by Gabriel Ariciu, DC
Often when I think of diabetes I can’t help but think of the Wilford Brimley commercials talking about his “diabeetus.” His pronunciation is used for memes and videos but it is about a serious problem. Diabetes is a common word used today for an increasingly common disease. I am going to run through a breakdown of what diabetes is, the different types, causes, how it is diagnosed, and how it is treated. Diabetes is personal to me as well. My mom suffers from it. I remember when she was diagnosed, it was a frightening day because she had not been well for awhile and then I receive a phone call that she is going to the emergency room. It is a scary memory especially due to the fact I had little to no education on healthcare at the time it happened. I don’t want others to feel scared or worried about the future. I don’t want others to think there is nothing to be done. That is why I write this article to inspire change.
Diabetes impacts over 380 million people in the world. That number is expected to hit almost 600 million by 2035. Over 30 million Americans have it. Of them, 1.25 million cases are type 1 diabetes. There are 1.5 million cases of diabetes diagnosed each year and a further 84.1 million Americans age 18 and older are prediabetic. It is a serious issue.
It is currently the 7th leading cause of death in the US and these statistics are old. So the numbers have probably changed and not for the better. The cost is another issue in of itself. Approximately, $245 billion is spent on diagnosed diabetes in the US in 2012. The prevalence and cost is only increasing.
My intention with this article is provide and bring some understanding too. The numbers are frightening and as diabetes has become a normal situation I want people to understand that for the most part it is a manageable problem. You can lead a normal life! I will talk about the the types of diabetes and what can be done. I do not subscribe to the conventional approach and this may not be for some people because requires a lifestyle change but as I tell all my patients it is worth it!
Types and Causes
First we must understand there are different types of diabetes. Diabetes has to do with blood sugar handling essentially. The full name itself alludes to this. Diabetes mellitus means large amounts of sweet urine. It can be described as either the inability to make insulin or the body is resistant to insulin. Insulin is a hormone that your pancreas produces to signal your cells to take in glucose, what we simply call sugar and since it is in your blood, blood sugar. Without insulin or being resistant to it increases the amount of blood sugar. Your body tries to get rid of the excess blood sugar by peeing it out, hence the sweet urine. But this is the key reason behind the 3 hallmark signs, excessive urination, excessive thirst, and excessive hunger. Now let’s talk about the different types.
Type 1 diabetes is often diagnosed in children or young adults. It makes up about 5% of diagnosed diabetes cases. In type 1 cases the body has stopped producing insulin due to the cells (beta cells) within the pancreas being destroyed. It is an autoimmune disorder. That is your body has turned on itself by ramping up the immune system. Normally the immune system attacks foreign invaders. A specific cause is unknown. There are links that have been made to dairy products. I will talk more on this later on. Type 1 is associated with other autoimmune diseases such as Celiac disease and Hashimoto’s. Celiac is well known to be a gluten sensitivity reaction. So the case that type 1 could be associated with a food sensitivity is possible. Determining what is causing it is difficult because it often happens when someone is a child. Nevertheless, autoimmune disease is a gut related issue in which the intestinal barrier has been broken down allowing “foreign invaders” to intrude causing the immune system to become hypervigilant over a period of time leading to autoimmunity. I have written a more in depth article on this topic.
Back to type 1. So without insulin your cells cannot take in glucose for energy production. As your blood sugar rises your body starts to dump it out in your urine as fast as it can. However, there are major complications if this goes untreated. In type 1 it is very dangerous because your body will not get the necessary energy to function. People with type 1 will be on insulin for the rest of their lives typically by manual injection or a device that acts as an artificial pancreas monitoring your blood sugar and releasing insulin as needed. Pretty neat developments for a difficult disease. I have read about some people decreasing the need to rely on insulin as much by adapting to a higher fat diet. That may be an option for your but of course discuss that with your doctor.
Type 1.5 diabetes is type 1 diabetes that happens in adults. It is also known as latent autoimmune diabetes of adulthood or LADA. Often times it is misdiagnosed as type 2. Approximately 20% of type 2 cases are autoimmune. They tend to be underweight rather than overweight like type 1. Often times the typical symptoms of excessive thirst, excessive urination, etc. take awhile to show up. It may take up to 10 years for insulin dependency to develop. Unlike type 1 there maybe more time to find what is causing the destruction of the beta-cells. Casein, a dairy protein, is often blamed as the culprit. This is due to the proteins in the beta-cells (GAD65) being similar to the casein protein. The immune system when hypervigilant can confuse the two proteins and target the beta-cells for destruction in a process called cross reaction. Gluten is another culprit that has come under scrutiny. But one of the big issues is why your immune system is targeting those two proteins in the first place. To investigate that we have to look at the intestines. Your gut has 80% of the body’s immune system because it is open to the environment for you to absorb food and water. The gut barrier is selective only allowing certain things through. However, that can breakdown as I said above. The gut barrier can be broken down for a variety of reasons and most of them are diet related. Our highly processed foods can be a direct cause or indirect by creating an environment for the wrong type of bacteria to flourish which break down the barrier. Environmental toxins are another cause as well.
