Diabetes - Basics you need to know
Open any magazine or newspaper, watch the adds on TV, scan articles on the internet, no matter where you look there’s talk of Obesity, Diabetes, Type 1, Type 2, Chromium, Insulin... It can be overwhelming, not to mention confusing!
Need some clarification?
Time for an overview:
Diabetes – what makes it so scary:
It’s a very frightening word today. And there are several good reason for that, including:
Diabetes is a disease that is affecting more and more people every day. It and its precursor Metabolic Syndrome (also known as pre-diabetes) have reached epidemic levels in the Unites States and getting close here in Canada as well.
Type 2 Diabetes (the form that previously only affected those over 40 years of age, is affecting younger people every day. It’s not uncommon to hear of children in their early-teens being diagnosed with Type 2 Diabetes!
The complications: personal (physical, mental/emotional), financial, etc., can affect almost every part of your body and may be severe if not treated/managed appropriately.
Worldwide, there are over 285 million people affected by diabetes.
And an estimated 7 million people develop diabetes each year (mainly Type 2)
In Canada today, more than 9 million people live with diabetes or prediabetes.
Another frightening about it is that it can be very confusing. I’ve heard it from patients: “I have diabetes? What does that mean? I have to start getting injections 3 times per day? I’ll go blind and possibly have my legs amputated?” While it may be true that insulin therapy and visual changes and other physical results do occur in many people who fail to properly control their A1C and blood sugar levels (two blood markers which are used as measurement tools in diabetics/pre-diabetics), it doesn’t always have to be the case. With proper management, it may be possible for many patients to live normal, healthy lives.
One big problem with this disease is that, besides the fact that many people don’t really know much about it, just as many newly diagnosed diabetics/pre-diabetics don’t really understand how they got diabetes in the first place nor understand how to properly manage it. There’s more to being a diabetic than just pricking one’s finger several times a day (which isn’t even necessary for most patients unless they’re on insulin) or staying away from sugar.
There are actually 4 main categories of diabetes:
Type 1 Diabetes: this is an autoimmune form of the disease where a person’s immune system is attacking and destroying the cells in one’s pancreas that produce insulin. Type 1 diabetes is more commonly diagnosed in children/teens (though it is not uncommon for individuals in their 20’s to be diagnosed). These individuals must be on injectable insulin for their lives.
Type 1 Diabetes affects between 5-15% of all diabetics
Is typically not thought to be a result of lifestyle or dietary factors
Type 2 Diabetes: Type 2 diabetes is a disease in which your pancreas does not produce enough insulin (the hormone that helps your body control how much glucose (sugar) is in your blood), or your body does not properly use the insulin it makes (more below).
This is the form of diabetes that is now affecting more and more of our population, in fact about 90-95% of all diabetics have this form.
Until recently, Type 2 Diabetes was most commonly diagnosed in middle aged to older individuals, however in the past few years it has become more and more common for children to be diagnosed in their early teens.
Type 2 Diabetes is the only one that is known to be COMPLETELY PREVENTABLE with lifestyle and dietary regulation/modification and often treatable similarly.
Type 1.5 Diabetes: may be loosely described as a combination of Type 1 and Type 2 in that it’s an autoimmune disease (as is Type 1) that affects older adults, more commonly people in their 30-40’s. This form is called “LADA”, which stands for Latent Autoimmune Diabetes of the Adult. There is much less known about this form of the disease.
Gestational Diabetes: this form of the disease occurs when a non-diabetic woman suddenly becomes diabetic for course of her pregnancy. The woman will commonly return to a non-diabetic state following delivery of her baby, however this condition puts both her and baby at increased risk of becoming Type 2 diabetic later in life. Additionally, the babies of diabetic mothers are often too large for a safe vaginal birth requiring them to have C-sections. The risk factors associated with this form include poor diet and excessive weight gain during pregnancy.
Considering the numbers, it is obvious that Type 2 Diabetes the form that is of greatest concern for the majority of people today. The numbers of individuals with this disorder is climbing every day causing enormous personal strain as well as great cost to the healthcare system. Another reason for the concern is that this disorder is almost completely a result of lifestyle choices, which goes to follow that making better choices can help prevent getting diabetes in the first place.
Causes of Type 2 Diabetes
As with any disease process, there may be several factors that that lead to a person developing Type 2 Diabetes.
Genetics may play a role:
There is a gene known as the “Thrifty Gene”, which developed to help people who had it survive in times when there was less food available. It, in essence, helped those individuals store more fat when food was there and loose less when there was little, while people without the gene starved and died. And though starvation is less commonly an issue in our culture, the gene is still present, making weight balance more difficult for those who have it.
Lifestyle & Dietary Choices:
Today, food availability, and an increased share of that food being battered fried and processed, loaded with trans and saturated fats as well as refined Sugars and High Fructose Corn Syrup, it’s hardly a surprise the population is becoming heavier.
Weight Gain is probably the most important factor in the Diabetic Epidemic. The human body and organs (particularly the pancreas, which secretes Insulin) simply wasn’t created to deal with high amounts of sugar, fat, etc. that are eaten.
Combine the above with the trend towards decreased exercise (and overall sedentary lifestyles), and the puzzle is complete.
