Diabetes: Understanding Your Type

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Diabetes: Understanding Your Type

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Diabetes is a disorder of carbohydrate metabolism caused by

inadequate production or utilization of insulin, the hormone

secreted by beta cells in the pancreas.

 

Type I diabetes (Insulin-dependent diabetes mellitus or IDDM) is also called

juvenile diabetes, as it appears most often in children under the age of 15.

 

It is an autoimmune disease that affects about 10% of the diabetic

population. The more prevalent Type II diabetes (non-insulin

dependent diabetes mellitus or NIDDM), is also called adult-onset

diabetes, as it appears most frequently in adults over the age of

20.

 

The age-related terms are becoming outdated, however, because

NIDDM is now showing up in increasing numbers in children, and IDDM

is appearing more frequently in adults. It is very important to

differentiate between the two types, partly because the dietary and

nutrient requirements vary in some important ways.

 

Major symptoms of diabetes include excessive thirst, fatigue and

frequent urination. The long-term health problems that can result

from diabetes are mostly vascular. Fluctuations in blood sugar shock

the mural cells in tiny capillaries, gradually weakening and

narrowing them. Most diabetic problems result from this breakdown in

the vascular system. The resultant damage is usually much more

severe in patients with poor blood sugar control and/or poor

nutritional status.

 

Through a process called glycosylation, excess sugar attaches to the

hemoglobin in your red blood cells and makes it more difficult for

them to deliver necessary oxygen to your tissues. The hemoglobin AIC

test (HbAIC) measures this giving you an idea of your level of

diabetic control - numbers should be below 8 (beware the lowering of

numbers going on with all blood tests to make people think they need

drugs). When there is a lack of insulin, the body burns fat instead

of sugar, causing an increase in toxic acids called ketones.

Diabetics who do not have the necessary discipline to take proper

care of their health risk blindness, kidney failure, burning nerve

pain and early death. Because of the horrific cost of poorly managed

diabetes, and because it is so easy to avoid or slow the onset of

problems with simple lifestyle and diet changes, specific programs

designed to increase patient awareness and compliance are now

rapidly being developed by the insurance health care industry.

 

It is possible to live a long and healthy life with diabetes. I

myself was diagnosed with Type I diabetes (IDDM) in 1961 at the age

of 11. Now, almost 44 years later, I have not suffered any major

diabetes-related health problems. I have been able to accomplish

this through strict discipline, by adhering pretty much to every

guideline explained here. The herbs I take vary according to signs

and symptoms.

 

I would like to emphasize here the importance of listening to your

body. As a child, when I found out I was diabetic I went to the

library and read everything I could. The books available at that

time told me I had no options, and that gradual deterioration would

inevitably lead to severe complications. I was terrified. I decided

to do everything I could to stay healthy. I began by cutting out all

dietary sugars except fruit. I spent the next ten years learning,

through trial and error, how to manage my disease. For example, I

figured out by 1965 that eating blueberries made me feel good, as

did exercising daily.

 

When my early doctors gave me insulin, I followed their instructions

to the letter and assumed I couldn't change the dose. I remember one

particular day when my sugar level was very high. I called my

doctor, who told me I could change my dose by two units. I did just

that, and immediately felt better. From that moment on, I took on

the responsibility of adjusting my own insulin as needed. Back when

the early blood sugar monitors first came out, before they were

available in drug stores, I stood in line to get one at a medical

supply outlet. I began to adjust my medicines and foods to keep my

sugars on an even keel. Remember, this all occurred decades before

researchers demonstrated the importance of exercise and good blood

sugar control, and the benefits of flavonoids in blueberries. I did

these things because instinctively, I " knew " they made me feel

better. I listened to my body. You can do the same.

 

In spite of my efforts, by the time I reached my early 20's, I began

to exhibit early signs of diabetic problems. My skin tone was pale

and I had some stiffness in my joints. My sugar levels would

sometimes fluctuate way too much. When I was 26 I met the late Dr.

Mana, my Ayurvedic teacher, in Kathmandu, Nepal. He started me on

herbal medications, and this put me on the road to true control of

my disease.

 

The following steps are crucial to gaining complete control of your

disease:

 

• Thoroughly understand the disease and its relationship to your

whole person.

• Learn how to manage the disease properly, which will help you

detect and treat any problems that may arise while they are still

small

• Adopt the necessary nutrition and lifestyle habits, and

incorporate herbal supplements that can prevent or repair problems

 

Understanding Your Type

 

Type I Diabetes

 

The pancreas contains groups of beta cells called islets that

secrete insulin. Type I diabetes (IDDM) mellitus results from a

progressive destruction of these insulin-secreting beta cells by T

lymphocytes, a type of white blood cell. This destruction may be

triggered by errors in the production of the insulin molecule, or

perhaps by viral invasion. These errors stimulate the white blood

cells (T cells and macrophages) to attack and destroy the beta cells

producing the insulin. Type I diabetics always need insulin, and

must maintain excellent control of their insulin levels to avoid

serious health problems.

