Diabetes

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Submitted Aug 22, 2003   Updated Sep 26, 2010
By Ray Fosterrlf@mt-rushmore.net

 

What is diabetes?

Diabetes is a disease of the body that results in too high of a blood sugar. If the fasting blood sugar on two occasions reaches 126 mg/dl or more then a person is diagnosed with diabetes.

Insulin is a hormone released by the pancreas that helps glucose to enter the cells. If a lot of insulin is present, then a lot of glucose can enter the cells causing a low blood sugar. If only a little insulin is present then only a little glucose enters the cells causing a high blood sugar with other things being equal.

 

 

How big of an issue is diabetes?

Diabetes is a very common disease: The rate for all ages of 3.1% was more than 3 times the rate of 0.53% from 1958. Of the 7.8 million people in the United States who had diagnosed diabetes in 1993, about 90 to 95% appeared to have non-insulin dependent diabetes mellitus. This is encouraging because this is the type of diabetes that can be well treated with lifestyle factors.

Tell us about the two types of diabetes.

Type 1 diabetes is a very serious type of diabetes where the body does not have enough insulin. This leads to elevation of the blood sugar. Type 1 diabetes is difficult to treat. The treatment used is insulin. At this point in time, insulin is usually given by injection. Some type 1 diabetics might even have a small insulin pump placed under their skin in order to more consistently and accurately deliver the insulin.

Type 2 diabetes is another type of diabetes and is much more common than type 1. This type of diabetes results from a resistance of the body to insulin. There is adequate amount of insulin in the blood, but it does not have as great of an effect as the same amount of insulin in a nondiabetic. Type 2 diabetes can often be improved or cured with some simple life changes.

 

Why do people get diabetes?

What causes type 2 diabetes?

What happens when a person gets diabetes?

Some have compared insulin to a key that opens "the doors" in body cells so that the vital fuel, glucose, can get into the cell. However, if there is an insufficient amount of insulin (as in Type I diabetes) or if the locks on the doors are "gummed up" so that the insulin key has difficulty opening them (as can occur with the insulin resistance of Type II diabetes), then blood sugar levels can rise. When blood sugar levels rise sufficiently, the ability of the kidney to contain the sugar is overwhelmed, and sugar comes out in the urine. The sugar takes water with it, thus leading to the excessive urination so familiar in uncontrolled diabetes. The loss of water results in another diabetes symptom: increased thirst. At the same time, sugar is not moving into the body’s cells adequately. In a sense, the body’s cells are starving for energy. This can cause fatigue, weight loss, and excessive hunger.

Are the symptoms of diabetes type 1 and type 2 similar?

Yes, but the symptoms of type 1 are more severe.

Because of the more subtle nature of Type II diabetes compared to Type I, it often goes undiagnosed. A person with Type II diabetes may not have any of the classic diabetes signs like excessive urination, excessive thirst, excessive hunger, fatigue, or weight loss. Around 50 percent of Type II diabetics have probably not yet been diagnosed. Of course, unrecognized diabetes still does its damage steadily and silently. About 20 percent of newly diagnosed Type II diabetics already had damage to their eyes (retinopathy).

Diabetes can also damage the kidneys and lead to dialysis. Damage to the nervous system may cause numbness and pain in the feet and elsewhere. This numbness can lead to the diabetic continuing to walk on a foot with a tack in it, or continuing use of the foot in other injury. This can lead to infection (which also occurs much more severely in diabetics). Blood supply may be often cut off to important parts of the body.

Diabetics are at higher risk for heart attack, but because of their nervous system damage, they might not have the usual chest pain that comes with a heart attack making early diagnosis more difficult.

Since diabetes affects the glucose fuel system to the body, the effects may be very widespread affecting multiple organs.

Afflictions of Diabetes

Life expectancy is shortened by 5 to 10 years or more

It contributes to 160,000 deaths each year

Two to twelve times the risk for heart disease

Two to four times the risk of stroke

Number one cause of blindness in adults with 12,000 to 24,000 new cases annually

A factor in half of all foot and leg amputations

Over 60,000 amputations yearly in diabetics

In any given year, over 50,000 diabetics are either on dialysis, or have had a kidney transplant (due to diabetic neuropathy)

Cause of peripheral neuropathy

Increased risk of breast and uterine cancers

What is gestational diabetes?

This is diabetes related to pregnancy. Women who have this condition need to be closely followed during pregnancy. Children of these mothers experience an increased risk of health disorders such as birth trauma, lower blood sugars at birth, and even premature death in infancy. The message is clear: if you are a diabetic who becomes pregnant, or if you develop gestational diabetes, you should have your blood sugar monitored closely.

