Living Healthy With VITAMINS, MINERALS, AND SUPPLEMENTS
Diabetes
Diabetes
* These statements have not been evaluated by the FDA. If you have diabetes or think that you might have diabetes you should contact your PCP who will refer you to the appropriate specialist such as a Board Certified Endocrinologist or in some cases to a Board Certified Ophthalmologist. You may also benefit from the help of a Naturopathic Physician or Clinical Nutritionist.
* The desire of anyone with diabetes to return to normal health is both reasonable and understandable. In the case of diabetes however, it is important to not be over zealous. It is not prudent for one to decide to suddenly start an intense exercise program or to buy a dozen new supplements for their condition. The reason for this is simple. A person who takes action that causes their blood sugar to decline while on insulin or oral hypoglycemic agents could be subjecting themselves to unnecessary risks since their blood sugar can drop to dangerously low levels. The better approach is to take incremental steps that are accompanied with the monitoring of one’s blood sugar. These incremental steps must of course be done under the supervision and approval of your doctor.
The condition that we will discuss in this section is known in the medical text books as diabetes mellitus. Diabetes insipidus is another form of diabetes which results in excessive urination most commonly due to damage to a part of the brain known as the hypothalamus. The hypothalamus could be considered the thermostat or regulatory center of the brain.
The common thread in either of the two classifications of diabetes is the problem of excessive urination. In fact, the term “diabetes” which has its origins from the Greek literally means “to go through” meaning that fluids rather than being contained in the body, go through it. The term “mellitus” literally means “like honey” referring to the diabetic’s urine which often smells sweet like honey.
Diabetes is an illness that results in elevated blood sugar causing a myriad of related complications. The likelihood of such complications depends on the severity of the illness, how long the individual has had the condition and the patient’s level of compliance in regards to diet, exercise and maintaining proper weight.
There are actually two types of Diabetes Mellitus: the first formerly known as “Juvenile Diabetes” and the second formerly referred to as “Adult Onset Diabetes”. Today, because of increased obesity in the general population, “Adult Onset” diabetes is now happening in children. Because of this alarming trend, “Juvenile Diabetes” is now referred to as Type I Diabetes and “Adult Onset Diabetes” is now referred to as Type II Diabetes.
Type I Diabetes is the result of the pancreas producing no insulin or simply insufficient amounts of insulin. As a result, blood sugar elevates to dangerous levels and requires insulin to manage the condition.
Type II Diabetes does not usually result from a lack of insulin, at least not initially. Rather the insulin the body produces is not “recognized” by the target cells. This phenomenon is referred to as insulin resistance. To understand the concept of insulin resistance we need to understand the role of insulin in the body.
First, we need to understand that there are both insulin dependent tissues in the body as well as insulin independent tissues in the body. Insulin dependent tissues are simply tissues which are made up of cells that cannot receive sugar from the blood stream without insulin acting as a key to “open the door” of the cell thus allowing sugar to enter. Muscle tissue is an example of an insulin dependent tissue. Insulin independent tissues are tissues that are made of cells that can receive sugar from the blood stream without the “help” of insulin. The brain is an example of an insulin independent tissue.
In the case of insulin resistance, the cells do not “submit to the authority” of insulin so to speak and as a result, sugar is unable to enter the cells. The body responds by secreting more insulin which works for a while but eventually, the pancreas is unable to keep up. At this point, signs and symptoms of diabetes will begin to appear even though the problem of insulin resistance may have been going on for years.
A common presentation occurring with or prior to the diagnosis of Type II Diabetes are skin tags occurring on the neck, armpits and groin. Individuals likely to develop Type II diabetes also present with elevated triglycerides and low HDL’s. HDL’s or high density lipoproteins are also referred to as “good cholesterol”.
A condition that can occur prior to the onset of Type II Diabetes is known as Syndrome X.
Syndrome X is characterized by:
1. Elevated triglycerides and cholesterol in the blood.
2. Hyperinsulinism or simply stated too much insulin in the blood due to insulin
resistance.
3. Obesity
4. High blood pressure
Other possible signs of increased insulin levels seen with Syndrome X include:
- Calcium oxalate kidney stones in men
- Earlobe creases
- Abdominal obesity
- Excessive body hair, light periods and polycystic ovary disease seen in women.
