Diabetes: Cause and Cure on the End of Your Fork
There are not many situations where the cause and the cure are wrapped in the same package, but when it comes to diabetes, the foods we consume are both the cause of diabetes and the cure for it. Yet the diabetes statistics continue to soar. No one would argue that we have got to do better with preventing and curing diabetes. 1.5 million Americans are diagnosed every year. In 2015, 84 million Americans 18+ had prediabetes. Diabetes still contributes to over 250,000 deaths each year. These are staggering numbers for a disease process that is so well understood and so simple to reverse.
Preventing and curing Type 2 Diabetes (and in some cases Type 1 Diabetes) is actually quite simple. So why do the rates of diabetes continue to climb and associated diseases continue to destroy the health of millions? Well, simple does not mean easy. When it comes to food related diseases, things get complicated. America’s relationship with food is complicated. Not only are many of the foods we commonly consume addictive in nature, therefore increasing our cravings for them, but reversing Diabetes requires behavior change and humans in general do not have a great track record with that. In addition, our chronically tired, stressed, inactive, but overly scheduled lives leave us depleted of energy and nutrients needed to do the hard work of behavior change. So although reversing diabetes is as simple as moving your body, supplementing strategically, and eating appropriately, we recognize it isn’t always easy and standard treatment doesn’t always give you the right tools and the full support you need to reverse it. A functional medicine approach to diabetes can give you what you need to be successful.
What is Diabetes?
Although a household name, many people still do not really understand exactly what is happening with Diabetes, so let’s break it down. For the purposes of this article, we will be addressing only Type 2 Diabetes. At it’s core, diabetes is an inflammatory disease that creates a maladaptive metabolic process primarily based on the body’s response to foods eaten. Here is a more indepth look at diabetes and inflammation that is important in fully understanding Diabetes, but beyond the scope of this article.
Diabetes is characterized by high blood glucose (blood sugar) meaning too much glucose circulating in your blood that should be in your cells. Insulin is produced by the pancreas when carbohydrate food is eaten and the body requires insulin to get glucose from your blood to the cells. Insulin is like the “key” that unlocks the door for glucose to get from the blood into the cells. However, this process goes awry in the presence of prolonged overeating, weight gain, and systemic inflammation and you develop diabetes. When you consistently over eat, and eat high levels of carbohydrate foods, excess insulin is produced. The cells protect themselves from too much glucose entering, by decreasing the number and sensitivity of the insulin receptors to glucose. Think about like this: insulin is turning the key to the door to let glucose in, but the cell is saying, we’re all full, go away, so it doesn’t answer. This leaves excess glucose circulating which signals the pancreas to make more insulin. When too much insulin is circulating, this gets stored as fat. Excessive fat storage creates more inflammation, and the cycle continues. Increased insulin is a primary risk factor for cardiovascular, neurological and endocrine diseases.
Excess glucose puts strain on the insulin receptors, and as the insulin receptors wear out or shut down, excess glucose and insulin are now present. This creates inflammation throughout the whole body. Brain, kidney, eye, and nerve damage are associated with diabetes because of the inflammation that is created from high glucose levels and insulin resistance.
Another issue of concern is “double diabetes, ” where there is beta cell insufficiency, like with Type 1 Diabetes, and insulin resistance, like in Type 2 Diabetes, at the same time. The beta cells of the pancreas wear out and it can no longer produce the insulin needed to control blood sugar. While at the same time, the insulin receptors wear out and cannot adequately get glucose from the blood to the cells. This occurs in Type 2 diabetics who do not control blood sugar well and essentially wear out the pancreas, requiring them to take insulin like a Type 1 diabetic. The same can happen for a Type 1 Diabetics who just keep increasing insulin dosage, gain weight, and do not control blood sugar with diet and exercise. The excess use of insulin and weight gain, causes insulin resistance, which in the presence of no beta cell function by the pancreas (Type 1 diabetes), is double diabetes.
Symptoms of Diabetes
Many people live with years of high blood sugars causing inflammation and organ/tissue damage before they actually “feel” high blood sugar. This is why routine lab testing is important for prevention. However, there are symptoms to watch out for:
- Increased thirst
- Trouble concentrating
- Blurred vision
- Increased frequency of urination
- Weight loss (does not occur in most type 2 diabetes)
Complications of Diabetes
The complications associated with diabetes are essentially endless because of its basis in inflammation which can affect every system of the body, but most common is a significantly increased risk for heart disease. Nerve damage is also quite common with uncontrolled blood sugars. The inflammation damages nerves and they simply die leaving people with decreased feeling in hands and feet. Wound healing is also compromised in diabetes. This combination of nerve damage and poor wound healing too often leads to amputation of toes, feet, and even legs. Poorly controlled blood sugar affects every system of the body and is incredibly taxing on the body. Good blood sugar management is recommended for people who are not even diabetic because optimal blood sugar decreases inflammation so substantially through the whole body.
The textbook risk factors for diabetes are being overweight and inactive, but many people overlook the effect of systemic inflammation on their increased risk for diabetes. It is important to note that inflammation causes diabetes and diabetes causes inflammation, so the risk factors compound when other inflammatory disease processes are occurring.
- Overweight: a key player in developing insulin resistance which leads to diabetes
- Inactive: exercise increases the body’s sensitivity to insulin so the pancreas does not have produce as much.
- Nutrient poor foods: nutrient poor foods, or filler foods, are most often high in carbohydrate and low in minerals
- Nutrient deficiencies: low magnesium, chromium and essential fatty acids are linked to increased risk for diabetes
- Other chronic inflammatory disease: Up to one third of people with hepatitis C develop diabetes. Inflammatory based diseases like rheumatoid arthritis, Chronic Fatigue, etc, are all at higher risk.