A woman who develops gestational diabetes has a tendency for diabetes later in life. She is at high risk to develop full-blown diabetes later in life. Practicing healthful habits throughout her life span thus becomes critical.

Can the destruction of diabetes be avoided?

Recently, a landmark Diabetes Control and Complications Trial (DCCT) was completed. This six-year study looked at 1441 Type I juvenile diabetics. Those diabetics who strove to keep their blood sugars as close to normal as possible (using insulin and lifestyle changes) had 76 percent less chance of developing diabetic retinopathy, a serious eye disease. They also experienced 54 percent fewer cases of significant kidney disease and 60 percent fewer cases of nerve problems involving the hands and/or feet (peripheral neuropathy). The participants also significantly lowered their blood cholesterol levels, suggesting that tight control could decrease heart disease risk by up to 35 percent.

Diabetics in this study who kept their sugars as close to normal as possible were practicing "intensive therapy" or "tight control." How tight was "tight control"? Fasting blood sugars in the morning as well as blood sugars before each meal were to be between 70 to 120. After-meal levels were to stay below 180. A middle-of-the-night sugar at 3 AM was to stay above 65. To find out how well the participants were adhering to these goals, an additional blood test called glycosylated hemoglobin was taken regularly. This test measures the amount of sugar that becomes attached to a person’s red blood cells. The amount of attached sugar in turn is directly related to the average amount of sugar in the blood throughout the life span of the red blood cells. Since red blood cells typically live for 90 to 100 days, the glycosylated hemoglobin value gives an approximation as to the average blood sugar level over a three-month period. In the DCCT study, levels were about 6.05 percent.

Results of Blood Sugar Control in Type I Diabetics.

76% reduction in diabetic retinopathy

54% reduction in significant kidney disease

60% reduction peripheral neuropathy

35% decrease in cardiovascular disease

Are there other ways to lower blood sugar than insulin?

Yes, several medications are available taken in pill form. And the method that we at NEWSTART prefer is lifestyle control.

I understand that lifestyle is sometimes helpful in a few patients, but will they help me?

Many type 2 diabetics can achieve control of diabetes with lifestyle measures so that medication is not needed. Even if this does not occur, lifestyle measures can help. You see, there are many areas that can work together to cause damage in the diabetic such as: high cholesterol putting a person a greater risk for atherosclerosis where the artery slowly narrows and is at risk for blockage; high blood pressure stresses these already damaged arteries; obesity puts a greater stress on a heart that may be diseased and obesity also worsens the diabetes.

Lifestyle can address all of these factors at the same time.

A large percent of type 2 diabetics, perhaps half, if they were to vigorously pursue lifestyle improvement, could be expected to successfully treat this problem without medication.

What is involved in lifestyle changes for diabetes?

Exercise plays a powerful role in lowering blood sugar levels. Evidence suggests that muscles in motion reduce resistance to insulin; that is, insulin sensitivity is improved by regular physical exercise. More simply put, exercise—in a sense—works like insulin in a diabetic: it helps sugar go out of the blood and into the muscle tissue.

Exercise not only helps diabetics control their blood sugars, it also helps non-diabetics decrease their risk of ever developing diabetes in the first place. One study showed that exercise dramatically decreased the risk of developing diabetes among those who were at high risk for the disease. As the amount of energy expended in exercise increased from 500 calories per week to 3500 calories per week, the risk of developing diabetes dropped by 48 percent. In other words, regular exercise nearly cut the risk of developing diabetes in half.

What kind of food should a diabetic eat?

The answer is that a healthful diet of plant-based foods benefits the diabetic and benefits you and me. So the question might be better stated what kind of a diet should we eat to be healthy.

Until fairly recently, diabetics were told that in order to control their blood sugars they had to eliminate most of the carbohydrates from their diet. They were told to avoid sugar, but the message did not stop there. Plant foods—naturally rich in complex carbohydrates—were also on the "hit list." The result left diabetics gravitating to a heavy meat diet.

With heavy meat consumption also came increased ingestion of cholesterol and saturated fat. Atherosclerosis then followed close behind.

Obesity is often one of the main determinants of insulin resistance (the primary cause of Type II diabetes). Thus it is important for an obese diabetic to lose weight if control of the disease is to be obtained by lifestyle changes alone. Meat is also dense in calories and makes weight loss more difficult. On the other hand, whole fruits, vegetables, and grains (without fatty toppings) are much less dense in calories, thus facilitating an excellent weight loss program.