Type 2 diabetes is the most common type. It is most prevalent in older adults however, it is becoming common amongst others even children. It is typically associated with obesity giving rise to the term diabesity. Genetic predisposition also plays a role. Type 2 is characterized by insulin resistance rather than dependence. Most have some degree of insulin deficiency but the body still produces some insulin. However, the cells have become resistant to it. The theory is due to a diet high in carbohydrates especially highly processed carbs and simple sugars increases the blood sugar levels causing cells to become overwhelmed and resistant. The body only needs so much glucose and if we overwhelm it, the cells will downregulate the receptors for insulin and not take in the glucose keeping the blood sugar levels high. Overtime, the resistance becomes worse and insulin becomes deficient leading to further complications. Often times, they will end up being insulin dependent.
Type 3 Diabetes is not fully accepted as of yet but researchers at UCLA began calling Alzheimer’s disease type 3 diabetes. They pinpointed insulin resistance in the brain as a key component to the development of Alzheimer’s.
People are often diagnosed after symptoms present themselves. The most common being excessive thirst, hunger, and urination. Lack of energy and even feeling weak are other symptoms people report usually due to hypoglycemia. They simply are not getting energy into their cells. Alarmed, these patients go to see their doctor. After a taking a history, the doctor will run several blood tests. Usually a comprehensive one to get an idea of the overall health. The typical blood sugar related tests are HbA1c and fasting blood glucose. HbA1c measures part of your blood (glycated hemoglobin) understand how your blood sugar has been over the last 3 months. Your HbA1c should be between 4.8%-5.6%. HbA1c between 5.7% and 6.4% is an increased risk for diabetes. Above 6.4% is diabetes.
Fasting blood glucose is a measurement of blood sugar levels after a period of fasting. The level should be between 65-99. Closer to the middle of those numbers is best. Between 100 and 125 is prediabetes and above 126 is considered diabetes. That is how it is diagnosed, HbA1c being the gold standard. Glucose tolerance test may also be used to see how well you your body handles blood sugar after eating food. As for treatments, they vary. I will explain them after talking about the risks for not seeking treatment.
Risks of not getting treatment
There are many risks with not getting treatment. It is incredibly sad to see the progression of this disease when it is not treated. As a nurse, I helped someone who went through a surgery to have her foot amputated. This due to the effects of high blood sugar and inflammation on our cardiovascular and nervous system. Especially in parts that have smaller blood vessels like your feet.
One issue that happens is called Diabetic Neuropathy. Essentially what happens is nerve damage caused by high blood sugar levels and inflammation. This typically happens in the feet but it can happen in several different areas causing a wide range of symptoms. It is not uncommon for people to lose feeling in their feet making it difficult to walk. If untreated they can lose toes and even whole limbs as the patient I helped as a nurse. Injuries are also very hard to heal with uncontrolled diabetes.
Another issue is Diabetic Retinopathy. This is damage to the retina which can lead to blindness. Diabetic nephropathy is damage done to the kidneys which can lead to kidney failure. Cardiovascular issues will arise as well. As you can see the complications are severe and life changing and can be deadly. It is essential that you seek treatment as soon as possible.
The conventional approach utilizes medications to curb the symptoms. Sometimes they receive dietary counseling from the doctor or a dietician. Diabetic patients are given many medications due to the variety of symptoms and other complications that come with the diseases.
Type 1 diabetic patients will be on insulin. Their pancreas cannot make insulin so they must get it from a medication. There are some very ingenious devices that have been created to make it a lot easier for these patients. Type 1.5 if it is diagnosed correctly will receive insulin after a period of time. Most of the time it is monitored until insulin is needed. A lof type 1.5 patients are misdiagnosed as type 2.
Type 2 patients are often given drugs like metformin which are intended to increase insulin sensitivity. Other medication may be given depending on other issues going on such as blood pressure medication or cholesterol lowering drugs. Often times the medication is intended to address a particular symptom or an effect from another medication. Type 3 patients are being given similar drugs to help with the memory loss and curb the progression of the disease.
The holistic approach evaluates each system of the body to see the effects of the disease as well as any other issues going on. Our body being made up of systems it is incumbent upon the doctor to investigate each system in relation to each other. We cannot treat one system without affecting another. A thorough history will be taken to get a grasp of the patient’s lifestyle, their habits, movement, and diet. Lab work tends to be more comprehensive looking for further problems going on in the body that can be missed with less comprehensive labs. Physical exam and other diagnostic tools such as muscle testing will further confirm what is going on with patients. From there the practitioners start piecing together the situation as it relates to the individual patient. Every patient is different so the approach can vary. However, the doctor will try to help support and heal the body through natural means. Another way to way to call this is natural medicine. Nevertheless, I will give some typical guidelines to the holistic treatment.
