Diabetes

Diabetes is a chronic disorder of inefficient metabolism of carbohydrates, fats, and proteins. There is a close relationship with being overweight, having a sedentary lifestyle, and developing diabetes. Left untreated, diabetes is linked to a rapid increase in cardiovascular disease, stroke, nerve damage, and blindness. Diabetes is reaching epidemic proportions with an estimate of 150 million people affected world wide. This figure is expected to climb to 300 million by 2025.

Type I and II diabetes

IcebergThere are two types of classification for diabetes. Type I, or insulin dependent diabetes typically occurs in children and adolescents. A person with Type I diabetes can not produce insulin and requires life long insulin supplementation. In contrast, Type II diabetes occurs later in life, more commonly after 40 years old and can most often be managed through lifestyle adjustments such as weight loss and exercise. Symptoms of diabetes include increased thirst, increased urination, visual changes, fatigue, and nausea. With persistently elevated glucose levels, a person may have recurrent bacterial or fungal infections.

The Tip of the Iceburg

Diabetes is often just the tip of the iceberg with high blood pressure, increased cholesterol, obesity, and heart disease preceding the diagnosis. With respect to conventional medical treatment of diabetes, treatment often begins after blood glucose has reached such high levels that destruction to micro and macro circulation has occurred for many years. 70% of all deaths in people with diabetes are a result of cardiovascular complications. This makes early detection and prevention of paramount concern.

Diet and Exercise can help?

Recent studies are supporting that proper lifestyle and adequate exercise are the superior treatment for delaying type 2 diabetes. Clinical trials have shown that moderate exercise (at least 30 minutes daily) and proper diet promote weight loss, thereby preventing diabetes through improving glucose tolerance. Exercise and diet have shown to decrease cholesterol levels, therefore improving the risk for heart disease. The American Diabetic Association encourages diet and lifestyle over the use of glycemic drugs for long term management of diabetes because glycemic lowering drugs have many side effects and their potential to interact with other medications.

The Hallmark of Diabetes

The hallmark of diabetes mellitus consists of insulin resistance, pancreatic beta cell dysfunction, and increased glucose production. Normally, glucose is maintained in proper balance and we are dependent on glucose for appropriate cellular function. Once present in the blood, glucose signals for insulin to be secreted by the pancreas. Insulin then acts on all cells and their receptors, allowing for glucose to enter the cell to be used for energy. Glucose cannot access a persons cell with out having the hormone insulin present. A person who is a type one diabetic does not produce insulin and requires life long insulin administration. With respect to type two diabetes, insulin may be made by the pancreas but cells do not react to it. This process is known as insulin resistance and is a common precursor to type 2 diabetes, the development of athersclerosis, and the complications associated with heart disease.

Screening for Diabetes

According to the American Diabetic Association screening for diabetes should be included in general medical exams for men and women who are 45 years or older. Screening the younger population is typically not indicated unless there are presenting symptoms (as noted earlier). However, screening should occur in younger people who are overweight (have a body mass index greater or equal to 25 kg/m2), where there is a family history and there is one of the following risk factors, have had gestational diabetes or a baby weighing greater than 9 pounds, are not Caucasian, have elevated blood lipids, or have hypertension. Appropriate screening for diabetes includes one of the following tests, the oral glucose tolerance test or a fasting glucose test. Both tests access the body’s ability to efficiently utilize glucose. A person is diagnosed with diabetes when they have an elevated blood glucose of 126 mg/dl in the fasting state and/or above 200 mg/dl 2 hours after a 75 g glucose load. It is important to note that a person may have elevated glucose on the high end of normal but not have diabetes. One must keep in mind that this may indicate the development of insulin resistance. If this is the case it is of benefit to visit with a physician to test insulin levels, as well as develop a preventative plan to stabilize glucose levels.

Treatment

Treatment of diabetes should include home glucose monitoring, a routine exercise program, a diet low in simple sugars, high in complex carbohydrates and fiber, as well as nutritional supplements and botanicals medicines to help maintain blood sugar regulation.

Fiber

Water soluble fiber has shown to be beneficial with controlling blood sugar and decreasing cholesterol. Water soluble fiber helps slow digestion, while giving the liver time to process glucose, therefore making glucose fluctuations more stable. Good sources of water-soluble fiber include legumes (beans), oat bran, nuts, seeds, psyllium seed husks, pears, apples, and most vegetables. A recommended daily intake of 50 grams of dietary fiber is recommended for diabetics.

Fats

Essential fatty acids (EFA’s) are a very beneficial for various health conditions. Essential fatty acids include both omega-6 and omega-3 fatty acids. With regard to diabetes, both fatty acids have shown to protect against diabetic neuropathy, atherosclerosis, and augment insulin secretion in type two diabetes.

