In the US, 23.6 million children and adults have Diabetes, 6 million of which have not been diagnosed yet. And there another 57 million people who have pre-diabetes.
In 2009, 10.6% of Texans were diagnosed with Diabetes compared to 9% of the total US population.
In 2007, 24.9% of Texans died due to diabetes compared to 22.5% of the total US population.
In 2007, 32.2% of Texan children (aged 10-17) were overweight or obese
Definition of Diabetes
Diabetes refers to a group of disorders with common underlying factors: hyperglycemia (increased blood sugar levels) and glucose intolerance due to insulin deficiency or insulin resistance.
Diabetes can be classified into 3 major categories:
- Type 1 Diabetes
- Type 2 Diabetes
- Gestational Diabetes Mellitus (GDM)
How is Diabetes diagnosed?
The following tests are used to diagnose Diabetes:
Fasting blood glucose (FBG)- this test measures blood glucose levels in the blood after fasting for at least 8 hours. A reading of 126 or more indicates Diabetes.
Oral Glucose Tolerance Test (OGTT)- this test measures the blood glucose after fasting for at least 8 hours and again 2 hours after ingesting 75 grams of a glucose drink. A result of 200mg/dl or more after 2 hours of drinking the glucose indicates Diabetes.
Random Plasma Glucose Test- blood glucose levels of 200mg/dl or more at any time indicate Diabetes especially if the following symptoms are present:
- Increased urination
- Increased thirst
- Unexplained weight loss
Hemoglobin A1c (HgA1c)- this test reflects what the blood sugar levels have been over the past 120 days. A result of 7% or more indicates poor sugar control.
Type 1 Diabetes
Type 1 Diabetes is sometimes called insulin-dependent, immune-mediated, or juvenile-onset diabetes. It’s caused by the destruction of the beta cells in the pancreas that produce insulin. An autoimmune process is thought to be involved with the destruction of the beta cells. Without enough insulin glucose cannot enter the cells of the body.
Although Type 1 Diabetes can affect people at any age, it is commonly found and diagnosed in children or young adults. People with Type 1 Diabetes require injections of insulin in order to control the levels of glucose in their blood.
The onset of Type I Diabetes can be sudden and dramatic. Symptoms include:
- Abnormal thirst and dry mouth
- Frequent urination
- Extreme fatigue/ lack of energy
- Constant hunger
- Sudden weight loss
- Slow healing wounds
- Recurrent infections
- Blurred vision
Type 2 Diabetes
Type 2 Diabetes is characterized by insulin resistance and insulin deficiency. Usually, Type 2 Diabetes occurs and is diagnosed after age 40 but it can happen earlier. There has been a rise in the diagnosis among children.
Type 2 Diabetes is often associated with obesity, but not always. There are several factors involved in the development of Type 2 Diabetes:
- Obesity, diet, lack of physical activity
- Increasing age
- Insulin resistance
- Family history
- Less than optimal intrauterine environment
Type 2 Diabetics are not dependent on insulin initially but may require it if their glucose levels are not maintained by medications or diet.
Gestational Diabetes mellitus (GDM) refers to high glucose levels which start or is first recognized during pregnancy.
Regulating blood sugar levels during pregnancy is critical to avoid complications during gestation and to the baby. Women who have GDM are at an increased risk of developing Type 2 Diabetes later on in life. It is also associated with an increased risk of obesity and abnormal glucose metabolism during childhood and adult life in the offspring.
Complications of Diabetes
Diabetes is among the leading causes of blindness, kidney failure, and lower limb amputation and it increases the risk for cardiovascular disease. People with diabetes are twice as likely to develop heart disease or have a stroke.
The Conventional Approach to Diabetes
Many medications are available to help lower blood sugar levels in Type 2 Diabetes. Each one works differently and it is common to combine 2 or more medications to get the desired effect.
The broad categories of medications are
Sulfonylureas- these drugs stimulate the pancreas to make more insulin (Glipizide, Glyburide)
Biguanides- the drugs decrease the amount of glucose produced by the liver (Glucophage/ Metformin)
Alpha-glucosidase inhibitors- these drugs slow the absorption of starches and slows down glucose production (Miglitol, Acarbose)
Thiazolidinediones- these drugs increase sensitivity to insulin (Actos, Avandia)
Meglitinides- these drugs simulate the pancreas to more insulin (Repaglinide, Nateglinide)
Incretin mimetics- these drugs help the pancreas to produce more insulin efficiently (Byetta)
Dipeptidyl Peptidase 4 Inhibitors- regulates the levels of insulin the body produces after a meal (Januvia)
Insulin- Different types of insulin are available based on their times of action onset and duration
The Naturopathic Approach to Diabetes
The first thing to understand is that the ‘road to diabetes’ is a long one meaning that you don’t just wake up one morning as a diabetic. It is a slow process that begins with numerous factors:
1) Genetic pre-disposition
2) Environmental influences
3) Lifestyle choices
4) Diet & Nutrition
The main difference in the Naturopathic approach is that we consider diabetes a condition or disease of insulin and not of just high blood glucose levels.
Type 2 Diabetes is a condition involving insulin resistance
Over time the production of insulin becomes disconnected to insulin demand. Insulin remains high and the cells become resistant. Excess insulin is very damaging to the body.
Addressing the principle organs that regulate blood sugar is important:
- The pancreas
- The liver
- The adrenal glands
The main strategies used to help reverse the diabetic disease process includes:
- Supplementation with specific nutritional and nutriceutical agents
Goals: to increase insulin sensitivity, protect against free radicals, reduce inflammation, enhance glucose tolerance, replenish nutrient deficiencies common in diabetics
- Diet therapy
Goals: Eat foods that will least aggravate the insulin response and provide optimal nutrition
Goals: Understand that the key macronutrients are needed in our daily food habits
Protein is vital for optimal health. It’s required for tissue healing and it helps to stabilize blood sugar levels
Carbohydrate intake should come mainly from vegetable sources. Complex carbs with a low glycemic index and high fiber content is optimal.
Fats are an essential part of the diet. Fatty acids is a key nutrient for every cell in the body, they are regulators of inflammatory pathways and are needed for the health of nerve tissue
Exercise is very important to help stabilize blood sugar. Both anaerobic and aerobic exercise is important.
- Lifestyle modification
Reducing and relieving stress is important in order to support adrenal health because the adrenals play a role in blood sugar regulation.
Naturopathic Approach for Type 1 Diabetes
Type 1 Diabetes is a disease of insulin insufficiency. Although in most cases insulin is required to take for life it is still important to investigate what is causing the destruction of the beta cells in the pancreas. Just like any other autoimmune condition various factors can play a role and determining what these are is important because the goal is to use the least amount of insulin necessary but still get the glucose into the cells.
International Diabetes Federation www.diabetesatlas.org
American Diabetes Association www.diabetes.org
State Health Facts www.statehealthfacts.org
National Diabetes Information Clearinghouse (NDIC) www.diabetes.niddk.nih.gov