 

Type I diabetics often require a diet higher in protein, vegetables

and healthy fats, which restricts sugars and grain carbohydrates

like wheat and corn. This type of diet alone will lower blood sugar,

reduce craving for sweets, and lower levels of glycosylated

hemoglobin. However, each patient's nutritional requirements are

unique due to our biochemical individuality. Some do better on the

HCF (high carbohydrate and fiber) diet sometimes recommended for

Type II diabetics. The HCF diet is high in cereal grains, legumes

and root vegetables, and restricts intake of fats and simple sugars.

Because many studies do not distinguish between high and low quality

fats, it is difficult to interpret the scientific data. This diet

will not work if the fats consumed are of low quality or excessive

in amount.

 

Type II Diabetes

 

Type II diabetes, the more common form, is characterized by onset at

a later age, and is often associated with obesity and poor diet. The

average American consumes nine percent of his or her daily diet in

the form of simple sugars, resulting in a significant reduction in

nutrient and mineral intake. This nutritional decline is exacerbated

by a modern trend of decreased nutritional value in ordinary foods.

The high levels of dietary sugar stresses the pancreas and the liver

and overall sugar regulation. This may result in depletion of

insulin supplies, or cells may become resistant to the insulin. The

incidence of Type II diabetes is much higher in countries where the

general population follows the standard American diet (the " SAD

diet " ). Native populations such as American Indians and aborigines

who abandon their traditional diets develop the disease much more

frequently than populations that maintain their native diets

(reported by Bergner, 1997).

 

Insulin resistance is a major concern for Type II diabetics. The

body produces enough insulin, but for some reason the cells resist

using it. Blood sugar control worsens as abnormal fat stores

increase and obesity increases insulin resistance. Therefore, weight

loss is often all that is needed for Type II diabetics to reduce

their medicine requirements. Some successful patients can even come

off their prescription medications altogether.

Prescriptions are not a substitute for healthy living. Various

prescription pills for NIDDM can " wear off " and stop working after a

few years as the body builds a tolerance. This phenomenon has been

known to occur in up to 40% of patients. You must learn to identify

and utilize lifestyle alternatives. For example, it appears that

garlic bulb (2 cloves per day) and onion (1 medium bulb per day) can

lower blood sugar by about the same amount as prescription medicines

in some patients (Tjokroprawiro et al., 1983, Sheela et al., 1995,

reported in Duke, 1997).

Type II diabetics sometimes do well on the HCF diet, which is high

in cereal grains, legumes and root vegetables, with restrictions on

fats and simple sugars. Conversely, some patients do better on the

higher protein diet usually recommended for Type I diabetics. As I

stated earlier, each person's nutritional requirements are unique,

so it is necessary to listen to your body to manage your diet and

your disease successfully.

 

Ayurvedic Understanding of Diabetes

 

Traditional Ayurvedic Medicine (TAM) doctors were perhaps the first

to classify diabetes as a separate disease, calling it madhumeha,

which means " honey-like urine. " They noticed that patients with this

malady had ants attracted to their urine. There were two distinct

types of diabetes in Ayurveda since ancient times. We discussed

earlier the Ayurvedic body types, and in this disease, the Vata or

nerve-natured person is more likely to get type 1 diabetes. The

obese person with strong appetite (Pitta-Kapha type) is more likely

to get type 2 diabetes.

Although Ayurveda had no idea of insulin, it is certainly clear they

understood long ago that the thin and wasting physical condition of

typical of young diabetics was related to digestive problems and

presence of sugar in the urine. As they described it, the nerve-

natured person is by nature thinner, restless and had a weaker

digestive system, which accounted for their generally low weight. At

the same time, the highly restless nature often displayed a craving

for sweets. Putting high levels of sugars into a weak digestive

system created dryness and heat, and favored promotion of toxic

gasses (Vata dosha). This in turn weakened the major digestive organ

called agnyasaya, Sanskrit for pancreas (Bajracharya, 1988). As

Ayurvedic physicians began to have access to modern physiological

teachings, theybegan to relate these ideas to type one diabetes and

hypoglycemia.

 

They described another scenario with regards to type two diabetes.

