Diabetes

DiabetesDiabetes is a chronic disease. It is a condition that results in higher than normal levels of glucose (blood sugar) in the blood. Blood sugar levels are controlled by insulin, a hormone produced by the pancreas. Diabetes occurs when the pancreas is unable to produce enough insulin, or the body becomes resistant to insulin, or both.

Insulin resistance is really a pre diabetes condition, where the body’s cells don’t respond normally to insulin. Glucose can’t enter the cells as easily, so it builds up in the blood. This can eventually lead to type 2 diabetes.

Insulin is a hormone made in your pancreas, a gland located behind your stomach. It allows your body to use glucose for energy. Glucose is a type of sugar found in many carbohydrates.

After any intake of food, the digestive tract breaks down carbohydrates and changes them into glucose. Glucose is then absorbed into your bloodstream through the lining in your small intestine. Once glucose is in your bloodstream, insulin causes cells throughout your body to absorb the sugar and use it for energy.

Diabetes with the dysmetabolic state present in insulin resistance and metabolic syndrome are related to dietary imbalances, physical inactivity, stress, lifestyle habits chronic inflammation as the all-important changes to the person’s microbiome (the total combination of prebiotic and probiotic existence in he host).

Diabetes is the fourth leading cause of death in developed countries. It is my opinion, that the use of antidiabetic drugs is hindered by their tolerability of the individual but also their side effects. They don’t seem to control high blood sugar by themselves. Naturopathic intervention may therefore help to address this issue as well as the correct dietary and lifestyle changes.

Testing for diabetes

 Oral glucose-tolerance test 

This test is most commonly performed during pregnancy. You typically have your blood drawn once, then drink a syrupy glucose solution and have your blood drawn at 30 to 60 minute intervals for up to three hours to see how your body is handling the consumed sugar.

Fasting blood sugar.

This is a common test because it’s easy to perform. After fasting overnight, you have your blood drawn at an early morning doctor’s visit and tested to see if your blood sugar is in the normal range.

Normal result: less than 5.5 mmol/L

Two-hour postprandial test.

This blood test is done two hours after you have eaten (prandial means meal).
Normal result:                        less than 7.9 mmol/L

Random blood sugar.

A blood sugar test is performed regardless of when you last ate a meal.

Normal result:                             less than 7.0 mmol/L

Hemoglobin A1C test.

This test measures how much sugar is stuck to your red blood cells, which generally have a lifespan of three months. Therefore, this test gauges how high your blood sugar has been in recent months.

Normal result for nondiabetics:     4% to 6%.
Normal result for diabetics:             7% or lower (sometimes it is suggest aiming for                                                                                 6.5% or lower is ideal)

If a haemoglobin A1C test result is 8% or higher, it’s a sign that blood sugar is not under control.

Self monitoring

There are also blood glucose monitors available so you can monitor blood glucose levels yourself at regular intervals. While this does not replace blood tests, it is sometimes necessary for people to monitor their glucose levels in between their blood tests.

These devices are used by pricking your finger and putting the blood onto a test strip that is connected to the blood glucose monitor. The blood glucose monitor then gives you a reading.

Instructions are provided with each unit.

There are also blood sugar monitors available that do not require pricking of your finger to obtain blood for measuring glucose levels. These devices use a small sensor that needs to be attached to your upper arm. A reader device is then used over this sensor to obtain a glucose level result without the need of pricking your finger to obtain a blood sample.

There are three main forms of diabetes:

Type 1 diabetes

Type 1 diabetes is considered to be an autoimmune and inflammatory disorder where the body’s immune system attacks the insulin producing cells of the pancreas. This results in the destruction of pancreatic β-cells, causing a subsequent loss of insulin production and secretion. The disease can occur at any age, although it mostly occurs in children and young adults. People with type 1 diabetes cannot produce insulin and require lifelong insulin injections for survival.

