Diabetes - Learn how to manage the disease properly,

[Guest guest]

Diabetes

Apr 18, 2007 14:32 PDT

 

 

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The age-related terms are becoming outdated,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.

 

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.

 

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.

 

• Many common vegetables are useful in the diabetic diet - garlic,

onions, cinnamon and others.

 

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.

 

 

 

JoAnn Guest

mrsjo-

www.geocities.com/mrsjoguest/Diets