Most of the people with diabetes that I see have the adult-onset type 2, which typically develops after age 40. Conventional medical treatment for this condition is certainly very good, and someone with well-controlled adult-onset diabetes can expect a perfectly normal life span. But too often, both physicians and patients consider diabetes a “medical problem”–meaning all a patient has to do is take his medicine, watch his sugar intake, and check in with the doctor every so often.
At WholeHealth Chicago, however, we’ve learned that diabetes, almost more than any other medical condition, requires a sharp focus on lifestyle changes to keep it under control. It takes a real commitment on the part of the patient. Our integrative approach is designed to complement whatever regimen you’re doing now, and may even reduce your medicine requirements or slow down the progression of your condition. Just remember, never make a change in your medications without your physician’s approval!
What is Diabetes?
In this chronic metabolic disorder, the body loses its ability to utilize glucose, the simple blood sugar that all cells in the body need for energy. Cells can absorb glucose only in the presence of the hormone insulin, which is produced by the pancreas, an organ located just below the stomach. A person who has diabetes either isn’t producing enough insulin or isn’t able to utilize it effectively–two underlying problems that have led medical experts to distinguish between two types of diabetes. In type 1 diabetes, also known as juvenile diabetes or insulin-dependent diabetes mellitus (IDDM), insulin production is impaired. This type of diabetes develops suddenly, usually in people under age 30 (the average age of onset is 12 to 14 years), and treatment entails taking daily insulin injections, usually for life.
In type 2 diabetes, insulin production is fairly normal–meaning that it can be higher or even slightly reduced–but cells don’t respond properly to insulin, a condition called insulin resistance. Also known as adult-onset diabetes and non-insulin dependent diabetes mellitus, or NIDDM, type 2 diabetes is far more common, accounting for about 90% of cases. It develops gradually and tends to affect people over age 40, particularly individuals who are overweight. Most people with type 2 diabetes do not require daily insulin injections but instead can manage their condition through diet, exercise, and oral medications.
If untreated, either type of diabetes will lead to abnormally high levels of glucose in the blood (hyperglycemia). This in turn may precipitate a number of complications, including cardiovascular (heart and blood vessel) disease, nerve damage, kidney disease and vision loss. And excess sugar is excreted in the urine, giving this condition its full name: diabetes mellitus–which means “honey-sweet urine.”
Fortunately, the use of conventional and complementary measures can help control diabetic symptoms and prevent some complications of this chronic ailment, which today affects some 16 million Americans.
- Excessive and frequent urination, sometimes as often as every hour
- Excessive thirst
- Increased hunger
- Unintended weight loss
- Weakness and fatigue
- Blurred vision
- Numbness or a tingling sensation in the hands and feet
- Recurring infections, such as urinary tract and vaginal yeast infections
- Slow healing of cuts and wounds
What Causes Diabetes?
The exact cause of diabetes is unknown. Type 1 diabetes is thought to be an autoimmune disorder, in which the body’s immune system mistakenly attacks the insulin-producing cells of the pancreas. Obesity seems to be a risk factor for type 2 diabetes. Genetic factors appear to play a role in both types. Women sometimes develop diabetes during pregnancy. Although gestational diabetes, as it’s called, usually disappears after childbirth, it does increase a woman’s risk of developing type 2 diabetes later in life.
Treatment and Prevention
Anyone who has diabetes (which is diagnosed through tests for blood glucose levels and glucose tolerance) should be under the care of a physician. Your doctor needs to monitor the progress of any symptoms, be alert to possible complications from diabetes and prescribe appropriate medications.
For type 1 diabetes, proper treatment entails daily insulin injections, a controlled diet, and regular exercise. Initially, type 2 diabetes is treated with dietary changes, weight control, and exercise. Later, your doctor may add any of a number of oral medications called hypoglycemic agents, which reduce the level of blood sugar. If, despite increasing doses or additional hypoglycemics, blood sugar remains out of control, a person with type 2 diabetes may be advised to start using insulin. In addition, people with either type of diabetes should, under the guidance of their doctors, perform blood tests at home to measure glucose levels. Because diabetes can cause serious eye complications, everyone with diabetes should get an annual eye examination.
