Diabetes is still on the rise. While the statistics tell us that 30 million Children and Adults have diabetes, and the health care cost of diabetes is 245 billion annually; we also know that 90-95% of diabetes cases are preventable, and treatable.
Having diabetes is not just about sugar. Having diabetes increases our chances for heart attack, stroke, coronary artery disease, impaired immunity, cancer, cognitive decline, blindness, hearing loss, nerve damage, kidney disease, hormonal imbalance, peripheral vascular disease, and loss of limb due to amputation.
Diabetes is classified as either type 1 or type 2. In Type 1 diabetes, the pancreas (the organ that produces insulin) is being destroyed by either an auto-immune process or a virus. This only accounts for about 5% of the cases of Diabetes. The rest of the cases are classified as Type 2 Diabetes.
There are four ways to “diagnose” diabetes:
1. Fasting blood sugar above 126 on 2 separate occasions (optimal Blood sugar is 85 fasting) 2. Blood sugar > 200 mg/dl with symptoms 3. 2-hour glucose > 200 in an Oral Glucose Tolerance Test 4. Hemoglobin A1C > 6.5 (Gives a glucose average over 3-4 months)
However, we certainly do not want to wait until the numbers get this bad before we start making modifications and treat. When blood sugar levels are above 100, sugar begins to be much more damaging. This is why insulin is so important; it helps to lower the amount of sugar in the bloodstream. Elevated blood sugar levels increase the formation of Advanced Glycation End Products. These are very pro-inflammatory and have been associated with many of the complications seen with diabetes noted above in paragraph 2.
Diabetes is actually an insulin problem. High blood sugar is a symptom of insulin resistance or lack of insulin. Insulin is a storage hormone secreted from the pancreas that helps sugar to get into our cells. Insulin also promotes the storage of excess sugar in the liver, the muscles and in our fat cells.
If you monitor most pre-diabetics, you will see high insulin levels before the occurrence of high blood sugar. Insulin is present to try to protect us from elevated blood sugar levels. After long periods of saturation with excess glucose, the insulin receptor becomes oversaturated and sugar cannot get into the cells.
At this point, excess sugar is converted into circulating fats called Triglycerides. High Triglycerides are an early sign of insulin resistance.
A continuous high need for insulin can also result in pancreatic “burn-out” which, in some people, may result in the need for exogenous insulin.
So what works for the treatment of diabetes?
1. Exercise: increases insulin sensitivity, burns sugar, and decreases stress. 2. Watch simple carbohydrate intake, or more specifically, Glycemic index and Glycemic load. Glycemic index is a scale that measures the insulin response your body will have after eating a certain food. The higher the Glycemic index, the more insulin your pancreas will secrete. Glycemic Load has to do with portion size. Some clinicians recommend limiting carbohydrates to 100 grams a day. It is ideal to get these carbohydrates from complex carbohydrates like low glycemic index vegetables and small amounts of fruit. 3. Eat protein, good fats and fiber with your carbohydrates. When you eat carbohydrates with good fat and fiber, it lowers the glycemic index. Protein helps to stabilize blood sugar. 4. Eat small frequent meals. Not eating regularly and eating larger meals, causes blood sugar and insulin spikes. When we go long periods without eating we are more likely to over eat and/or be more careless with our food choices. 5. Manage Stress. When we start to address diabetes and pre-diabetes, we need to also address stress. Stress, and the Cortisol response, also has a role in diabetes. Cortisol is the “stress hormone” and one of its jobs is to increase blood sugar. Cortisol does this by stimulating release of stored sugar (glycogen) from the liver. Cortisol also reduces the sensitivity of the insulin receptors on the cell. 6. Medications are an option for helping with sugar control. However, the first five points above are part of any successful diabetes treatment program. 7. Try to preform 12 hour fasts every night. This helps to reset the metabolism and has many health benefits.
If you have general questions about diet and diabetes prevention set up a consult and we can discuss strategies for achieving your best health.
– Cambria DeMarco, BA, RN, MSN, ACNP-BC, Functional Medicine Practitioner