When someone is obese and has strong digestive energy (Pitta-Kapha

personality), constantly eating heavy and/or sugary foods, the

pancreas can becomes over-active. There is an increase in bile flow

to the intestine to digest the fats, and weight gain ensues. In this

condition, secretions are increased, and the mucous membranes and

arteries are " working overtime. " These increased secretions cause

blockages in the vessels and ducts, as well as obesity. The

secretions and blockages irritate the nervous system and change the

physical properties of the blood. The altered sugars

(called " greaseless sugar " ) cannot be absorbed, so they exit through

the urinary system as honey-urine (Bajracharya, 1988).

 

Although Ayurveda has no concept of " insulin resistance, " it is

obvious they were describing type two diabetes in another way.

Because we now know the duct and membrane blockages tends to slow

blood flow and metabolism, that excess fats change cell receptor

sites, and high levels of sugars stimulate insulin release, it is

easy to speculate that the physical conditions described in the

traditional literature could by causative of insulin resistance.

This would also make it more clear why Type 2 diabetes often recedes

or disappears when patients lose weight. Adding their understanding

to modern understanding, we see that type two diabetes is a disease

of obesity and insulin resistance (Western understanding) and poor

fat digestion and resultant excess mucus exudation and duct blockage

(Eastern understanding). In my own opinion, I tend to think of it as

a disease of metabolism, and strengthening metabolism is a major

goal. Looking at it from these different perspectives broadens our

therapeutic options.

 

Management - Lifestyle Rules for Both Diabetic Types

 

• Regular daily exercise is essential for diabetics. A sedentary

period will elevate your blood sugars within half a day. A few hours

of exercise will bring sugars down. Regular (and frequent) exercise

is helpful for burning fat and improving cardiovascular health. This

consequently improves circulation and metabolism, which will help

your body fight off other diabetes-related symptoms. In one study

that followed a group of nurses for eight years, the ones who

exercised the most had a 54% lower incidence of diabetes than the

sedentary subjects (Christensen, 1999). Diabetics must keep moving.

One of the Ayurvedic treatments for diabetes is to walk 2-3 hours

per day while taking shilajatu and garlic pills, and following a

careful diet. They reported cures if this was done for two years..

 

• The appropriate amount of insulin is the one that causes the least

fluctuation in your blood sugar levels, and keeps you at a healthy

weight. You may have to experiment under a doctor's supervision to

find your proper insulin dosage and the best times of day for you to

take insulin. Some patients also need to use more than one type of

insulin. There are both long and short-acting forms.

 

• Check your blood sugars several times per day, and act

accordingly. If your sugars are above 150, it is a good idea to

delay meals. Otherwise, food will cause them to rise above 200,

leading to the production of toxic ketones. You might want to

consider using Humalog, the fast-acting insulin, to bring down

levels quickly. Check your levels two hours after eating, when

sugars are usually highest, and take a few units of Humalog right

then and there (I learned this trick from another diabetic -

however, overuse of humulog, being so strong, may increase insulin

resistance). Other strategies that will help stabilize sugar levels

include increasing exercise on the spot, or reducing food intake on

your next meal. Consciously figure out how to keep your levels from

getting too high.

 

• Relaxation and stress reduction techniques have also been shown to

reduce insulin needs in some patients. Learn T'ai Chi, meditation or

Yoga. Studies have shown that such stress reduction tactics can

reduce medication need and reduce sugar levels (McGrady and Horner,

1999, Jain et al., 1993).

 

• Check your glycosylated hemoglobin (HgbA1c) every 3-4 months, to

find out how well you are controlling your blood sugars. This test

requires a doctor's prescription.

 

• Get a yearly eye examination by a good ophthalmologist. Diabetics

are more prone to retinopathy, glaucoma and cataracts. The earlier

treatment is initiated, the greater the success. If you develop

retinopathy, there are herbs that can resolve the problem even in

cases where bleeding has started (refer to our discussion of all

three diseases in Chapter 16 for more information).

 

• Avoid artificial sweeteners. There is concern that some are toxic

to nerves, and diabetics are more susceptible to this reaction. Try

stevia leaf or erythritol, available in most health food stores.

These natural sweeteners will not increase your blood sugar. But

while these concerns may be minor, it is feeding that " sweet tooth "

that is most problematic. If you train yourself to stop eating

things that are excessively sweet, your desire for healthy foods

will increase.

 

• Eat more beans. Your body metabolizes beans slowly, which slows

down the absorption of sugars from the intestinal tract, aiding your

body's regulation of sugar levels. A diet high in fiber is very

helpful for diabetics due to this beneficial action.

 

• Eat lots of berries, especially blueberries. Blueberries (or

bilberries) contain anthocyanins, plant chemicals that help repair

tiny blood vessels especially in the eyes. Consume about one quart

of fresh or one bag of frozen blueberries per week. Blueberries,

blackberries and raspberries are also low in sugar.

