse her disease, and you will be the first person in line to have her get it. As you should be. But quit lying about vaccines. You’ve created a trope that is ridiculous, unscientific, and is harming children by making parents maybe decide against vaccines, though I hate to give you that much credit. Start thinking Markus, if you are capable of that.
- Black SB, Lewis E, Shinefield HR, Fireman B, Ray P, DeStefano F, Chen R. Lack of association between receipt of conjugate haemophilus influenzae type B vaccine (HbOC) in infancy and risk of type 1 (juvenile onset) diabetes: long term follow-up of the HbOC efficacy trial cohort. Pediatr Infect Dis J. 2002 Jun;21(6):568-9. PubMed PMID: 12182385.
- DeStefano F, Mullooly JP, Okoro CA, Chen RT, Marcy SM, Ward JI, Vadheim CM, Black SB, Shinefield HR, Davis RL, Bohlke K; Vaccine Safety Datalink Team. Childhood vaccinations, vaccination timing, and risk of type 1 diabetes mellitus. Pediatrics. 2001 Dec;108(6):E112. PubMed PMID: 11731639.
- Demicheli V, Rivetti A, Debalini MG, Di Pietrantonj C. Vaccines for measles, mumps and rubella in children. Cochrane Database of Systematic Reviews 2012, Issue 2. Art. No.: CD004407. DOI: 10.1002/14651858.CD004407.pub3
- Laitinen OH, Honkanen H, Pakkanen O, Oikarinen S, Hankaniemi MM, Huhtala H, Ruokoranta T, Lecouturier V, André P, Harju R, Virtanen SM, Lehtonen J, Almond JW, Simell T, Simell O, Ilonen J, Veijola R, Knip M, Hyöty H. Coxsackievirus B1 is associated with induction of β-cell autoimmunity that portends type 1 diabetes. Diabetes. 2014 Feb;63(2):446-55. doi: 10.2337/db13-0619. Epub 2013 Aug 23. PubMed PMID: 23974921.
- Numazaki K, Goldman H, Wong I, Wainberg MA. Infection of cultured human fetal pancreatic islet cells by rubella virus. Am J Clin Pathol. 1989 Apr;91(4):446-51. PubMed PMID: 2648801.
- Oikarinen S, Tauriainen S, Hober D, Lucas B, Vazeou A, Sioofy-Khojine A, Bozas E, Muir P, Honkanen H, Ilonen J, Knip M, Keskinen P, Saha MT, Huhtala H, Stanway G, Bartsocas C, Ludvigsson J, Taylor K, Hyöty H; VirDiab Study Group. Virus antibody survey in different European populations indicates risk association between coxsackievirus B1 and type 1 diabetes. Diabetes. 2014 Feb;63(2):655-62. doi: 10.2337/db13-0620. Epub 2013 Sep 5. PubMed PMID: 24009257.
- Skyler JS. Primary and secondary prevention of Type 1 diabetes. Diabet Med. 2013 Feb;30(2):161-9. doi: 10.1111/dme.12100. Review. PubMed PMID: 23231526; PubMed Central PMCID: PMC3580116.