By: CLIFFORD SONNIE, M.D., M.P.H.
I got a phone call over the holidays from the friend of a friend who wanted to talk about diabetes. I took quite some time explaining simple things to do to help blood sugar but couldn’t overemphasize the need to be thoroughly tested by your family medical physician. After I hung up I thought that this would make a pretty good article. Here goes!
Twenty four million people in the US have been diagnosed with diabetes. In fact the rate of new cases has increased 65% over the past 12 years according to several studies. What causes it? Yah, you guessed it, some science. The pancreas produces insulin. When the body takes in food it is essentially broken down to sugar. The insulin allows the cells to remove the sugar from the blood so it can be utilized as fuel inside the cell. Ok, enough for the time being. There are two flavors to diabetes. The first is Type I diabetes which is usually diagnosed at a very early age and is the result of a genetic or autoimmune problem. In either case the pancreas does not produce insulin or produces too little. This is when you need to take insulin by shot. Only about 5% of all cases of diabetes start out as Type I. Type II is also known as “adult onset” or “non insulin dependent diabetes”. It comprises the remaining cases and can indeed become insulin dependent (more later). Essentially it is caused by unhealthy eating and lifestyles. In either Type the result is a higher blood sugar and can be accompanied by damage to the nervous system, the vascular system, the heart and many more problems. Diabetes is the leading cause of kidney failure, blindness and amputations due to poor circulation and nerve damage. It is also a major player in dementia, erectile dysfunction and chronic pain.
As many of us eat processed carbohydrates and more and more sugar the rate of Type II diabetes has almost doubled. Incredibly, the answer lies in the problem. Diet and lifestyle, not negotiable! Sugar is rated if you will. It is rated by a glycemic index. The higher the number, the more vigorous the pancreas will produce insulin in response to that food. Guess what the best tasting foods have as a glycemic index. You guessed it, high! After a while of eating the wrong foods, the pancreas keeps cranking out tons of insulin and the cells keep gobbling up sugar. Eventually the cells say enough already and will become resistant to the insulin and the pancreas will “burn out” and produce smaller and smaller amounts of insulin. When it produces too little, it’s now time to take insulin by shot. Now it’s not quite that simple, but I like to look at it like this as the answer to the problem is so very simple.
Ok, so what do we have to do to attack Type II diabetes? First fix the diet. The glycemic index can be found anywhere on the internet. Pick a diet low in carbs and foods that have a low glycemic index. I don’t like named diets and would prefer people to just use common sense. But if you want a diet then the Mediterranean or Atkins diet is acceptable. Both, and common sense diets too, will emphasize veggies, fruits, and proteins like fish poultry and very lean meats (know where they come from). Likewise processed grains should be all but eliminated. You can get your carbs from other places like fruits and veggies. Bottom line, stay away from the high glycemic, glucose spiking carbs in processed and starchy foods. I give something to all my patients. It states that in a perfect world 1/3 of calories should each come from fats, proteins and carbs. If you want to lose weight or are a diabetic, cut down the carbs and increase the fats and proteins proportionately.
This brings us to weight. Lose weight and the diabetes will improve. How do you do that? Change the diet and exercise. Now what if you are thin and have Type II diabetes? Doesn’t matter. In either case, change the diet. Get your calories from fats and proteins and low glycemic index carbs rather than the processed carbs.
Next is what goes in must go out. Get off your duff and move. You don’t need insulin to burn blood sugar as long as you exercise. Do a combination of aerobic and anaerobic exercise. Namely, do endurance as well as resistance stuff. You don’t need to join a gym. Push ups and sit ups are free. Work around the house and walk to the bank instead of drive. You will see results!
Additionally supplements will and do help. I am not saying to stop any medications that your doctor has put you on. Just be aware of potential side effects. In many cases I agree to start traditional treatments but I also look at them as rescue medications, not medications to take until you leave this earth. Anyways, there are supplements that will help. Vanadyl sulfate, chromium, alpha lipoic acid, cinnamon and Gymnema to name a few. Now, don’t go buy a boat load and gobble them down. Remember everything in moderation. (Didn’t I say that before?). Likewise keep a check on your blood sugar. I don’t recommend a daily log as anyone’s sugar will fluctuate. Even a person without diabetes will have an occasional high blood sugar depending on diet, etc. Don’t agonize over that. Instead watch something called hemoglobin A1C (HbA1c) levels. This gives you an average over the past couple months. That’s what we wanted to bring down in the first place isn’t it?
Anyways, diet, exercise and certain supplements can and have been very effective in the treatment of diabetes. And as I’ve said before, everything in moderation. As always, don’t stop any medication that your physician has placed you on without speaking to them. So talk to your family MD or DO or stop by and we can talk. After all the smart health care consumer is informed and aware.
Clifford M. Sonnie, M.D. is the Medical Director at the Balance of Life Clinic