Take steps to understand, prevent diabetes
By Dr. Martin Gleixner, MSc, ND
The time is ripe for a new and effective way to prevent and treat diabetes.
If you already have diabetes, your doctor may have told you about all the scary statistics related to the disease. How common it’s becoming, how it’s a big contributor to the spiraling costs to our medical care system, and how there are so many severe complications.
Why are these messages not heard?
Why are so many with pre-diabetes and diabetes not able to make the lifestyle changes needed to heal their disease? Can we blame this trend merely on our genes?
Are medical doctor’s (MD) office visits too short (usually 10 minutes long) to provide diabetic patients the education or attention they need to understand, heal and/or be able to control their disease? Are pharmaceutical drugs sufficient to cure diabetes? Are diabetics receiving sufficient information and incentive to make changes from dieticians?
Are diabetic patients simply not taking their blood sugars regularly enough at appropriate times during the day to know that their disease is out of control?
Have people (whether diabetic or not) received adequate nutritional information to prevent diabetes or heal themselves if the disease is already manifesting? Do people truly understand the importance of exercise?
The reality is stark: our present medical system to prevent and heal diabetes is insufficient. A new approach is timely and necessary. The importance of MDs and naturopathic doctors (NDs) working together has never been so important.
Today’s column will be the first of a series of articles focusing mainly on the understanding, prevention and treatment of diabetes.
First I’ll provide an informative discussion of diabetes and it’s different types. Future columns will look closely at causes, diagnosis criteria, and treatments that include both drug and naturopathic therapies.
Let’s start our educational tour by describing the main types of diabetes:
Type 1 diabetes
Type 1 diabetes is an autoimmune disease that usually occurs at a young age. A person’s own immune system attacks their pancreas, thereby destroying the cells of the pancreas that normally produce insulin. It accounts for approximately 5-10% of diabetics. This form of diabetes comes on quickly resulting in near complete destruction of the pancreas. For this reason, patient with type 1 diabetes must be on injectable insulin so that they can adequately control their blood glucose levels.
Type 1.5 diabetes
Also known as LADA (latent autoimmune diabetes of adults), this form of diabetes is under diagnosed and poorly understood. Because it comes later in life (usually late 30s or 40s) and progresses more slowly than type 1 diabetes, many patients can be wrongly diagnosed with type 2 diabetes. As research continues to provide a better understanding of this disease, blood tests do exists to help diagnose this condition.
Gestational Diabetes
This occurs when a women becomes diabetic during her pregnancy. The causes for this form of diabetes are similar to type 2 diabetes. Although additional risk factors and causes are found in pregnancy, an improper diet and excess weight gain are important contributing factors for the disease. Women diagnosed with gestational diabetes have a high risk of developing type 2 diabetes later in life (especially if they required insulin during pregnancy).
Type 2 diabetes (& pre-diabetes)
The rate of type 2 diabetes has increased markedly in the last 50 years and is the form of diabetes that is causing our present epidemic. Approximately 90% of diabetics have this form of the disease. Obesity, genetic predispositions, poor diet, lack of exercise, stress, toxins, hormone imbalances and drug side-effects are all causes of type 2 diabetes which will be discussed in great detail in upcoming columns.
Rather than an autoimmune attack, type 2 diabetes (and gestational diabetes) develop because of a process called “insulin resistance”. Understanding this concept is crucial because it provides the reasoning for the benefits of lifestyle changes in healing diabetes.
The pancreas is a long slim organ located behind your stomach that produces and releases insulin in the blood stream. Insulin in turn only affects cells that have receptors for insulin: these include muscle, liver and fat cells. By attaching itself to a receptor located on the outer layer of a cell, insulin acts much like a key fitting in a door handle. Insulin provides the instructions to allow blood sugar to enter the cell (much like a door that allows people to enter a room). These cells in turn will either store the glucose as energy or it will burn the fuel depending the body’s metabolic needs (e.g. if you are exercising or not). As blood sugar enters cells, levels in the blood drop, which cues the pancreas to stop producing insulin.
Unfortunately, insulin has a strong tendency to tell fat cells to store food as energy (triglycerides) rather than burn the glucose for metabolism. The higher someone’s insulin levels (as we will see occurs in type 2 diabetes except in advanced cases), the more blood sugar will be stored as fat.
In non-diabetic patients, a lower blood glucose level keeps insulin low thereby allowing the body to burn energy as needed and maintaining normal weight.
With weight gain, lack of exercise and poor diet, our cells do not listen to insulin as well (like a key that doesn’t fit in the socket any longer). When our cells stop responding to insulin (even when levels of insulin are high), we say that our body is becoming “insulin resistant”. When this happens, blood sugars are not able to enter cells and stay too high in the blood stream. It’s a case where cells are starving in a world of plenty (i.e. lot’s of blood sugar but it’s not getting inside the cells where is can be used!).
Unfortunately, the pancreas doesn’t know that the liver, fat and muscle cells are having a tough time taking in blood sugars. What is does know is that sugar levels are still elevated so it continues to put out more and more insulin. This in turn will cause the body to gain even more weight and prevent the body from losing it. This becomes a viscous cycle until blood sugar levels become high enough for diagnosing someone with diabetes.
If insulin resistance and high blood sugar levels goes on for too long, the pancreas eventually gives up. After years of pumping huge amounts of insulin (that goes unheard by our body’s cells), the pancreatic cells burn out. Hence why even type 2 diabetics may eventually require insulin injections.
High blood sugar levels (whether you are pre-diabetic or diabetic) are also problematic because its extremely irritating to the body (i.e. inflammatory), causes abnormal fat depositions and blockages, and results in decreased circulation of blood to nerves. Most importantly, small blood vessels are affected first. This is why the kidneys, the eyes, and the nerves (especially in the legs) become affected. This is where all the complications begin…
But don’t give up hope!
Every form of diabetes can be treated.
Although type 1 and type 1.5 diabetes will always require insulin injections once it’s needed, naturopathic suggestions/treatments can help them decrease the amount of insulin needed. This in turn will substantially improve their overall health and quality of life.
In type 2 diabetes, as long as the pancreas has not burnt out, it can be completely reversible. Prevention is especially important especially if you or your doctor already suspects blood sugar imbalances.
For all forms of diabetes, educating yourself is the stepping-stone for healing. As a naturopathic doctor, helping patients understand their condition is the first step in this new approach to address the diabetes epidemic.
Published by Dr. Gleixner on Thursday March 22nd, 2012 in Times & Transcript.
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