An excellent source of EFA’s are cold water fish such as salmon, herring, mackerel, and halibut. A person can have health benefits from these sources with eating as little as 2 - 3 serving per week. The omega-3 fatty acid oils have shown to be very beneficial in lowering total cholesterol, LDL cholesterol, and triglycerides, while raising the “good” HDL cholesterol. Consumption of flax seeds will provide high levels of omega-3 oils. The recommended dose is 1 - 2 Tbsp of flax seed daily. It is important to note that when consuming any seed or nut, choosing organic is always best because pesticides are concentrated in the oils.

Botanicals

  1. Onions and garlic have demonstrated blood lowering action as well as the lowering of cholesterol and blood pressure. 2. Gymnema Sylvester extract improves blood sugar control and has shown benefit in treating both type I and type II diabetes.
  2. Panax ginseng has blood sugar lowering activity.
  3. Bitter melon also known as balsam pear, has been shown to lower blood sugar.
  4. Fenugreek seeds or defatted fenugreek powder improves glucose tolerance as well as lowering total cholesterol levels.
  5. Salt brush, a woody branch native to the Mediterranean, has demonstrated to improve blood glucose regulation and glucose tolerance in patients with type II diabetes.
  6. Green tea is high in epicatechin, a flavonol that has strong antioxidant properties. Studies have shown that plants that contain epicatechin can help restore functioning of pancreatic beta cells in animals.
  7. Ginkgo biloba extract is used in the prevention of diabetic neuropathy and may help reduce retinal damage from macular degeneration, a cause of blindness particularly threatening for diabetics.
  8. Vaccinium myrtles, bilberry or European blueberry is high in anthocyanosides. A bioflavonoid which has shown to help heal small blood vessels. Specifically, anthocyanosides are very protective to the blood vessels of the eye and retina. Studies have shown positive effects with treating diabetic retinopathy, macular degeneration, cataracts, retinitis pigmentosa, and night blindness.

Nutritional Supplementation

When looking for nutritional support the best way to obtain nutrients should always be from whole foods and a balanced diet. The following supplements benefit people who have diabetes or blood sugar regulating difficulties. This list is not recommended to be taken in its entirety as some preparations can be tailored to your exact needs. It is important to consult with a doctor when adding or changing any part of a diabetic program, especially if on any medications.

  1. Chromium is vital to proper blood sugar control. Chromium works closely with insulin by facilitating the uptake of glucose in cells. An excellent source for chromium can be found in brewers yeast.
  2. Coenzyme Q10 improves circulation and stabilizes blood sugar.
  3. Vitamin C is important in tissue repair, as well a proper immune functioning. In addition vitamin C has shown to decrease intracellular sorbitol, a sugar that is often elevated in diabetics and has been linked to diabetic complications, such a eye and nerve diseases. Vitamin C is high in leafy green vegetables, broccoli, peppers, brussels sprouts, and citrus fruits.
  4. Niacin is important because enzymes that depend on it for proper functioning play a role in energy production; fat, cholesterol, and carbohydrate metabolism. Niacin, like chromium has shown to improve glucose tolerance.
  5. Biotin helps to manufacture and utilize carbohydrates, fats, and amino acids. Biotin is manufactured by gut bacteria and biotin supplementation typically is not indicated. However, a more vegetarian diet has shown to increase biotin’s absorption.
  6. Vitamin B-6 has shown to prevent diabetic neuropathy (nerve pain associated with nerve damage in diabetes).
  7. Vitamin E is an excellent antioxidant. It is important because it improves the action of insulin as well as being supportive to cardiac functioning.
  8. Magnesium is involved in several areas of glucose metabolism and there is large evidence indicating that diabetics are deficient. It is important to note that as a whole the average American diet provides less than the RDA for magnesium. This is a result of our diet being high in processed foods, meat, and dairy products, which are low in magnesium. Excellent sources of magnesium include tofu, legumes, seeds, nuts, whole grains, and green leafy vegetables. Lastly, when supplementing magnesium, B-6 should be supplemented as well because B-6 intracellular B-6 is needed for magnesium to be utilized.
  9. Manganese is a cofactor in many enzyme systems involved in blood sugar control, energy metabolism, and thyroid function.
  10. Zinc is important because it helps support the immune system, tissue healing, and insulin metabolism. Zinc also has a protective effect against beta-cell destruction. Zinc is found in high amounts of the following foods; whole grains, legumes, nuts, and seeds.
  11. Flavonoids help protect blood vessels from damage and decrease inflammation. Flavonoids are found in many fruits, such as berries, kale, red and purple grapes, oranges, green tea, cranberries, and grape fruit.