Type 2 diabetes

This is a chronic metabolic disorder which results from a reduction in insulin secretion and the development of insulin resistance in major target tissues. It is characterised by an impaired pancreatic β-cell insulin response to glucose levels after ingestion of food, reduced glucose tolerance and a failure of elevated glucose to stop gluconeogenesis (the production of glucose). There is also a strong association between insulin resistance and the development of type 2 diabetes.

In simpler terms, the hormone called insulin, which is essential for converting food into energy, is not produced in adequate amounts or is not utilied effectively by the body. Instead of the glucose (converted by the body from carbohydrates) being turned into energy, it remains at higher than normal levels and keeps circulating in the blood without purpose.

This type of diabetes is largely preventable and is mostly caused by lifestyle factors, such as obesity, insulin resistance, bad eating habits, an unhealthy diet, lack of exercise, raised stress levels.

While diabetes type 2 is mostly identified in adults over the age of forty, it can appear at any age.

Gestational diabetes. (Diabetes during pregnancy)

During pregnancy, some of the hormones produced by the placenta reduce the action of insulin. The pancreas then needs to produce extra insulin to keep blood glucose levels in the normal range. If the pancreas is unable to produce enough insulin, blood glucose levels rise, and gestational diabetes develops

This occurs in pregnant women It affects 12%-14% of pregnancies, usually around the second trimester, which is between the 13th and 28th week of pregnancy

After the birth, the mother’s blood glucose levels usually return to normal. However, there’s an increased risk of type 2 diabetes in the future – both for the mother and the child, when he or she grows. Some women continue to high blood glucose levels after delivery, leading to a diagnosis of type 2 diabetes

Women have a higher risk of gestational diabetes if they:

  • are over 40 years of age
  • have a family history of type 2 diabetes
  • have a first-degree relative (mother or sister) who has had gestational diabetes
  • have had gestational diabetes in a previous pregnancy
  • are overweight
  • have gained weight too rapidly in the first half of pregnancy.
  • have had elevated blood glucose levels in the past
  • have polycystic ovary syndrome
  • have previously had a large baby (weighing more than 4.5kg)
  • are taking some types of antipsychotic or steroid medications

It is important to always check for gestational diabetes during pregnancy If blood glucose levels are high during pregnancy, extra glucose passes across the placenta to the baby, who then makes extra insulin. This can sometimes make the baby grow too big, and this in turn can cause problems during labour, and increase the risk of early delivery or the need for a Caesarean section. After birth, the baby may have a greater risk of low blood glucose levels (hypoglycaemia). This is because the baby is no longer receiving extra glucose from their mother, but they continue to make extra insulin, causing their blood glucose levels to drop. In addition to the above, women with gestational diabetes also have an increased risk of developing high blood pressure during pregnancy.

Diabetes related complications

The complications of diabetes can be serious, but if you make appropriate lifestyle changes and pay attention to your blood glucose control, you can substantially reduce the risk of complications occurring.

If diabetes is left undiagnosed or unchecked for too long, it can lead to serious and often life threatening health conditions including:

  • Heart disease
  • Kidney disease
  • Blindness
  • Limb amputation
  • Erectile dysfunction
  • Persistent infections

It is important to treat diabetes – and most importantly to prevent it. Diabetes can cause many complications.

Eye health in diabetes

Diabetes related eye disease. Diabetic retinopathy can be caused when glucose levels are above normal in the blood. If there is also high blood pressure and high cholesterol, the risk increases again.

Diabetic retinopathy is a complication of diabetes which can damage the tiny blood vessels inside the retina at the back of the eye. This can cause bleeding and swelling in the retina and seriously affect vision, and in some cases cause blindness.

Anyone who has diabetes, even if it is managed, is at risk of diabetic retinopathy. It is estimated than about 1 in 4 people with diabetes have this condition – many may not even be aware. Sometimes there are symptoms such as blurred vision or double vision. It is vital that people with diabetes have regular eye checks.

Cardiovascular disease

 People with diabetes have increased risk of heart disease and stroke due to raised blood glucose levels, in association with high blood pressure and cholesterol. Unfortunately, sometimes a person has a heart attack before they find out that this has been caused by their diabetes that they were unaware they had.