A large Southern California study done among Seventh-day Adventists showed that those that ate meat six or more times per week were at 3.8 times greater risk of dying from diabetes than those who ate meat less than once per week.

Are some plant foods more healthful than others?

Plant foods should not be highly processed, when plants are processed, fiber is often removed.

This occurs for example: when whole wheat is changed to white flour, when an apple is turned into apple juice, when sugar cane is turned into sugar.

The fiber is helpful in decreasing the higher up and down swings in blood sugar that can occur with processed foods. So eating an apple will be better for the blood sugar than will drinking apple juice.

Fiber also is helpful in lowering blood cholesterol. This is important to decrease the risk of atherosclerosis.

High-fiber-foods lead to a slower rise in blood sugar, and as a result, require less insulin to handle the meal. Fiber, especially soluble fiber like the pectins and gums, slows the emptying of food from the stomach and helps to slow the absorption of simple sugars in the small intestine. This should be contrasted with high fat meals that can result in high blood glucose levels for up to 5 hours after the meal.

There are many foods rich in fiber. A high content of insoluble fiber is found in wheat (especially the bran) and bananas. Foods strong in soluble fiber include most fruits, vegetables, legumes (fresh or dried), oats, brown rice, and barley. Most foods that are strong in soluble fiber are also strong in insoluble fiber.

Addition of these types of dietary fiber can improve diabetes control. Eating a low fat, high fiber, vegetarian diet keeps blood sugars low even when fruits are eaten. Dr. James Anderson and colleagues at the University of Kentucky found that by using a high carbohydrate and high fiber diet, the need for insulin was greatly reduced. Blood sugar control was better and fasting levels of cholesterol and triglycerides fell.

Diabetic Benefits of a High-Carbohydrate, High-Fiber Diet

Reduces levels of serum cholesterol and triglycerides

Reduces blood pressure in those with hypertension

Promotes discontinuation of insulin therapy for non-insulin dependent diabetics

Reduces risk of death from heart disease

Improves gastrointestinal Function

Reduces body weight in the obese

Reduces risk of kidney damage

Reduces insulin requirements

Improves glycemic control

Does it matter how often I eat?

Toward evening, your body’s ability to handle sugar decreases.

In a study of subjects with Type II diabetes, absolute blood sugar levels were 10 to 15 percent higher when eating six times a day (three meals and three snacks) compared to just three meals a day.

Does it matter when I eat?

Years ago Dr. Charles Cupp proposed that weight gain is the result of inappropriate timing of food intake in relation to the evening sleep time. Cupp instructed hundreds of patients on his novel approach to weight control. Overweight patients were instructed to change their meal pattern from a heavy meal and snacks in the evening to a heavy morning meal, a moderate lunch, and a light supper. They were to eat their last meal ideally at noon but by no means later than 3:00 p.m., and they were instructed not to go to sleep for at least eight and a half hours after the last intake of food. Of significance, they were not asked to change their food choices nor the amount of calories they ate. Researchers in the Department of Nutrition at Tulane University’s School of Public Health analyzed the records of 595 of Cupp’s overweight patients.

The results of their study are shown:

Those who ate only breakfast averaged 10 pound weight loss a month.

Those who ate breakfast lunch and snacks averaged 5 to 6 pounds a month.

Those who lost from 20 to 30 pounds showed and increase in hemoglobin level.

Blood sugar levels of diabetic patients who lost 30 pounds or more were normalized.

Hypothyroid patients showed a reduction in daily thyroid maintenance requirements.

Is sugar a Problem?

Sweet, empty calorie foods give the blood sugar a quick boost, but this rise is not sustained.

Sugar consumption weakens the ability of white blood cells to destroy bacteria.

Study data show that if a person consumed no sugar for 12 hours, each white blood cell could destroy an average of fourteen bacteria. If that same individual ate the equivalent of six teaspoons of sugar (such as found in a half-cup of pudding or a mere two ounces of candy), each white blood cell could only eliminate ten bacteria—a 25 percent decrease in killing power. When 24 teaspoons of sugar were consumed (the amount in a medium piece of cheesecake or a milk shake), the white blood cells were so compromised that they could only destroy an average of one bacterium each. That represents a 92 percent reduction.

This provides one explanation why diabetics frequently get foot infections and other types of infections. Keeping a healthy immune system is simply a personal choice that each one of us is free to make.