The good news is that not everyone who shows signs consistent with Syndrome X will develop diabetes. The bad news is the fact that individuals with Syndrome X face a higher risk of accelerated aging and premature death even if they never develop diabetes.
Therefore, individuals demonstrating clinical signs consistent with Syndrome X should take action to delay or prevent the onset of Type II Diabetes. Modifying their lifestyles by restricting calories and carbohydrates is a good start. Incorporating an exercise program into one’s lifestyle is also an effective way to keep the diabetes monster in his cage.
Symptoms especially with Type II Diabetes can be either frank or subtle. Fatigue, weight change, tingling in the hands and feet, increased hunger, excessive thirst, frequent urination and slow wound healing are the most common ways that diabetes presents.
Standards for the diagnosis of diabetes are based on fasting glucose levels. Historically, fasting plasma glucose levels of 140 mg/dl on two separate occasions confirmed the diagnosis of diabetes. More recently, the American Diabetes Association has lowered the criteria for fasting plasma glucose levels to 126mg/dl on two separate occasions.
Complications resulting from diabetes include vision loss due to cataracts and retinopathy, mononeuropathy, kidney failure, atherosclerosis, heart disease including heart attacks and gangrene to name a few. Diabetes also results in increased free radical activity and elevated inflammation thus contributing to the earlier onset of disease and premature death.
Let us now discuss factors that contribute to delaying the onset of diabetes as well as those that minimize the ill effects that diabetes exerts on one’s health. Remember however that this information is provided for educational purposes only. Treatment of any condition including diabetes requires the expertise of your PCP and/or a Board Certified Endocrinologist. If you are already under the care of your M.D., a clinical nutritionist and/or a naturopathic physician can also provide the care and invaluable information needed to keep you in optimal health.
Recommendations for Diabetes:
Check your blood sugar
Watching your blood sugar after eating certain foods for the first couple of hours will give you an idea as to which foods cause your sugar to spike and how much of a given food you should eat without pushing your sugar levels too high. You will also be able to see the effect that exercise or a lack thereof has on your blood sugar.
Check your glycosylated hemoglobin 3-4 times per year
Checking your blood sugar reveals how high or low sugar levels may be at any given time. Glycosylated hemoglobin is different as it demonstrates how your blood sugar has been doing over a period of weeks. If blood sugar on average is high, this will elevate your glycosylated hemoglobin and reveal that even though your sugar may be normal from time to time it is still too high on average. This test needs to be ordered by your doctor.
Consume foods with high ORAC indices
ORAC means Oxygen Radical Absorption Capacity. Simply stated, this discusses how good a particular food is at absorbing free radicals. The following is a list of foods with high ORAC values. One should however remember that some of these foods should be consumed more sparingly than others due to higher levels of sugar. While not particularly high on the ORAC list, onions and garlic have demonstrated the ability to lower blood glucose levels in some studies.
Top-Scoring Fruits and Vegetables |
|||
ORAC units per 100 grams (about 3 ½ ounces) |
|||
Fruits |
Vegetables |
||
Prunes |
5770 |
Kale |
1770 |
Raisins |
2830 |
Spinach |
1260 |
Blueberries |
2400 |
Brussels sprouts |
980 |
Blackberries |
2036 |
Alfalfa sprouts |
930 |
Strawberries |
1540 |
Broccoli flowers |
890 |
Raspberries |
1220 |
Beets |
840 |
Exercise
Exercise is helpful in both the prevention and treatment of diabetes, especially Type II. This is because exercise works in different ways against diabetes. First, exercise helps to fight obesity which is the most significant risk factor with Type II diabetes. Exercise also increases insulin sensitivity and thus makes your body’s own insulin work better. Exercise also lowers blood fats such as triglycerides and cholesterol. You must remember however that it is important to choose an exercise program that is appropriate for your age and ability. Starting too quickly or with too much intensity can often result in more setbacks than progress. Being consistent is always better than being a “weekend warrior”. Talk with your doctor about what type of exercise program is best for you.
Get your eyes examined at least annually by an ophthalmologist
Diabetes can result in cataracts, retinopathy and glaucoma. This means that every diabetic should not only get regular checkups from their PCP and their endocrinologist but also with their ophthalmologist.