Lab Testing for Diabetes
Lab testing is relatively straight forward for diagnosing diabetes, but catching small shifts in how the body is processing glucose can prevent it from developing. There also may be additional labs a functional medicine doctor will consider that a conventional doctor may not
These are the most basic diabetes labs used for diagnosis:
Fasting blood sugar > 125
Random, non-fasting blood sugar > 200
Hemaglobin A1C > 6.5%
Your personalized plan will determine if glucose monitoring at home after meals (postprandial) is needed and most work with an MD to get glucose testing supplies at lower cost or covered by insurance. Although home glucose monitoring is not the only lab value that needs to be monitored, is is very helpful data for the practitioner, as well as for the patient in understanding how food, exercise and supplement plans are affecting blood sugar levels.
However, looking for more and looking for it earlier is needed. Early markers include mild elevations in glucose and insulin, high triglycerides, low HDL cholesterol, high LDL cholesterol, increased insulin, increased c-peptide levels, and levels of Pancreatic Islet cells.
The above tests will give not only a clear picture of the severity of diabetes if present, but also can detect the development of diabetes before it meets standard diagnostic criteria. Regardless of where you land in the severity when lab testing is done, diabetes continues to be mostly reversible with supplementation, diet and activity changes.
Your functional medicine practitioner will most likely dig deeper than only looking at glucose related labs and desire to see what is occurring with cardiovascular risk as well as total body inflammation, therefore more labs may be recommended. Although they may not be directly related to diabetes, they are very important pieces of information in managing the damage the high glucose does in the entire body.
The standard of care for diabetes continues to start with diet and exercise, but then progresses to oral medications. Then if glucose is not managed, insulin is used. Far too many Type 2 diabetics are now treated with insulin because conventional diet, lifestyle, and oral medications do not work effectively. It is important to remind that using insulin to manage blood sugar will always create inflammation, leads to weight gain and continues a very slippery slope of other health risk factors.
The conventional diet recommendations are usually to meet with a dietitian to learn carbohydrate counting. Here are where the idea to manage with food intake instead of medication is spot on, but the methodology falls short. Many hospital dietitians prescribe far too high a carbohydrate amount and do not take into consideration the type or nutrient density of the carbohydrate source, therefore communicating to people that an apple is the same as a piece of white bread. This is true in the most basic sense of they are both 15g of carbohydrate, but the way an apple is processed by the body, and what it contributes to health is vastly different than a piece of white bread. Additionally, there is no effort to detect or replete nutritional deficiencies or address gut related issues that may be occurring and contributing to inflammation.
Functional Medicine Approach to Diabetes
The laboratory approach to diabetes is outlined above, but ongoing monitoring of inflammatory markers, glucose markers, and other chronic disease markers are all part of the functional approach to diabetes. The main elements of a root cause approach to diabetes lies in labs, food, exercise and supplements. The specific plan for you is determined by your functional medicine practitioner and will differ for each person’s unique situation.
Low Carbohydrate, Nutrient Dense Eating: Food is the way out of diabetes. It is not possible to reverse diabetes and not address nutrition and food intake. Your specific carbohydrate amount, types of carbohydrates to include in your diet, and safe sugar alternatives will be determined based on your specific needs with your functional medicine team. Here are a few key elements that are part of most all food plans for diabetes.
- Limit total carbohydrate intake to 75-100g daily for most people
- Work with dietitian on meal spacing/timing
- Focus on carbohydrates coming mostly from vegetables, legumes, and low glycemic fruits
- Limit or eliminate all refined starches and processed sugar
- Increase nutrient density of foods by following a Plant Dominant Paleo eating approach
- Choose organic produce and grassfed/pastured/wild caught proteins whenever possible
- Daily Movement: movement is paramount to optimal diabetes management. There is no substitute for the increase in efficiency of the glucose and insulin process during and after exercise. The type of movement that will be best for you to avoid injury and prevent adding stress to the body will be determined by your functional medicine team.
- Supplementation: like any good functional medicine plan, your supplements are designed based on your specific needs. However, there are key areas of supplementation that are common in managing diabetes
- Protein shake such as Opti-Metabolix 2:1 is a pea protein based shake used to support optimal glucose control. It contains specific types of polyphenols, cinnamon, b-vitamins, alpha lipoic acid, protein and carbohydrate uniquely designed to promote great blood sugar control during meals and through the day. This is often used 20-30 minutes prior to a meal to support the blood glucose levels around well designed food choices.
- Anti-inflammatory herbs and essential fatty acids
- Vitamin/mineral support for areas of deficiency as well as optimization specific to diabetes such as Chromium, B-vitamins, Vitamin D, Magnesium and Zinc.
There is no one supplement regimen for every person who has diabetes. The underlying cause of inflammation and your body’s specific weak areas are unique to you and need a plan that is unique to you.
At its core, (Diabetes is an inflammatory disease. It is part of the larger story of your past, current and future inflammation story. We live in a culture that is primed for diabetes considering chronic stress, poor food choices, sleep deprivation, and lack of movement. The start of this article addressed diabetes being simple to reverse, but not necessarily easy. This is because of the lifestyle changes that are required in preventing and reversing diabetes. Most of us know at least part of what we need to do to improve our health, but few are able to implement it long term. This is the main reason diabetes management needs a functional medicine team. Functional medicine is a whole body, whole person solution to your health needs. Diabetes is preventable and reversible. You do not have to live on medications with unwanted side effects or continue to promote inflammation by poorly managed insulin usage. You can have energy again and preserve your health for years to come.
LifeWorks Integrative Health is your solution to getting to the root cause of your condition. Our functional medicine practitioners focus on inflammation causing triggers that lead to chronic degenerative disease.