^ Jump up to: a b Safren, S.A., Gonzalez, J.S., Wexler, D.J., Psaros, C., Delahanty, L.M., Blashill, A.J., Margolina, A.I., & Cagliero, E. (2013). "A randomized controlled trial of cognitive behavioral therapy for adherence and depression (CBT-AD) in patients with uncontrolled type 2 diabetes". Diabetes Care. 37 (3): 625–33. doi:10.2337/dc13-0816. PMC 3931377. PMID 24170758.
In medical world, diabetes is known more commonly by the name of diabetes mellitus. In simpler and day-to-day language, it is referred as diabetes. It is a group of metabolic diseases in which a person has high blood sugar, either because cells do not respond to the insulin that is produced, or the body does not produce enough insulin. In both the conditions, the body is not able to get enough amount of insulin to function properly.
Some medical professionals use an Oral Glucose Tolerance Test (OGTT) to test for diabetes. If you’ve ever been pregnant and had to drink the sickeningly sweet sugar cocktail and then have blood drawn, you are familiar with this one. Basically, a patient is given 50-75 grams of glucose in concentrated solution and his blood sugar response is measured. I’m not a fan of this test because no one should be ingesting that much concentrated glucose, and the test is not a completely accurate measure. (Just a side note: if you are a drinker of the “Big Gulp” drinks or large amounts of soda, you are putting your body through a similar test each day! Eventually, your body will respond, probably with something like “Fine, you want diabetes, I’ll show you diabetes!)
Whole-body insulin resistance is the earliest predictor of type 2 diabetes onset, and this mainly reflects muscle insulin resistance (26). However, careful separation of the contributions of muscle and liver have shown that early improvement in control of fasting plasma glucose level is associated only with improvement in liver insulin sensitivity (20,21). It is clear that the resumption of normal or near-normal diurnal blood glucose control does not require improvement in muscle insulin sensitivity. Although this finding may at first appear surprising, it is supported by a wide range of earlier observations. Mice totally lacking in skeletal muscle insulin receptors do not develop diabetes (27). Humans who have the PPP1R3A genetic variant of muscle glycogen synthase cannot store glycogen in muscle after meals but are not necessarily hyperglycemic (28). Many normoglycemic individuals maintain normal blood glucose levels with a degree of muscle insulin resistance identical to those with type 2 diabetes (29).
Alternative medicine for diabetes is big business, because the public health burden of diabetes is massive, and growing. In 1985, the worldwide prevalence was 30 million people. In 2000, it was 150 million. By 2030, it could be 250 million. Why are more people being diagnosed with diabetes? Obesity, sedentary lifestyles, and an aging population. At its core, diabetes is a disease of sugar (glucose) management. Insulin, secreted by the pancreas, allows cells to use glucose. When the pancreas doesn’t produce insulin, it’s called Type 1 diabetes. This is an autoimmune disease that strikes early in life, and was a death sentence until insulin was discovered. When the pancreas can produce insulin, but the amount is insufficient, or when there’s a problem with the uptake of insulin into cells, it’s termed type 2 diabetes. 90% of all diabetes is type 2. Typically a disease of older adults, type 2 diabetes can potentially be treated without drugs of any kind, but success rates are low and medication is eventually advisable. There’s also gestational diabetes, a disease of pregnancy, and prediabetes, where blood sugars are elevated, and diabetes is an expected future diagnosis.
Following these five principles can significantly influence blood glucose levels. However, not everyone responds the same. Some people with have immediate low blood glucose levels. Others may experience a slow and steady improvement of glucose control. Some may have temporary high glucose levels. Our experience is that this is transient and most people will improve.
Is this okay to use against gestational diabetes? I have PCOS and am pre-diabetic. I actually followed this way of eating (before seeing the Ted talk) with my first GD pregnancy and was scolded by the nutritionist. Yet my blood sugar was kept below 98 and I lost 15 lbs and our son’s blood sugar was perfect with an apgar of 10. So I’m thinking of just going this way again despite the ADA’s recommendations.
Focus on low glycemic index foods: While reducing fat and increasing fiber can significantly improve insulin sensitivity, low glycemic index (GI) foods reduce after-meal blood glucose levels. Low GI foods include pumpernickel or rye bread, oats, beans, bran cereals, most fruit, and sweet potatoes, compared to higher GI foods such as white potatoes, processed foods, and cold cereals.
Control and outcomes of both types 1 and 2 diabetes may be improved by patients using home glucose meters to regularly measure their glucose levels. Glucose monitoring is both expensive (largely due to the cost of the consumable test strips) and requires significant commitment on the part of the patient. The effort and expense may be worthwhile for patients when they use the values to sensibly adjust food, exercise, and oral medications or insulin. These adjustments are generally made by the patients themselves following training by a clinician.
Sugars raise insulin levels, and over extended periods of time, damage the pancreas and cause insulin resistance, a precursor for diabetes. Fructose is the top offender in the sugar world, as it is recognized as a toxin the body and has no proven benefit to the body. Fructose is immediately taken to the liver, where it must be processed, and some doctors now suggest that this may be a large factor in development of fatty liver disease. Excess sugar in the bloodstream also increases the release of cortisol and adrenaline (more on those in a minute), slows the immune response, decreases necessary Leptin levels and promotes fat storage. There are various types of sugar and sweeteners, and while all should be limited, some are worse than others:
Pramlintide (Symlin) was the first in a class of injectable, anti-hyperglycemic medications for use in addition to insulin for type 1 diabetes or type 2 diabetes. Pramlintide is a synthetic analog of human amylin, a naturally occurring hormone made by the pancreas to help control glucose after meals. Similar to insulin, amylin is absent or deficient in person with diabetes.