Kidney disease

Your kidneys are wonderful filters that clean your blood, by remove waste from the blood and passing it out of the body as urine. Over time, diabetes can cause damage to your kidneys – this is a condition called diabetic nephropathy.

As there are usually no symptoms, you m=probably won’t notice damage to your kidneys until it’s quite advanced.

The risk of developing kidney problems is reduced by managing your blood glucose levels, having regular kidney and blood pressure checks and leading a healthy lifestyle. Finding out about kidney damage early is simple and painless. Early treatment can prevent kidney damage and serious complications.

Nerve damage and lower limb complications

 Diabetes causes gradual and increasing damage to your nervous system. There are different mechanisms and complications. In general terms, progressive damage to your nervous system can lead to loss of feeling of your hands and/or feet. Reduced circulation (due to high blood glucose) can affect would healing of your extremities, which means that simple damage can take a long time to heal and develop into permanent injury. Note that because of altered feeling you may not be aware that you have an injury, such as for example an ulcer on your foot, minor cuts, blisters or burns.

Severe neuropathy can weaken the bones in your foot. The consequence of this is that these bones may crack or break, making your foot red, sore, swollen, or warm to the touch. But because you can’t feel it, you may keep walking on your foot and deform it.

These are just examples about possible problems with your feet. Depending on the affected nerves, symptoms of diabetic neuropathy can range from pain and numbness in your legs and feet to problems with your digestive system, urinary tract, blood vessels and heart.

Oral health

 Teeth and gum problems are more common in people with diabetes, including:

  • Gum inflammation (gingivitis)
  • Infection and inflammation of the ligaments and bone that support the teeth (periodontitis)
  • Tooth decay
  • Dry mouth
  • Fungal infections (oral thrush)
  • Disturbances in taste

Sleep problems

While more research is needed, it is known that diabetes and sleep apnoea are closely linked. Sleep apnoea can exist for other reasons with no diabetes present, but it is worth noting the link in many cases.

Prevention of diabetes

Exercise and diet can make a big difference for diabetics. To demonstrate how significant even a small reduction of glucose can be, we consider the Diabetes Control and Complications Trial, which was conducted from 1983 to 1993 by the National Institute of Diabetes and Digestive and Kidney Diseases.

This study showed that keeping blood glucose levels as close to normal as possible slows the onset and progression of eye, kidney, and nerve diseases caused by diabetes.

In fact, it demonstrated that any sustained lowering of blood glucose helps – even if the person has a history of poor control. HbA1c (glycosylated haemoglobin) reflects average blood glucose levels over a two- or three-month period. In this study, researchers found that even a 2% decrease of blood glucose levels was associated with dramatic results: a significant reduction in risk of developing eye disease, a reduction in the risk of kidney disease, and a reduction in nerve disease.

A healthy diet is of course very important not only for diabetes but for also preventing many other diseases.

Naturopathy for diabetes

Diet and Lifestyle Dietary and lifestyle guidelines that may assist in the management of type 2 diabetes include:

  • Weight reduction where appropriate is essential. It is important to see a health practitioner that understands dieting and the failures that come with dieting that either does not suit the individual case, is not properly supplemented for best results and better fat burning ability, but also continues for too long. Diet should be appropriately interrupted at regular intervals. (More of this in other sections for weight management). We have had some anecdotal evidence of great improvement in our clinic using diet, supplements and herbs.
  • In general, following the principles of a balanced healthy regime to include at least 5 servings of vegetables, quality protein, reducing high glycaemic load foods, and to consume essential fatty acids.
  • The Mediterranean Diet has been found to be beneficial in managing high blood fats. This is comprised of whole grains, fresh fruits and vegetables, fish, olive oil and garlic. This diet is high in monounsaturated fatty acids and has been shown to increase HDL cholesterol “(the good cholesterol)” blood levels and reduce susceptibility to LDL oxidation “(bad cholesterol)”
  • Lifestyle modifications that are beneficial include increased physical activity, stress reduction, relaxation techniques.
  • Smoking adversely affects so many health areas, and diabetes is no exception here, therefore do not smoke.
  • Alcohol is also detrimental, especially binge drinking, which contributes to liver damage, insulin resistance and diabetes.