 

• Take your vitamins. Diabetics can benefit greatly from vitamin

supplements (Kahler et al., 1993), and I recommend taking a

multivitamin twice each day.

 

• Vitamin C (2000 mg), which makes collagen and keeps capillaries

strong.

 

• The B vitamins, including niacin, zinc and other minerals, which

are important for sugar metabolism.

 

• Vitamin E and essential fatty acids (EFAs), which are important

for cell membrane stability.

 

• Alpha-lipoic acid, which protects nerves, decreases insulin

resistance and can reverse neuropathy (Reljanovic et al., 1999).

 

• Quercetin (1,000 mg per day), one of the most powerful

bioflavonoids that prevents capillary leakage.

 

• Always take a multi-mineral if you have diabetes. Three minerals

that are known to lower blood sugars are: GTF chromium (200 mcg per

day), manganese (5-15 mg per day) and vanadium (20 mg per day for

two weeks, and then 2 mg per day). Interestingly, one study showed

that herbs traditionally used to treat diabetes contained higher-

than-normal levels of chromium (Castro 1998). Barley also contains

high levels of chromium.

 

Herbal Treatments for Both Diabetic Types

 

Numerous herbs can affect blood sugar levels and overall diabetic

status. Be aware that there have been reports of other herbs in many

parts of the world that act on blood sugar levels, so this is a

fertile field for continued research.

 

Recommendations and Research Highlights

 

•Turmeric root, black atractylodes rhizome, fenugreek seeds, bitter

melon (which contains an insulin-like molecule), prickly pear cactus

(Opuntia fuliginosa- used by Native Americans), ganoderma mushroom,

gymnema, Malabar kino (Pterocarpus marsupium), green tea, maitake

mushroom, devil's club root bark (Oplopanax horridum), neem leaf,

jambul seed (Syzygium jambolanum), fig leaf (Ficus carica), Siberian

eleuthero root bark, and bay leaves can help regulate and lower

elevated blood sugars.

 

• Ayurvedic doctors use a complex mineral formula called trivanga

bhasma to lower blood sugars, not available in Western world due to

its heavy metal content, albeit purified. This is prescribed side-by-

side with digestive medicines such as garlic and trikatu for both by

types of diabetes until the urine is free of sugar, and then

discontinued in favor of the medicines listed below.

 

• Long-term use of shilajeet and triphala is excellent for improving

energy in Type I diabetics and reducing long-term complications.

This is the combination Dr. Mana gave me in 1976, and I still take

these herbs frequently.

 

Herbs that promote digestion, such as garlic or trikatu are also

important, as well as high quality oils to maintain membrane

moisture and health. If the patient is emaciated, ashwaghanda root

is used. For Type Two diabetes, in addition to trivanga bhasma and

digestive medicine, weight-loss medicines and those that open

blockage are useful, especially shilajatu mixed with agnimantha root

& bark (Premna integrifolia).

 

• Some studies indicate that the use of niacinamide (a form of

niacin, also called nicotinamide) very early in the disease process

can sometimes prevent the destruction of beta cells. Some patients

have had complete reversal (Cleary, 1990). The reason it works is

that it inhibits monocyte/macrophage function in the peripheral

blood preventing production of the beta-cell destructive cytokines

interleukin-12 and tumor necrosis factor-alpha (Kretowski et. al.,

2000).

 

• Herbs from the vessel-strengthening group, especially tien chi

root, act directly on capillary vessel weakness, thus preventing

diabetic complications. Tien chi root is one of my herbal mainstays.

I take it several months each year to prevent vessel and eye damage.

 

• Diabetics suffering from neuropathy may benefit from acupuncture,

alpha-lipoic acid supplements, and ginkgo leaf (Reljanovic et al.,

1999, Chung et al., 1999).

 

• Coenzyme Q10 (CoQ10) can help with heart problems and blood sugar

control in diabetics. In one study as many as 59% of patients

responded to supplementation (reported in Murray, 1996).

 

• Evening primrose oil was shown in a double-blind clinical trial of

22 diabetics with neuropathy to reduce pain and improve motor

function after six months of supplementation (Jamal, 1987).

 

• Chinese research shows that herbs from the moving blood group

(salvia root, carthamus flower, tien qi root, dang gui root etc.)

help prevent diabetic complications (Huang et al., 1997). I use

herbs from this group several months per year for preventive

purposes—I recommend you do the same.

 

 

• Get the the excellent book by Dr. Richard K. Bernstein, " Dr.

Bernstein's Diabetes Solution. " Dr. Bernstein, like myself, is a

juvenile diabetic who learned how to stay healthy, especially with

diet. http://www.diabetes-normalsugars.com

_________________

JoAnn Guest

mrsjoguest

www.geocities.com/mrsjoguest/Genes