Supplements can also play a role in regulating blood glucose levels and possibly preventing diabetes complications. For example, nutritional supplements may help reduce risk of infections and promote healing when a person who has diabetes sustains injuries or is undergoing elective surgery. Some supplements, however, require changing the dosage of insulin or the hypoglycemic drugs prescribed for type 2 diabetes. Any changes in your medications must be done under the guidance of your doctor.
The most intelligent step a person with diabetes can take is to become well educated about the condition. Although you can learn a great deal from books (the American Diabetic Association is an excellent source), you can also work with a good nutritionist. Some hospitals and health plans have diabetes educators who are skilled in teaching you about healthful eating, exercise, medications, insulin administration, and overall attitude adjustment.
Alternative therapies are of limited use in treating diabetes. Acupuncture has been helpful in easing the discomfort of nerve damage caused by diabetes. Relaxation techniques, like biofeedback, can improve your circulation and may possibly reduce your insulin requirements.
There is no known way to prevent type 1 diabetes, although some research suggests that feeding cow’s milk to infants may be associated with a greater risk of developing the insulin antibodies found in type 1 diabetes. Although no definitive connection has been established so far, studies are ongoing.
Maintaining a healthy weight through diet and exercise is the key to reducing your risk for type 2 diabetes. Early detection of type 2 diabetes is also extremely helpful for controlling symptoms and lessening the risk of developing complications. For this reason, we at WholeHealth Chicago recommend that all adults over age 45 undergo regular blood and urine testing for diabetes as part of your regular checkup by your doctor.
Just a reminder: If you have a serious medical condition or are taking medication, it’s always a wise idea to talk with your doctor before beginning a supplement program.
How Supplements Can Help
Start with B vitamins, which help convert blood glucose to energy and may play a role in preventing diabetes-related nerve damage.
Add chromium to help lower blood glucose levels and cholesterol, risk factors for heart disease.
The herb gymnema sylvestre can help regulate blood glucose levels to the extent that it may reduce the need for insulin or other diabetes medications. Consult your doctor before taking the herb or altering any dosages.
Take essential fatty acids in the form of borage oil and fish oils to protect against diabetes-related nerve and arterial damage. Fish oils, in particular, may help reduce heart disease risk.
Antioxidants may also prevent diabetic damage to the nerves, eyes, and heart. Vitamin E is especially useful for blocking plaque buildup in arteries, while alpha-lipoic acid promotes the efficient use of blood glucose and has been shown to prevent diabetic neuropathy.
Zinc helps the body use insulin effectively and speeds the healing of wounds. If you take zinc supplements long-term, add extra copper.
Magnesium, which helps the body with energy metabolism in the nerves and muscles, tends to be lost easily in the urine of diabetics. Supplemental magnesium may prevent some muscle and nerve pain, as well as the heart and cardiovascular complications and vision problems that can develop in people with type 2 diabetes. (Do not use magnesium supplements if you have kidney disease.)
Take the herb bilberry to protect against diabetes-related vision loss. The herb ginkgo biloba can help control two common diabetes complications: nerve damage and poor circulation in the extremities.
Get supplement dosages and tips in our WholeHealth Chicago Supplement Recommendations for Diabetes.
To help with self-management of diabetes, check with your doctor or health plan and ask for a referral to a diabetes educator if you or anyone in your household is newly diagnosed with diabetes.
If you have type 1 diabetes, self-management through eating a low-fat diet and getting regular exercise are crucial. Both diet and exercise help lower blood sugar levels and aid in weight loss. Exercise may also help insulin work more efficiently. Be sure to follow the timetable recommended by your doctor for monitoring blood glucose, injecting insulin, eating, and exercising.