There are many nutrients and herbs that can assist. We stress that each case is different. Also even if diabetes persists, it is essential to use the right natural medicines so you can keep healthier and reduce the many risks associated with diabetes, as well needing to increase or adding to your medication.

Several nutrients and herbs have been identified as helping maintain healthy blood glucose levels. Examples are Cinnamon, Goats Rue and Gymnema among others as far as herbals are concerned, and vitamins and minerals such as Biotin, Zinc, Chromium, Magnesium and Alpha Lipoic Acid have also shown promising results in many studies. It is beyond the scope of this short article to go into greater details about the various natural remedies, suffice to say that treatment is specialised and the advice of a professional must be sought for satisfactory results. Any treatment would again consider in conjunction with natural remedies, the importance of dietary factors, exercise and stress levels.

Let’s look at some examples of how these can assist.

Thiamine can be taken as an example of a vitamin supplement that may assist. Thiamine plays a vital role in carbohydrate metabolism within all cells of the human body. There have been suggestions for many years that diabetic patients have impaired absorption of thiamine and may display low levels of thiamine deficiency. In addition, surges of glucose can destroy thiamine, leaving the cells with a functional deficiency, meaning they still work but not as well as they could if they had the thiamine they need. If your thiamine level is deficient, it throws the whole system off. Without adequate thiamine, your cells are “soaking” in a toxic glucose bath. This gives glucose ample opportunity to move in and cause all sorts of problems, from fatigue to neuropathy.

Gymnema is one of the many herbs that I have mentioned above. Although more studies are needed, the statement below is from a study that I Have sighted for your information.

The effectiveness of GS4, an extract from the leaves of Gymnema Sylvestre, in controlling hyperglycaemia was investigated in 22 Type 2 diabetic patients on conventional oral anti-hyperglycaemic agents. GS4 (400 mg/day) was administered for 18-20 months as a supplement to the conventional oral drugs. During GS4 supplementation, the patients showed a significant reduction in blood glucose, glycosylated haemoglobin and glycosylated plasma proteins, and conventional drug dosage could be decreased. Five of the 22 diabetic patients were able to discontinue their conventional drug and maintain their blood glucose homeostasis with GS4 alone. These data suggest that the beta cells may be regenerated/repaired in Type 2 diabetic patients on GS4 supplementation. This is supported by the appearance of raised insulin levels in the serum of patients after GS4 supplementation.

(Baskaran, K., et al. Antidiabetic effects of a leaf extract from Gymnema Sylvestre in non-insulin-dependent diabetes mellitus patients. Journal of Ethnopharmacology. 30(3):295-305, 1990).

Cinnamon has been researched for its ability to assist the process of high blood sugar regulation. It also appears that cinnamon improves glucose tolerance in healthy individuals as well as improve insulin sensitivity – useful in insulin resistance.

There are various ways that cinnamon works, as for example a content of cinnamon, cinamatannin, activates the phosphorylation of the insulin receptor. It is worth noting that cinnamon is also used for non-alcoholic fatty liver disease. (there are other uses but we restrict our discussion here on diabetes related issues).

It is of great importance to understand that herbs cannot be easily prescribed by the layperson for a number of reasons. Except that they require special knowledge and expertise, not all herbs are the same. The dosage would depend on the strength of the herb as well as its combining with other herbs. The quality of herbs can vary greatly in active ingredients and strength of the final product after processing and this is a critical factor in prescribing herbs. The herbs available to practitioners are not available to the general public. Depending of which herbs we combine, we will appropriately adjust dosage and frequency. Monitoring of results and adjusting dosage and combinations are also important considerations.

At the Centre of Health we only use the best quality herbs after careful study and consideration of how they are manufactured, their strength, content of active ingredients and purity. You can always rest assured that you are getting the absolute best available at our clinic.

An example of a protocol we may use at our clinic to help you further understand the way we work is presented in the drawing below for information.

diabetes infographic

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