Whether you were diagnosed with type 2 diabetes a week ago or 8 years ago like Jacquie, this life-altering day is almost impossible to forget. Your diagnosis day often marks the beginning of a daily routine of prescription medications or injections, and now there is growing evidence that the burden of diabetes may take a huge toll on your mental health over time as well.
Diabetics often find their bodies swinging wildly out of equilibrium. In Type 1 Diabetes, the body attacks insulin-producing cells in the pancreas, causing a rise in blood sugar levels. In Type 2 Diabetes there is insufficient insulin produced in the pancreas, which slows the metabolism and elevates blood sugar levels. Both conditions, if not treated correctly, can cause a host of unpleasant side effects including high blood pressure, neuropathy, kidney damage, and in extreme cases amputation and even death.
The food pyramid recommended 6-11 servings of carbs per day, and very little fat — a low-fat, high-carb diet. As we outlined in our last video, type 2 diabetes is a disease of carbohydrate intolerance. Someone with type 2 diabetes or prediabetes has a low carbohydrate tolerance, so eating carbs will lead to exaggerated blood sugar spikes. While those with a high carb tolerance may be able to eat a carb-heavy diet and remain healthy, someone with a low carb tolerance will experience chronic high blood sugar and likely even weight gain if they eat a high-carb diet.
Any food that you ingest is processed and metabolized by the body. Food is broken down into the various building blocks the body needs, and what cannot be metabolized or used is processed and removed by the liver. Protein and fats are used for muscle and tissue regeneration and other processes in the body. Carbohydrates are typically a fast fuel for the body, but when more are eaten that the body immediately needs, they must be stored. A simple explanation from a previous post:
Taking 200 micrograms of chromium picolinate three times daily with meals can help improve insulin sensitivity. A review published in Diabetes Technology and Therapeutics evaluated 13 studies that reported significant improvement in glycemic control and substantial reductions in hyperglycemia and hyperinsulinemia after patients used chromium picolinate supplementation. Other positive outcomes from supplementing with chromium picolinate included reduced cholesterol and triglyceride levels and reduced requirements for hypoglycemic medication. (14)
People with T1D work with an endocrinologist to determine proper insulin-to-carb ratio. This ratio is the amount of insulin needed to balance the intake of a certain amount of carbohydrates (typically measured in grams). Measuring the amount of carbohydrates and factoring the insulin to carb (I:C) ratio helps maintain stable blood-sugar levels after eating.
These seeds, used in Indian cooking, have been found to lower blood sugar, increase insulin sensitivity, and reduce high cholesterol, according to several animal and human studies. The effect may be partly due to the seeds’ high fiber content. The seeds also contain an amino acid that appears to boost the release of insulin. In one of the largest studies on fenugreek, 60 people who took 25 grams daily showed significant improvements in blood sugar control and post-meal spikes.
He emphasizes lifestyle changes and weight loss as a first step. "We give them a 3-month trial of diet and lifestyle [modification] before starting medications," he says. "A lot of times, for many patients newly diagnosed, we will see the sugars melt back into the normal range" after the weight loss and other changes. He has seen it happen after a weight loss of 7% to 10% of their starting weight.
Diabetes is a serious disease that you cannot treat on your own. Your doctor will help you make a diabetes treatment plan that is right for you -- and that you can understand. You may also need other health care professionals on your diabetes treatment team, including a foot doctor, nutritionist, eye doctor, and a diabetes specialist (called an endocrinologist).
11. Get regular eye exams: Diabetic retinopathy is caused by elevated levels of blood sugar, which can happen when diabetes goes out of control. The disease can damage the blood vessels around the eye and retina, leading to blurred vision and blindness. Diabetic retinopathy cannot be cured, and often has no early symptoms, which makes it difficult to catch. Diabetics should make sure they get regular eye exams, for early detection and treatment.