If you have type 2 diabetes, control your weight by eating a low-fat diet and exercising regularly. If you are taking insulin or drugs to lower blood sugar, learn how to give yourself a concentrated sugar boost from an easily absorbed source such as orange juice in case your blood sugar gets temporarily too low. (This condition, called hypoglycemia, can cause weakness and loss of consciousness, and can sometimes prove life threatening for someone who has multiple health problems.)
To prevent the cardiovascular complications of diabetes, stop smoking if you smoke; reduce the saturated fat, salt and cholesterol in your diet; and take prescribed medications for cholesterol or hypertension faithfully.
Diabetes reduces sensation in the feet, so that small sores or other foot problems may go unnoticed and can subsequently turn into major infections. Therefore, it’s important to check your feet every day for injuries.
When to Call a Doctor
- If you experience any of the symptoms of diabetes, especially a sudden or gradual increase in hunger, thirst, or urine output
- If you have diabetes and you contract an illness with fever and chills, such as flu, urinary infections, dental infections or winter-time bronchial infections, which can cause your blood glucose levels to go out of control
- Call an ambulance if you experience dry mouth, flushed skin, fruity-smelling breath, difficulty breathing, vomiting and abdominal pain. (These are symptoms of a life-threatening complication called diabetic ketoacidosis, caused by insufficient insulin in type 1 diabetes patients.)
- Call an ambulance if you experience extreme thirst, lethargy, weakness and confusion. (These are symptoms of another potentially fatal complication, called a hyperosmolar nonketotic state, usually associated with extremely high blood glucose levels in type 2 diabetes patients.
Supplement Recommendations for Diabetes
From David Edelberg, M.D. at WholeHealth Chicago: Because the overall management of type 2 diabetes is so complex, I’m going to assume that you’re already under a physician’s care. Doubtless, you have been given some dietary precautions, and you may be on oral medication or insulin injections.
The overall goal of our supplement recommendations is to improve the control of your blood sugar, slow down the development of complications of diabetes, and perhaps reduce your current medication requirements. However, you should make no changes in your medicine without the approval of your physician.
How to Take the Supplements
The supplements listed here are safe to use over the long term. You can start them all together, or, if you have a stomach that’s sensitive to nutritional supplements, start with one or two supplements on the list and add another every two or three days.
The supplements can be taken along with insulin and other prescription drugs, and by people with both type 1 and type 2 diabetes. Some will have a mild (not severe) effect in lowering your blood sugar, so keep an eye on your blood sugar levels. The possibility that the supplements will bring about actual hypoglycemia (excessively low blood sugar) is unlikely.
Both the chromium and gymnema sylvestre can improve blood-sugar control. Working with your doctor, you may find that your medication requirements are reduced. Zinc aids the body in insulin use (and should be joined with copper when taken long term).
Taking magnesium can help compensate for the low magnesium levels that affect many people with diabetes. This mineral can improve insulin utilization, reduce insulin resistance, and protect against a number of complications of type 2 diabetes, including eye disease, nerve pain, and cardiovascular problems. (People with kidney disease should not take magnesium supplements, however.)
All the other supplements help protect the body from the diabetes complications. The B vitamins, alpha-lipoic acid, and gamma linolenic acid (GLA) in borage oil protect the body from diabetic neuropathy (nerve damage). The herbs bilberry and ginkgo biloba may help prevent or delay diabetes-related eye damage and prevent damage to small blood vessels throughout the body.
For special consideration:
Because diabetes increases the risk of atherosclerotic heart disease, try adding some omega-3 essential fatty acids each day. EFAs prevent hardening of the arteries and lower triglyceride levels. Eating fish (salmon, tuna, mackerel, or sardines) several times a week will do the job nicely. Or take fish oil capsules (2000 mg three times a day) instead.
If you’re aware that your cholesterol level is high, you can additionally offset the cardiovascular risk of diabetes with niacin. Regular niacin can cause an uncomfortable facial flushing, so use a slightly altered form called inositol hexaniacinate (500 mg 3 times a day). Important:
We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.
Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions.
For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700 ext. 2001.
David Edelberg, MD