Information About Diabetes
Diabetes Mellitus (DM) is a disease that occurs when your body doesn't make enough insulin or doesn't use insulin the right way. Insulin is a hormone that helps your body use sugar (glucose) for energy. Because your body has a problem with insulin, your blood sugar builds up. Your body can't use it for energy, average blood glucose levels rise (hyperglycemia) and some of the sugar is urinated out of your body.
Three Types of Diabetes
There are three main types of diabetes. These are:
- Type 1 (also called insulin-dependent and previously called juvenile diabetes). Type 1 diabetes develops most often in children and young adults. It is treated with insulin.
- Type 2 (also called noninsulin-dependent, or adult-onset). Type 2 diabetes is much more common and usually develops in older adults. It is now being found at younger ages and is even being diagnosed among children and teens.
- Gestational (pregnancy-related). Some women develop diabetes during pregnancy. Although it goes away after pregnancy, these women have a higher risk for developing type 2 diabetes later in life.
The information about diabetes on this page will focus on Type 2 diabetes.
How Common Is Diabetes?
According to the Centers for Disease Control:
- Seventeen million Americans have diabetes. There are 5.9 million Americans who are unaware that they have the disease.
- It is the 6th leading cause of death in the United States. Over 200,000 people die each year of related complications.
- Among U.S. adults, diagnosed diabetes increased 49% from 1990 to 2000. Similar increases are expected in the next decade and beyond.
What Causes Type 2 Diabetes?
The most common causes for Type 2 diabetes are poor diet, lack of exercise, and insulin resistance. Insulin resistance is something you can acquire. Insulin resistance means that the cells in your body aren't sensitive enough to react to the insulin produced by your pancreas. Because the cells need sugar for fuel, the pancreas works overtime to make more insulin—enough to overcome the insulin resistance and carry sugar into your cells where it can be burned for energy.
No one knows if obesity causes insulin resistance, if insulin resistance causes obesity, or if they develop independently. We do know that insulin resistance is aggravated by obesity—particularly the type where your weight collects around your middle (like an apple). Physical inactivity also aggravates insulin resistance. Eating too much dietary carbohydrate most likely plays a large role in causing insulin resistance.
Over time, the pancreas "wears out" and can no longer pump out enough insulin to overcome the insulin resistance. When this happens, you get Type 2 diabetes.
What Are the Risk Factors for Type 2 Adult Diabetes?
- Being more than 20% overweight
- Physical inactivity
- Having a first degree relative with diabetes (parents or siblings)
- Certain ethic groups have a higher risk of diabetes, including: African American, Native American, Latin American, Asian American, Pacific Islander
- Having a history of gestational (pregnancy-related) diabetes or giving birth to a baby which weighed more than 9 pounds
- Having a history of hypertension (high blood pressure)
- Having a high fasting blood sugar or an impaired glucose tolerance on previous blood tests.
- Having Triglycerides (a lab measure of fats in the blood) which are more than 250 mg/dl
- Having HDL cholesterol ("good" cholesterol ) which is less than 35 mg/dL.
What Are the Symptoms Adult Diabetes?
A person might have SOME or NONE of the following diabetes symptoms:
- Frequent urination
- Excessive thirst
- Unexplained weight loss
- Extreme hunger
- Sudden vision changes
- Tingling or numbness in hands or feet
- Feeling very tired much of the time
- Very dry skin
- Sores that are slow to heal
- More infections than usual.
People who think they might have diabetic symptoms should visit a physician for diagnosis.
Complications of Diabetes
It has many serious complications, which are preventable with proper treatment. These complications include:
- Eye disease and blindness. Each year, 12,000–24,000 people become blind because of diabetic eye disease, including diabetic retinopathy. Screening and care could prevent up to 90% of diabetes-related blindness.
- Kidney disease. About 38,000 people with diabetes develop kidney failure each year. Treatment to better control blood pressure and blood glucose levels could reduce diabetes-related kidney failure by about 50%.
- Diabetic neuropathy. Damage to nerves from high blood sugar may cause numbness, tingling, and paresthesias in the extremities and, less often, debilitating, severe, deep-seated pain and hyperesthesias.
- Amputations. About 82,000 people have diabetes-related leg and foot amputations each year. Foot care programs that include regular examinations and patient education could prevent up to 85% of these amputations.
- Cardiovascular disease. Heart disease and stroke cause about 65% of deaths among people with diabetes. These deaths could be reduced by 30% with improved care to control blood pressure and blood glucose and lipid levels.
- Pregnancy complications. About 18,000 women with preexisting diabetes deliver babies each year, and an estimated 135,000 expectant mothers are diagnosed with gestational diabetes. These women and their babies have an increased risk for serious complications.