When you have type 1 or type 2 diabetes, you need to be very aware of not only what you eat, but also when and how much you eat. A Certified Diabetes Educator (CDE) at Joslin can work with you to develop a healthy meal plan that fits your lifestyle. Following a meal plan can also help you lose weight and lower your risk of developing complications.
According to studies, cinnamon may have a positive effect on the glycemic control and the lipid profile in patients with diabetes mellitus type 2. This is because it contains 18% polyphenol content in dry weight. This popular Indian spice can improve insulin sensitivity and blood glucose control. According to a study published in Journal Of The American Board Of Family Medicine, “cinnamon lowered HbA1C by 0.83% compared with standard medication alone lowering HbA1C 0.37%. Taking cinnamon could be useful for lowering serum HbA1C in type 2 diabetics with HbA1C >7.0 in addition to usual care.”
Mr. Tutty, who weighed about 213 pounds before the trial, lost a little more than 30 pounds, the average weight loss in the trial. The people in the study most likely to respond to the treatment were in their early 50s on average and younger than the nonresponders, and they had had diabetes for fewer years. The responders were also healthier before the trial: They had been taking fewer medications than nonresponders, had lower fasting glucose and hemoglobin A1c before the trial, and had higher baseline serum insulin levels. Three of those who went into remission had lived with diabetes for more than eight years.
Obesity is a disease, not something created by lack of character. It is a hormonal disease. There are many hormones involved, and one of the main ones is a hormone called insulin. The vast majority of obese individuals are resistant to insulin and that causes a lot of trouble. So, what does being insulin-resistant mean? Insulin resistance is essentially ‘pre-pre-type 2 diabetes.’ Insulin’s job is to drive glucose or blood sugar into cells where it can be used. In a nutshell, when someone has insulin resistance, they are having trouble getting glucose where it needs to go, into the cells. It can’t all hang out in the blood after we eat, or we would all have a diabetic crisis after every meal. When there is resistance to insulin, our bodies will just make more of it. The insulin levels rise and rise and for a while, years usually, this will keep up and blood sugar will stay normal. However, eventually it can’t keep up, and even elevate insulin levels are not enough to keep blood sugar normal, and blood sugar rises. And that is diabetes.
When this happens for a period of time, the cells start to become resistant to the presence of insulin, causing a vicious cycle. The body then releases even more insulin, trying desperately to get the cells to uptake the toxic glucose. The presence of excess insulin in the bloodstream is also toxic and further damages the receptors on these cells. Eventually, the insulin allows the glucose access to your fat cells to get it out of the bloodstream. In other words- Fat isn’t stored as fat in the body- Sugar (from carbohydrates) is stored as fat!
The twin cycle hypothesis of the etiology of type 2 diabetes. During long-term intake of more calories than are expended each day, any excess carbohydrate must undergo de novo lipogenesis, which particularly promotes fat accumulation in the liver. Because insulin stimulates de novo lipogenesis, individuals with a degree of insulin resistance (determined by family or lifestyle factors) will accumulate liver fat more readily than others because of higher plasma insulin levels. In turn, the increased liver fat will cause relative resistance to insulin suppression of hepatic glucose production. Over many years, a modest increase in fasting plasma glucose level will stimulate increased basal insulin secretion rates to maintain euglycemia. The consequent hyperinsulinemia will further increase the conversion of excess calories to liver fat. A cycle of hyperinsulinemia and blunted suppression of hepatic glucose production becomes established. Fatty liver leads to increased export of VLDL triacylglycerol (85), which will increase fat delivery to all tissues, including the islets. This process is further stimulated by elevated plasma glucose levels (85). Excess fatty acid availability in the pancreatic islet would be expected to impair the acute insulin secretion in response to ingested food, and at a certain level of fatty acid exposure, postprandial hyperglycemia will supervene. The hyperglycemia will further increase insulin secretion rates, with consequent enhancement of hepatic lipogenesis, spinning the liver cycle faster and driving the pancreas cycle. Eventually, the fatty acid and glucose inhibitory effects on the islets reach a trigger level that leads to a relatively sudden onset of clinical diabetes. Figure adapted with permission from Taylor (98).