Increase Dietary Fiber
Dietary fiber slows the digestion and absorption of carbohydrates in decreases the likelihood of spiking blood sugar levels. Foods such as vegetables, beans, nuts, oat bran, apples and pears are all good sources of fiber.
Recommended Vitamins:
B Complex Vitamins
- B complex vitamins are important in sugar metabolism and in nerve health. See vitamin guide for more details.
- Vitamin B6 shows some degree of promise in its abitity to provide a hedge of protection against diabetic neuropathy. B6 may also be helpful in preventing glycosylation of proteins. Women with gestational diabetes have also benefited from B6 in at least one study.
- B12 may also be helpful with diabetic neuropathy.
- Diabetics have received positive results with niacinimide.
Biotin
Supplementation has been shown to increase insulin sensitivity
Vitamin C
Most sources recommend about 200 mg/day. Vitamin C keeps capillaries strong and thereby prevents or at least delays the process of diabetic retinopathy. In addition because Vitamin C is actually a carbohydrate, it depends to some degree on insulin to get into the cell. Because of this, diabetics may be in need of greater amounts of Vitamin C than the normal cross section of the population
Vitamin E
Vitamin E acts as an antioxidant and diabetics seem to have a higher need for this vitamin than the normal population. Vitamin E has also been show to increase insulin sensitivity and glucose tolerance.
Warning: Vitamin E can cause blood sugar to drop and therefore the best approach is to start with a dose of 100 IU and then if indicated, increase the dose by increments 100 IU at a time.
Inositol
May be helpful in preventing diabetic neuropathy
Recommended Minerals:
GTF Chromium
Most sources recommend 200 mcg/day. This mineral increases the sensitivity of the body’s cells t to insulin. Chromium has also been shown to improve the action of insulin, decrease cholesterol and triglycerides and increase HDL’s or good cholesterol levels
Magnesium
To list all of the roles of magnesium would be exhausting but in the case of sugar metabolism magnesium is essential. Magnesium deficiencies are common in diabetics. Sadly food processing and mineral depleted soils make it more difficult to obtain adequate amounts of magnesium through diet alone. While the RDA is 400 mg/ day diabetics may need as much as 600 mg/ day or more
Manganese
Most sources recommend 5-15 mg/day. Some recommend as high as 30 mg/day. Manganese is involvedenergy metabolism and blood sugar control.
Potassium
Potassium plays an important role with insulin sensitivity. It is preferred that potassium be obtained from the diet as much as possible since prescribed potassium salts can have negative side effects. Diabetics with kidney disorders need to consult their doctors as to how much potassium they should consume.
Vanadium
Most common recommendations are about 2mg/day
Zinc
Zinc is involved in the synthesis, secretion and utilization of insulin. Diabetics tend to lose greater amounts of zinc in the urine and therefore would benefit from supplementation.
Recommended Herbs:
Bilberry
Exerts potent antioxidant effects and protects capillaries thereby aiding in the prevention of diabetic neuropathy. Most sources recommend about 80-160 mg three times a day
Bitter Melon
Also known as balsam pear has anti-diabetic properties by decreasing blood sugar levels and glycosylated hemoglobin levels while improving glucose tolerance. Bitter melon is often sold in juice form.
Fenugreek
50 mg twice daily resulted in decreased fasting blood glucose levels and improved glucose tolerance. Cholesterol and triglyceride levels were also reduced with fenugreek.
Ginkgo Biloba
Improves blood flow in the peripheral tissues
Gymnema sylvestre
Found mostly in India. Believed to support the cells that produce insulin as well as enhancing the action of insulin and improving blood sugar control. A common dose is about 400 mg/day
Recommended Natural Supplements
Alpha Lipoic Acid
Decreases insulin resistance and increases insulin sensitivity. Works in the Kreb’s cycle and quenches free redicals
Carnitine
Breaks down fats into energy and lowers blood fats while raising HDLs. Also increases insulin sensitivity
Coenzyme Q10
Promotes insulin secretion
Conjugated Linoleic Acid
Improves insulin sensitivity and aids in management of weight
Fish oil and Flax Oil
Lowers cholesterol and triglyceride levels and raises HDL levels
N-Acetyl Cysteine
NAC works by protecting beta cells from free radicals. Beta cells are involved in the production of insulin within the pancreas.