Holistic Management and Prevention of Diabetes
Are you at risk for insulin resistance and diabetes? Do you have a family history of diabetes or heart disease? Are you overweight or have a sedentary lifestyle? Have you been diagnosed with high blood pressure or have another inflammatory disease? Do you have cholesterol abnormalities? Do you eat a poor diet, smoke, or have other toxic exposures? Or are you a woman over the age of 54 or a man over the age of 44? If you answered yes to any of these, then you may be at risk for insulin resistance or diabetes.
Diabetes is one of the fastest growing diseases in our country. The World Health Organization estimates that 1 in 3 Americans will have diabetes by the year 2050. This is a frightening prospect and will have devastating effects for individuals, families, and our nation as a whole. Type 2 Diabetes (which is what I refer to in this article) is a chronic disease characterized by the body’s inability to effectively use insulin, termed insulin resistance. The result is high levels of glucose in the blood that have many and varied negative consequences. Type 2 diabetes was formerly an adult disease diagnosed typically over the age of 40, however, children are now being diagnosed with increasing frequency.
Type 2 diabetes is largely a result of excess body weight and physical inactivity, however, many factors contribute to the development of diabetes. Individual triggers such as major or chronic stress, physical trauma, infection, medications, environmental toxins including cigarette smoke, food sensitivities and the quantity as well as quality of food are all components in the development of the disease.
Long-term consequences of insulin resistance and diabetes include damage to every organ system in your body as a result of inflammation. When we think of insulin we think of diabetes. However, insulin resistance not only plays a role in the development of diabetes but evidence indicates that insulin resistance promotes cardiovascular disease, hypertension, polycystic ovarian disease, cognitive decline, and even colon and breast cancer. An excess of insulin, as in the case of insulin resistance, has many negative biochemical effects including systemic inflammation. Research is continuing in this field to better understand the comprehensive effects of insulin resistance and how it contributes to the disease state.
Diabetes is typically diagnosed by a blood test that indicates high levels of glucose in the blood. However, insulin resistance begins long before the body begins to fail at regulating glucose. The pancreas produces more insulin in response to insulin resistance in order to maintain normal glucose levels in the blood. After time, this mechanism fails resulting in high blood glucose as measured by standard testing. This is the point at which disease is recognized in the conventional setting. Conversely, measuring insulin levels directly provides a more proactive approach to the prevention of diabetes by recognizing the early signs of disease. Given the deleterious effects that high levels of insulin has on your body, even before the diagnosis of diabetes can be made, measuring insulin levels can provide valuable information about your state of health and can help guide and direct treatment toward the prevention of disease.
Most importantly, insulin resistance and diabetes can be reversed! The devastating effects of insulin resistance are by no means inevitable. In recognizing the problem and understanding the individual triggers, a plan of action can be tailored to each individual and optimal health can be restored. There are a few elements of treatment that are important for every person who is at risk for or who has the diagnosis of diabetes.
Proper nutritional intake both in quantity of calories as well as quality of foods is central to reversing insulin resistance. The Mediterranean diet has been shown in research studies to be beneficial in diabetes management. The good news is that not only is it a healthy diet to follow but delicious meals can be prepared and enjoyed following the principles of a Mediterranean diet. The focus is on whole foods including fruits and vegetables, whole grains, beans and legumes, nuts, olive oil, moderate amount of low fat dairy, fish and high quality meats. It is also recommended to enjoy green tea and moderate amounts of dark chocolate. It is important to avoid fast food, processed food, soda and other sugar sweetened beverages and sugary desserts. A poor diet high in refined carbohydrates, sugars, trans and saturated fats and low in fibers, phytonutrients, and antioxidants activates the immune system resulting in inflammation that promotes disease. The Mediterranean diet, conversely, results in a decrease in inflammation in your body. An individually tailored diet may also be important if evidence of food sensitivities is present.
Exercise is of critical importance for persons with diabetes and/or insulin resistance. Independent of weight loss, exercise improves the body’s ability to maintain blood glucose levels. Insulin resistance is decreased during the 24-48 hours after exercise. Therefore, it is important to keep a regular practice of exercise.
If you are overweight it will be important to work toward weight reduction. This should be done slowly over time with the aim of maintenance and sustainability. The challenge with weight loss in diabetes is that high insulin levels (a result of insulin resistance) promotes weight gain and makes losing weight an often disheartening challenge. It’s an uphill battle but once inflammation is decreased and insulin resistance improved weight gain will become easier. Even just as little as a 7% reduction in weight significantly improves insulin sensitivity and glucose control. With the appropriate treatment plan weight loss will be attainable! Our physicians and nutritionist can work with you to find a successful weight management and body composition program that works for you and your busy lifestyle.
Stress management is also tantamount to your health and this is certainly the case in diabetes. Living with diabetes can create a lot of emotional stress. Stress itself creates inflammation that can aggravate the already stressful symptoms of insulin resistance and diabetes. In addition, the burden of the disease can cause fatigue and a general sense of not feeling well. Mind-body practices are a wonderful accompaniment to your daily routine and provide much needed mental relief. There are many options such as meditation, breathing exercises, yoga, tai chi, etc. I think an easy place to start is with breathing exercises. Make it a habit to spend 5 minutes a day on deep belly breaths, inhaling slowly to the count of 4 as your belly expands like a balloon, then exhaling slowly to the count of 4, breathing out tension as you exhale. The breath is our connection to our nervous system. The autonomic nervous system is divided into the parasympathetic and sympathetic nervous systems. In our culture, we tend to be largely shifted toward sympathetic over-drive (this is the ‘fight or flight’ system that is activated during times of stress). Breathing exercises are a way that we can control the balance of our nervous system with a shift of the balance toward the parasympathetic side (‘rest and digest’). The result is an overall improvement in health including insulin resistance and an improved sense of well-being.
Finally, supplements play a significant role in the treatment of insulin resistance. Magnesium is necessary for glucose metabolism and deficiency is common among those with diabetes. Low levels of magnesium have been shown to increase the risk for diabetes while supplementing helps to prevent the complications of diabetes. In addition Metformin, a common medication for diabetes, can also decrease magnesium levels. Vitamin D is also important for glucose metabolism and deficiency is almost ubiquitous in our society. Supplementation with vitamin D is important for insulin resistance but also for many other aspects of our health. Other important vitamins and minerals for glucose control include zinc, chromium, calcium, vitamin C, and vanadium.
In addition to the vitamins and minerals, there are several other key nutrients and botanicals that play a role toward improving insulin resistance. For example, a useful supplement, alpha lipoic acid, is a potent antioxidant and has been shown to improve glucose control. Bitter melon is an herb commonly used for the treatment of diabetes in Australia, South America, and Asia. The unripe fruit and seed of the herb have been shown to significantly improve glucose tolerance and decrease fasting and postprandial glucose levels. Curcumin is a potent anti-inflammatory that helps to quell the inflammatory process.
There are many supplements that can help in restoring health in the condition of insulin resistance and diabetes. Supplements need to be tailored to a person’s specific needs. In addition to the basic principles of treatment discussed above, keep in mind that individual triggers may also need to be effectively addressed for a true reversal of disease.
If you have diabetes or you are at risk for developing diabetes, we can work together to restore your health, vitality, and longevity! We encourage you to come in and discuss testing, lifestyle modifications, optimal dietary planning and supplementation to ensure your optimal health and well-being.