Firstly, diet will be addressed. A healthy nutrient dense diet is crucial for a diabetic patient especially for those who want their symptoms resolved. Diet is often what caused the issue in the first place. It being a major culprit in all forms of it. Sometimes the damage has been done and there is nothing that can be done like in the case of type 1. Insulin is needed in those cases. However, a good diet will decrease the overall need for insulin and it will lead to other health benefits as well such as decreasing the risk of heart disease.
A nutrient dense diet consists of large amounts of vegetables and fruits. This should take up the majority of your plate. Meat should come from healthy sources such as grass-fed cattle or pasture-raised chicken. Grains should be kept to a minimum. They should also be soaked, sprouted, and fermented like in the case of wheat. This how our ancestors used wheat and it helped break down the anti-nutrients, the harmful substances inside them. A caveat, some people are sensitive to wheat, barley, and rye and it cause further complications. Your healthcare provider should evaluate for this sensitivity. Other food sensitivities should be evaluated too especially in the case of type 1 and type 1.5. Those are autoimmune diseases and food is often the culprit. So the specific culprit needs to be found and eliminated. In addition to this, all processed foods must be removed. Simply removing simple sugars is not enough. A lot of our products have processed grains which the body digests like simple sugars. White bread and even whole wheat bread can act like sugar. It is important to check out the glycemic load with certain foods. NOT the glycemic index. Certain fruits can test high on the index but the load is low. Meaning it doesn’t raise blood sugar very high. Carbohydrates are still important but a more balanced meal is needed. We have more information on diet in other articles. Nevertheless, a competent holistic practitioner will address diet to help get the blood sugar under control as well as helping your body get the proper nutrition for healing. Thus the body heals via natural means just as nature intended.
Secondly, exercise will be addressed. Exercise is an another essential part of treating diabetes. We live in a world of convenience and it has cost us. We do not need to move as often. Due to our lifestyle strength training is one of the most beneficial in helping overcome our lack of movement. It also greatly increases insulin sensitivity. We have a plethora of articles talking about the benefits of strength training. Often you will hear that you should run, but the research shows that strength training is more beneficial. Chris Kresser has a great podcast on it. In addition to this I often recommend walking. We simply do not walk or move enough. Get out and enjoy nature. Being nature has other health benefits as well such improving our immune system. Increasing insulin sensitivity will help in reversing symptoms and leading you on the path to healing.
Lastly, supplementation. Supplementation is an important aspect. We are deficient in many nutrients. Some of these nutrients help with insulin sensitivity. Many help with other parts of blood sugar regulation. Utilizing various diagnostic tools and techniques, holistic practitioners are skilled at finding what your body needs. I will list a few that I have given to my patients. These are examples and not intended for advice. Seek out your holistic or natural medicine practitioner for what you need specifically.
- Chromium is a mineral that many of us are deficient in. It increases our sensitivity to insulin. Chromium is abundant in shellfish, broccoli, nuts, and pears. It also is available in the form of a supplementation. I often find people need this so I give them the supplement form and modify their diet to make sure they are getting this valuable nutrient.
- Berberine, often used in Chinese medicine, has anti-inflammatory and anti-diabetic effects. Cinnamon also has benefits in reducing fasting blood glucose levels.
- There may be other aspects to diabetes that need to be addressed as well. There could be poor utilization of glucose and fatty acids within the cells. Certain nutrients are crucial with making sure everything is running smoothly such as B vitamins and CoQ10.
Again this is not an exhaustive list of every nutrient or herb that may be beneficial. Other options include trying to utilize more fat for energy and intermittent fasting. There is some tremendous research going on in regards to both of them. Utilizing fat for energy has been very beneficial especially for type 1 diabetes. Fat does not need insulin like glucose does. Intermittent fasting has been shown to help regulate hormones and increase insulin sensitivity. But in the end, this is something your healthcare practitioner should go over with you.
Well I hope this helped and maybe gave you some new options in handling your healthcare! Diabetes is a prevalent disease but it doesn’t have to be for the most part. Many have had type 2 diabetes only to change their diet and exercise resolving the symptoms of the disease. There is always another way. There is always another approach. You have options. Find what works for you. You do not have to live with the status quo. Eat well. Move well. Live well.
Forouhi, Nita Gandhi, and Nicholas J. Wareham. “Epidemiology of diabetes.” Medicine 42, no. 12 (2014): 698-702. doi:10.1016/j.mpmed.2014.09.007.
Ballantyne, Sarah. Paleo Principles. Place of publication not identified: TUTTLE Publishing, 2017.