Get Your Fats in Good Balance– Overabundance of Omega-6 fats in the diet is a contributing factor in diabetes. Pay attention to your intake of Omega-3 and Omega-6 fats and try to get them closer to a 1:1 ratio. For many people, supplementing with a good quality Omega-3 oil can help while dietary adjustments are being made. Avoid Omega-6 seed oils and their sources (these are used at almost every restaurant). Eat fatty fish like salmon and sardines for the Omega-3s.
A spice that is popular for soothing your stomach and aiding digestion, Ginger also has the ability to normalize blood sugar levels. Multiple studies conducted on rats show that ginger extract can have a significant anti-hyperglycemic effect. It lowers serum total cholesterol, triglycerides and increases the HDL-cholesterol levels. Diabetes is a digestive disorder. Diabetics often face issues with acid reflux. Ginger soothes the entire digestive tract, giving diabetics another reason to add ginger to their supplement regimen.
The way you take insulin may depend on your lifestyle, insurance plan, and preferences. You may decide that needles are not for you and prefer a different method. Talk with your doctor about the options and which is best for you. Most people with diabetes use a needle and syringe, pen, or insulin pump. Inhalers, injection ports, and jet injectors are less common.
Fasting is the simplest and fastest method to force your body to burn sugar for energy. Glucose in the blood is the most easily accessible source of energy for the body. Fasting is merely the flip side of eating – if you are not eating you are fasting. When you eat, your body stores food energy. When you fast, your body burns food energy. If you simply lengthen out your periods of fasting, you can burn off the stored sugar.
When the insulin levels are unable to keep up with the increasing resistance, blood sugars rise and your doctor diagnoses you with type 2 diabetes and starts you on a pill, such as metformin. But metformin does not get rid of the sugar. Instead, it simply takes the sugar from the blood and rams it back into the liver. The liver doesn’t want it either, so it ships it out to all the other organs — the kidneys, the nerves, the eyes, the heart. Much of this extra sugar will also just get turned into fat.
Because the initial symptoms (fatigue, weakness, frequent urination) are usually mild, about 30 percent of all people with diabetes do not realize that they have the disease. And that can have tragic consequences, because with early diagnosis and treatment, the chances of living a long and productive life are higher than if the disease creeps along until irreversible damage occurs.
The bottom line is that diabetes can be bad news—but this doesn’t have to be the case. Interventions can prevent or delay the disease in people with prediabetes. The Diabetes Prevention Program (DPP), a large study of people at high risk of diabetes, has established a prevention plan that’s both feasible and cost-effective. The DPP showed that weight loss and increased physical activity reduced the development of type 2 diabetes by 58% during a three-year period.
According to the American Diabetes Association, nearly 21 million people in the United States have diabetes, with about 90 percent to 95 percent having type 2 diabetes. Sugar, in the form of glucose, is the main source of fuel for body cells. The hormone insulin allows glucose in the blood to enter cells. In type 2 diabetes, either the body doesn't produce enough insulin or cells are resistant to effects of insulin.
1. Avoid toxins as much as possible: There is no doubt that we live in a polluted world, and it is next to impossible to avoid all toxins, however, recent research suggests that environmental toxins such as pesticides in our food and drinking water can be factors in causing or worsening Type 1 Diabetes. To lessen the amount of toxins that enter the body, try to buy “green” cleaners, organic fruits and vegetables, and dairy that is from organic or grass-fed cows. Although these items may be a bit more expensive, the health benefits are well-worth the higher price tag.
Sage can have metformin-like effects, according to a study published in the British Journal of Nutrition. So you may want to consider cooking with this herb often. It has been used on traditional medicine for centuries, as one of the important herbs to reduce blood sugar. A word of warning – taking high doses of sage along with diabetes medications might cause your blood sugar to go too low, a condition called hypoglycemia. Monitor your blood sugar closely.
