Need help navigating life with diabetes? You can always Ask D’Mine… Welcome back to our weekly Q&A column, hosted by longtime type 1 and diabetes author Wil Dubois.

Today, Wil tackles a question with a new spin on an inquiry we received in the past: Tick Bites. Specifically, whether they have the potential to actually cause diabetes. Whoa!

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Dan, type 1 from Colorado, writes: I read your article on tick bites and type 1 diabetes too late. Three years ago in March, before being diagnosed with type 1 diabetes, I received two tick bites on the back of my head. In the next 30 days, I lost 32 pounds and went into diabetic ketoacidosis. I was in intensive care for 4 days. The diagnosis was type 1 diabetes. The doctors said the ticks had nothing to do with causing my type 1, but I strongly disagree. What do you think?

Wil@Ask D’Mine answers: I think it’s possible that you are right. I also think it’s possible that the docs are right. But I know for sure that it doesn’t make a bit of difference. More about that in a bit. Here’s the deal, everyone is confused because we really aren’t sure what the Sam Heck causes type 1 diabetes in the first place. No. Wait. That’s not stated with the necessary clarity. This is complex. We know what causes type 1diabetes in the first place, but just not in the second place. Let me try again: Type 1 diabetes is caused by a genetic susceptibility, but it’s launched by a yet-to-be determined trigger. 

So we only understand half the recipe.

As far as the true root cause—the genetics—we even know which genes are involved. They are part of the human leukocyte antigen (HLA) complex, who all live together in a crack house on chromosome 6. By the way, that’s the same genetic neighborhood that rheumatoid arthritis and ankylosing spondylitis live in. Given the choice of three bad options, I’ll stick with the diabetes, thank you very much.

Put another way, your body was built for T1D from the second of conception, but something else—at some point—was needed to convert that susceptibility into a full-blown response. It takes both. T1D isn’t something anyone can catch, like all the nasty illnesses ticks carry; it’s more like a failure in the cooling system in a nuclear reactor that leads to a meltdown. There needs to be an inherent design flaw prior to someone pressing the wrong button.

That said, what turns this well-recognized genetic susceptibility into diabetes is less clear, but the leading theory is some sort of viral infection. When a virus invades the body, the immune system creates antibodies to wipe it out. The thinking goes that some viruses might have antigens similar to our own beta cells, so the antibodies engineered by our genetically warped T cells are just screwed up enough that they turn on the beta cells once they wipe out the virus. The leading suspects in the lineup down at the Diabetes Police Station are German measles, Mumps, Rotavirus, and something called B4 strain of the coxsackie B virus. None of those are on the lengthy list of diseases carried by ticks, although a different strain of coxsackie is sometimes seen, so who knows?

But here’s the thing, this process isn’t exactly fast. It can take several years for the immune system to destroy enough of the beta cells to lose glucose homeostasis. This is a ship that sinks sloooooooowly. And I think that’s probably the primary reason the docs said “no way” when you asked them if the tick bites triggered the diabetes. To them, the timing was too short. A month instead of years? That, combined with the fact that ticks don’t commonly carry the usual suspects in the lineup of potential diabetes-triggering viruses. But you know what? The docs could be wrong. After all, we really don’t know how the triggers work, and I personally suspect that there’s a much wider net of possible triggers than we’ve figured out so far.

As to the illness, I’m sorry you had such a rough ride. The profound weight loss is what you’d expect out of extreme hyperglycemia (high blood sugar), and the fact that you lasted a month before going into DKA is likely due to your age. Younger kids go from onset to DKA in a relative blink of an eye, the destruction of the beta cells reaches a tipping point more quickly, while those of us with adult onset T1D seem to be able to linger longer. It’s probably because as we age, the immune system isn’t as strong.

So, what do I think? Was it the tick bites that triggered your diabetes? Even though it doesn’t quite fit the profile, I’m open to the possibility. Ticks carry one heck of a lot of viruses, sometimes giving their victims more than one disease in a single bite, and you had two of the little blood suckers. That’s a heck of a wallop to your immune system. Maybe it supersized and super-accelerated the diabetes onset for you. Or maybe you had a bout of rotavirus three years before that you didn’t realize or have forgotten about, and the timing of the tick bites was a coincidence. The symptoms of rotavirus in adults tend to be mild, and can be chalked up to a bad fish sandwich or some funky Chinese carry out.

But in the end I think it doesn’t matter. Take no insult! Here’s the thing: Let’s say for the sake of argument it was the ticks. That doesn’t change the party on chromosome 6.

I understand the desire to comprehend what happened to you — to figure out what caused this. That’s human. That’s natural. I get it. But please don’t get stuck obsessing over what caused your diabetes, as it was your genetic destiny, sooner or later. So rather than be angry over it happening when it did, be grateful it didn’t happen earlier. Then accept it and move on.

Oh, but still check for ticks when you come back in out of the woods. Diabetes aside, they still carry plenty of other nasty diseases that you don’t want, and you will have a harder time fighting those off now that your diabetes has risen from its genetic slumber!


Will Dubois lives with type 1 diabetes and is the author of five books on the illness, including “Taming The Tiger” and “Beyond Fingersticks.” He spent many years helping treat patients at a rural medical center in New Mexico. An aviation enthusiast, Wil lives in Las Vegas, NM, with his wife and son, and one too many cats.

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. Bottom Line: You still need the guidance and care of a licensed medical professional.