- Flu- and pneumonia-related deaths. Each year, 10,000–30,000 people with diabetes die of complications from flu or pneumonia. They are roughly three times more likely to die of these complications than people without diabetes.
How Is Diabetes Diagnosed?
It is diagnosed by lab test results plus symptoms. Screening is done routinely, and diabetes without symptoms may be diagnosed based on lab tests alone.
- Fasting blood glucose level of greater than 125 mg/dL on two occasions in an adult or child.
- An oral glucose tolerance test (OGTT) may be helpful in diagnosing type 2 DM in patients whose fasting glucose is between 115 and 125 mg/dL (people with "impaired" glucose tolerance) and in those with a clinical condition that might be related to undiagnosed DM (eg, polyneuropathy, retinopathy).
- Lab tests that may be used for monitoring diabetes and risk
of heart disease include
- Hemoglobin A1C, which is a measure of blood sugar control in the previous 1-3 months. This test is an indirect measure of average blood glucose levels.
- Fructosamine, which is a measure of blood sugar control within the previous 1-3 weeks. This test is an indirect measure of average blood sugar levels.
- Fasting serum insulin, which measures insulin levels in the blood.
- Blood lipids: cholesterol, including HDL "good" cholesterol, and LDL "bad" cholesterol, and triglycerides.
- Other markers for risk of heart disease, including: cardio CRP, lipoprotein (a), and/or homocysteine.
Conventional Treatment
- Oral Antidiabetic Drugs.
- Sulfonylureas (e.g glyburide) lower plasma glucose primarily by stimulating insulin secretion.
- Biguanides (e.g. Metformin) act by decreasing the liver's glucose production and may improve insulin sensitivity in those who lose weight.
- Alpha glucosidase inhibitors ( e. g. Acarbose) delay carbohydrate digestion in the small intestine (by inhibiting enzymews which do this) and subsequent absorption, resulting in less postprandial elevation of blood glucose levels
- Thiazolidinediones (e.g. troglitazone ) are insulin-sensitizer drugs that improve insulin sensitivity in skeletal muscle and suppress hepatic glucose output. Only used in combination with other medications.
- Nonsulfonurea meglitinides (e.g. repaglinide) Similar in action to sulfonureas, but used in poeople with sufa sensitivity.
- Insulin.
- Medications to manage elevated blood lipids or hypertension are also often used.
- Many of the above medications have significant side-effects and/or liver toxicity.
Natural or Alternative Treatment
Natural treatment (or prevention) of diabetes includes many factors. Note: because natural treatment can drastically affect blood sugar levels, you should make these changes only with physician supervision. Your medication needs may change and blood sugar and medication levels must be closely monitored.
Lifestyle. Exercise and weight reduction have been shown to be highly beneficial. Exercise helps reduce weight, lower blood sugar, improve insulin sensitivity, improve immune system, improve circulation, lower blood pressure, lower LDL ("bad") cholesterol, raise HDL ("good") cholesterol, and reduce risk for heart disease.
Diabetes Diet. A diabetic diet will reduce blood sugar, reduce insulin levels, and reduce the need for medications. A diabetic diet plan includes a low glycemic index, low simple carbohydrate, moderate protein, high fiber diet. This diabetic diet also helps to reduce weight, reduce blood pressure and support overall health and energy. (Note: you should never adjust your medications without direct supervision of your physician.).
Education. One of the main principles of naturopathic medicine is education. Your doctor can also provide you with sample diabetic recipes and menus, suggestions for diabetic desserts, and other helpful information.
Nutritional Therapy. There are a variety of nutritional therapies which may be helpful. Nutritional therapies can help to lower blood sugar and insulin levels, reduce cholesterol levels, reduce triglyceride levels, reduce blood pressure, improve energy, and reduce risk of heart disease. Nutritional supplements can also be used to protect your tissues (eyes, kidneys, blood vessels) from the damage of diabetes.
Herbal Therapy. A variety of herbal therapies may be considered. The goal of herbal medicine might include: reduce blood sugar levels, support your immune system, protect your heart, and stabilize and strengthen circulation.
How Can Diabetes Be Prevented?
Diabetes can be prevented. If you have a family history of diabetes, have "impaired" glucose tolerance, or are otherwise at risk for or concerned about diabetes, you should start now with a plan to reduce your risk. Most important are dietary changes which can help to regulate blood sugar and insulin levels. A number of studies have shown that regular physical activity can significantly reduce the risk of developing type 2 diabetes. Nutritional supplementation which supports healthy glucose tolerance may also be recommended.
What Should You Do Next?
The doctors at The Connecticut Center for Health are very experienced in the treatment of diabetes. If you have (or suspect you have) diabetes symptoms and want to learn more about natural treatments for this condition, we recommend that you contact one of our clinics for a free consultation about diabetes or an appointment.