Another concern with sugar for the diabetic is that sugar itself provides plenty of calories, but very little in the way of trace minerals and other nutrients. There are growing concerns that certain minerals may help with diabetes control. Two examples are zinc and vanadium. Other minerals and vitamins suggested to have an important role in diabetes include magnesium, manganese, chromium, potassium, and pyridoxine (vitamin B6). The more you fill up on sugar, the less capacity you will generally have for the nutrient-rich foods like fruits, grains, and vegetables.

What about artificial sweeteners?

What about artificial sweeteners? Today many believe artificial sweeteners are a good alternative to sugar in everything from soft drinks to cakes and candies because they contain fewer calories. NutraSweet, for example, is the brand name of a synthetic amino acid called aspartame. In small amounts it can mimic the taste of sugar.

Do the low calorie soft drinks really work? Those who drink the most diet drinks have the most problems with their weight. And it seems to be more than just a situation where heavier people are choosing lower calorie items. One study of over 75,000 women ages 50 to 69 found that users of artificial sweeteners were significantly more likely than non-users to gain weight over timeIn another study, 30 volunteers drank four diet sodas daily for two weeks. Surprisingly, these diet soda users ate more food and gained more weight than when they were free to drink regular sugar-sweetened soft drinks. Simply put, artificial sweeteners may be increasing the desire for the real sweeteners. This is a problem of obvious significance. In our country, an average of over 20 pounds of artificial sweeteners are consumed per person per year, but despite this increase in consumption of artificial sweeteners, actual sugar consumption continues to rise. 

How can diabetes be reversed?

  • Contact your doctor to let him/her know that you intend to make major changes in your lifestyle including diet and exercise. (Your doctor might want to lower your medication dose even before you start to prevent serious low blood sugar problem).
  • Begin a regular walking program of about 2 miles twice daily (if this sounds intensive remember what you might have to gain). You might want to work up to this over several days or a couple of weeks.
  • Start eating 2 or no more than 3 meals per day (no snacks unless you have a low blood sugar reaction).
  • Let everything that you eat be simple, low fat or no fat, and plant based. Good choices include: whole wheat bread, oatmeal, vegetables raw or cooked, fresh fruit [yes, fresh fruit is good for you!], and small amounts of nuts such as almonds. Avoid processed foods: white flour will not be as good as whole-wheat flour; blood sugar is much easier to raise too high with juice as opposed to fruit; and avoid sugar like poison. Use no meat, or cheese, and avoid dairy products.
  • Check your blood sugar more frequently since you will probably have significant fall in blood sugar.
  • Keep your doctor informed of your falling blood sugar so that he or she can reduce or stop your medications (this is important!).

Fortunately, only about 5 to 10 percent of diabetics in America fall under the Type I diabetes category. The remainder are Type II diabetics. These individuals either have a problem called "insulin resistance" or a less severe underproduction of insulin than those with the Type I variety. In actuality, most fully developed Type II diabetics have both of these problems. There appear to be many different causes of Type II diabetes; most seem to have a genetic basis. The majority of individuals with this type of diabetes have a family member that had also been diagnosed with the disease. For example, many Native Americans have this genetic tendency; however, it appears they did not have diabetes until they adopted a Western diet with an overabundance of sugar and fat. Simply put, it usually takes a combination of two factors to develop adult onset diabetes. One is genetics, and the other is a poor diet—like that consumed by the average American. Many individuals with Type II diabetes generate plenty of insulin but their body is resistant to it.

This condition of insulin resistance can be addressed by lifestyle changes. By maintaining an excellent diet, achieving an ideal weight, and embarking on an exercise program, many Type II diabetics can control their blood sugars with these lifestyle changes alone. Some may need diet changes plus a pill to help control their blood sugar.

Proof Positive by Neil Nedley M.D.:

Type I diabetes is the most severe form of the disease. It typically occurs in childhood (but can develop at any age) and for this reason was previously called "juvenile diabetes." The most common cause of Type I diabetes is destruction of the insulin-making cells in the pancreas by the person’s own immune system. This is referred to as "autoimmune destruction." The specific factors that trigger this autoimmune process have proved elusive. Although some cases have been linked to viruses or chemical toxins, much is still unknown about the beginnings of the Type I diabetes process. There does seem to be a genetic susceptibility to the disease, plus an environmental factor that triggers the disease process. Some of the most interesting recent research links some cases of Type I diabetes to an abnormal immune reaction to milk protein. We now know that children who are breast-fed for a shorter time or who are started on cow’s milk earlier have an increased risk for this type of diabetes. In fact, the drinking of cow’s milk may be the trigger that initiates the disease in over half of all Type I diabetics.