What’s happening in Type 2 Diabetes:
The pancreas is long slim organ that lies behind your stomach. It has 2 jobs, one (generally unrelated to Diabetes) being digestive enzyme production and the other (related to Diabetes) the production and release of insulin into the blood.
Normally, after a meal, when there is a large amount of glucose (sugar) in the blood, insulin is released.
Insulin has 2 main roles in the body:
1st: It lands on it’s receptors on cells (especially on the fat cells, but also the liver and muscle cells), and tells the cells to take in blood sugar. As the glucose is absorbed and blood sugar levels drop, the pancreas stops making insulin until after the next meal.
2nd: It tells the body’s fat cells to store food rather than using it.
In people who with normal insulin levels, who don’t have diabetes and who aren’t overweight, this just allows the body to burn energy at a regular rate between meals.
However in an individual who’s overweight (therefore has a lot of fat cells) and who doesn’t exercise*, the insulin causes metabolism to get slower and slower. Also, as one gains weight, the cells start to “ignore” the insulin and don’t take glucose in as well. This is what’s known as “insulin resistance”. In these situations, blood sugar levels stay high, so the pancreas continues to pump out more and more insulin. The insulin causes the metabolism to slow down even further, thus more fat is stored and the cycle continues: High insulin à Insulin Resistance à Higher Blood Sugar levels à More Insulin à Larger Fat Cells & Fat Storage à More Insulin Resistance à à Eventually, the pancreas tires out and is unable to continue to produce such high amounts of insulin (known as “Pancreatic Burn-Out”) so blood sugar levels get and stay measurably high constantly, and at this point a person is diagnosed as Diabetic.
*Exercise can help prevent this cascade from taking place by helping increase the metabolic rate and energy expenditure/fat burning.
Personal & Medical Costs associated with Diabetes: There is a long list of complications that are associated with a diagnosis of Diabetes, and these include increased incidences of:
As well as an early onset and increased incidence of cataracts, glaucoma and retinal damage
Reported in 15% of diabetics, but estimated to affect many more
Damage to the nerves in the arms, hands, legs and feet
Results in symptoms like sharp pains, burning, tingling, pin pricks, throbbing or numbness in the fingers and toes.
Affects over 60% of diabetics
Diarrhea, constipation, etc
Results from damage to the nerves and circulation.
If untreated can ultimately lead to amputation.
Heart disease or stroke
80% of Diabetics die of these conditions
A very serious complication that can lead to Kidney failure.
May be impacted as a result of both physical and emotional complications.
Diabetics tend to die earlier than non Diabetics of complications of their illnesses
Death is directly related to complications of Diabetes in nearly 42000 Canadians/year
Medication Costs: $1000 to $15000/year
Treatment for Type 2 Diabetes
The standard treatment by MDs for Type 2 Diabetes is overwhelmingly prescription medication (for example Metformin, Glyburide, Insulin to name a few). For the majority of people, being on medication for the rest of their lives is not generally desirable. Not only that, medication is not always able to get Blood Sugar and A1C (a test of long term blood sugar control) levels into safe ranges, meaning that more and more meds get piled on in order to decrease risk. It points to the fact that, as for many disease processes, it takes more than a pill to fix a problem.
Naturopathic Medicine is a leader in diabetic management. We focus on lifestyle modification, dietary education, exercise counseling to help patients achieve better Blood Sugar balance, whether they’re already on medication or are still what’s considered “pre-diabetic”. Additionally, we have the training and knowledge to utilize natural supplements, herbs and vitamins that are not only useful but essential in first achieving then helping to maintain blood indices in the correct balance (either alone or in conjunction with prescription medication), thus allowing for the proper long-term functioning of a patients organs (all of which are critically affected by this disease) and therefore body.
Some of our Naturopathic Diabetic Therapies include:
Diet: Low Carbohydrate and Whole Foods along with counseling to help patients understand what foods work for them and why. NDs are also able to educate their patients about the dangers of refined sugars, high fructose corn syrup etc and help them make better choices.
Neutraceuticals: Chromium, Zinc, B Vitamis, ALA and NAC, all of which help improve insulin and blood sugar levels, increase metabolic rate and fat burning, protect cells and organs from free radicals and oxidation
Botanical Medicine: Many herbs are excellent at helping reduce blood glucose levels, improve pancreatic functioning and insulin release, improve energy and metabolism, decrease appetite, reduce stress, protect and help heal the kidneys, eyes, and nerves (which are the principle body parts affected by diabetes), etc…
Exercise: Helping patients find safe and effective exercise protocols which will help them lose weight and improve metabolic rate, not to mention lowering stress and ultimately feeling better!
Counseling: A diagnosis of Diabetes is a heavy burden and many concerns arise. NDs are able to help counsel patients to help them feel more in control of their bodies and health, and their families to help them feel more able to support their loved ones both emotionally and in terms of lifestyle and diet at home.
If you or your loved one has received a diagnosis of Diabetes, either recently or in the past, working with a Naturopathic Physician can be a key step in your overall health. We have the tools and education to help you live a longer, healthier more fulfilling life!
Dr Katarine Holewa, ND