Although there are several different types of ginseng, most of the promising studies on ginseng and diabetes have used North American ginseng (Panax quinquefolius). Those studies have shown that North American ginseng may improve blood sugar control and glycosylated hemoglobin (a form of hemoglobin in the blood used to monitor blood glucose levels over time) levels.
Dr. Mona Morstein is a naturopathic physician with a medical practice focused in integrative diabetes treatment. Her clinic, Arizona Integrative Medical Solutions, is located in Tempe, Arizona, where she sees patients of all ages and genders for acute and chronic conditions. An expert on prediabetes and diabetes, she is a frequent lecturer at conferences and webinars, and is the founder and executive director of The Low Carb Diabetes Association. Dr. Morstein is also a member of the Arizona Diabetes Coalition. Visit her website lowcarbdiabetes.org
Because many patients with diabetes have two or more comorbidities, they often require multiple medications. The prevalence of medication nonadherence is high among patients with chronic conditions, such as diabetes, and nonadherence is associated with public health issues and higher health care costs. One reason for nonadherence is the cost of medications. Being able to detect cost-related nonadherence is important for health care professionals, because this can lead to strategies to assist patients with problems paying for their medications. Some of these strategies are use of generic drugs or therapeutic alternatives, substituting a prescription drug with an over-the-counter medication, and pill-splitting. Interventions to improve adherence can achieve reductions in diabetes morbidity and mortality, as well as significant cost savings to the health care system. Smartphone apps have been found to improve self-management and health outcomes in people with diabetes through functions such as specific reminder alarms, while working with mental health professionals has also been found to help people with diabetes develop the skills to manage their medications and challenges of self-management effectively.
An aromatic herb that is used commonly to add flavor and aroma to meats and soups, Rosemary also helps normalize blood sugar levels naturally. It promotes weight loss as well, which is a double boon for many diabetics who struggle with weight issues. A research conducted in Jordan to study the effects of rosemary on lipid profile in diabetic rats proved that rosemary has no significant influence on serum glucose level and lipid profile of normal rats. But when rosemary extract was administered to diabetic rats for 4 weeks, their blood sugar levels reduced by 20%, cholesterol levels by 22%, triglyceride levels by 24%, and LDL by 27% while HDL increased by 18% respectively. The study was published in African Journal of Plant Science Vol. 6 in 2012.
Capsaicin cream, a topical ointment made with cayenne, has been reported by some patients to help lower pain in the hands and feet from diabetic neuropathy. But people with loss of sensation in the hands or feet should use caution when using capsaicin, as they may not be able to fully feel any burning sensation. Check with your doctor if you are thinking of trying this product.
Implementing integrative and functional medical nutrition therapy, I helped the patient understand that she could reverse the trajectory she was on by making lifestyle changes—and that’s what she did. We engaged in shared decision making in our ongoing nutrition consultations. Over the course of one year, her physiology and health status changed for the better. Her A1c dropped from 7.2% to 5.6%, and she no longer required medications. She continues to adhere to her new lifestyle program and is confident she’ll remain free of a diabetes diagnosis.
Currently, one goal for diabetics is to avoid or minimize chronic diabetic complications, as well as to avoid acute problems of hyperglycemia or hypoglycemia. Adequate control of diabetes leads to lower risk of complications associated with unmonitored diabetes including kidney failure (requiring dialysis or transplant), blindness, heart disease and limb amputation. The most prevalent form of medication is hypoglycemic treatment through either oral hypoglycemics and/or insulin therapy. There is emerging evidence that full-blown diabetes mellitus type 2 can be evaded in those with only mildly impaired glucose tolerance.
Pramlintide is administered by injection just prior to meals (three times each day) for type 1 diabetes as an additional treatment to mealtime insulin therapy for those failing to achieve desired glucose control despite optimal insulin therapy and type 2 diabetes as an additional treatment to mealtime insulin therapy for those failing to achieve desired glucose control with optimal insulin therapy.