A Natural Approach to Diabetes - Brief Article

Townsend Letter for Doctors and Patients,  Jan, 2002  by Farhang Khosh, Dr.

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Diabetes is defined as a disorder of carbohydrate metabolism caused by absence or deficiency of insulin, insulin resistance, or both, ultimately leading to hyperglycemia. People with diabetes cannot properly process glucose, a sugar the body uses for energy. As a result, glucose stays in the blood, causing blood glucose to rise. At the same time, however, the cells of the body are starved for glucose. Diabetes mellitus is typically classified into two subtypes: type-I or insulin-dependent diabetes mellitus (IDDM), and type-II or non-insulin-dependent diabetes mellitus (NIDDM). Type-I is called juvenile onset diabetes, and type-II is called adult-onset diabetes. In IDDM, the pancreas can't make the insulin needed to process glucose as a result of destruction to islet cells of the pancreas which secretes insulin. With NIDDM, the pancreas makes enough insulin, but the body has trouble using it. Type-I and II are differentiated on immunological-etiological grounds with type-I referring to an immune-mediated condi tion, whereas type-II is non-immune-mediated. Diabetes mellitus (DM) is a common disease affecting an estimated 4% of the population of which 90% of them are NIDDM, and is highly associated with western, industrialized cultures in which the refined and processed, rich, fiber-depleted diets are found there. Although hereditary predisposition, viral and bacterial affliction of the pancreas, and auto-antibodies have their effect on the pancreatic islets and contribute to the development of this disease, diet, lifestyle, and obesity are by far the most significant risk factors for the development of diabetes.

Signs and symptoms of DM -- Frequently asymptomatic; polyuria, polydipsia, weight loss, glucosuria, and dehydration. The serious complications include diabetic nephropathy leading to kidney failure and need for dialysis, retinopathy leading to blindness and poor healing of ulceration of the feet leading to gangrene and amputations.

Treatment -- In treatment of type-II DM diet is of utmost importance and can be very successful in its control. The focus is on eating High Complex Carbohydrate, High Fiber diet (HCF). (1) The HCF recommends 70-75% of calories come from complex carbohydrate, 15-20% from protein, and 5-10% from fat. The carbohydrate portion of this diet must be very best quality and does not include sugar or processed starches. This high fiber diet is highly recommended for diabetes. Guar gum and pectin fiber has also been shown to have a positive effect on blood sugar control. One study found consuming up to 26 grams of guar gum per day resulted in a lowered insulin requirement and a reduced amount of sugar spilled over into the urine.

Dietary Recommendation

* Increase cereal grains like oats that are high in soluble fiber

* Increase legumes like lentils, peas, and navy beans which are high in soluble fiber

* Increase root vegetables like yams

* Increase fresh organic vegetables

* Include onions and garlic on a daily basis

* Avoid simple sugars, but whole organic fruit like pears and green apples are good

* Decrease fat, avoid margarine because of trans fatty acids

* Avoid highly processed foods and flours

Specific nutrient supplementation

Chromium -- An essential micronutrient that functions as a cofactor in all insulin-regulating activities. Despite 40 years of research on the potential role of chromium in carbohydrate and lipid metabolism, significant progress has only recently been made regarding the mode of action of chromium at a molecular level. The oligopeptide low-molecular-weight chromium-binding substance (LMWCr) may function as part of a novel insulin-signaling autoamplification mechanism. This proposed mechanism sheds some light on the potential of chromium in the treatment of NIDDM. (2) Chromium is part of the glucose tolerance factor. Double blind research shows that chromium supplements improve glucose tolerance in people with both NIDDM and IDDM, apparently by increasing sensitivity to insulin. (3)

Niacin -- Is a component of the glucose tolerance factor. (4)

Selenium -- May protect against retinopathy. Maintaining proper selenium levels appear, to be especially important as the antioxidant enzyme glutathione peroxide requires selenium to detoxify free radicals. It has been shown that patients with diabetes have pronounced decreased selenium concentrations in erythrocytes as compared to controls. (5)

Magnesium -- Is essential for glucose homeostasis, and it is a co-factor in glucose transport and regulates energy production in liver mitochondria. A tendency for magnesium deficiency in patients with diabetes mellitus is well-established. The plasma magnesium level has been shown to be inversely related to insulin secretion in patients with type II diabetes. (6) Hypomagnesemia is most pronounced in patients with the most severe retinopathy. (7)

Vitamin B6 -- As the coenzyme pryidoxal phosphate, B6 plays an important role in the metabolism of carbohydrates, therefore B6 has been associated with impairments in gluconeogenesis and abnormal glucose intolerance. (8) B6 prevents diabetic neuropathy and inhibits glycosylation. Many diabetics have low blood levels of B6. (9) Levels are even lower in diabetics with nerve damage. (10). The clinical response to therapeutic doses of B1 and B6 were determined in diabetic patients with clinical symptomatic peripheral neuropathy after four weeks of treatment. The results showed that pain reduced in 88.9%, numbness in 82.5%, paresthesia in 89.7% and signs of peripheral neuropathy decreased in 48.9% of patients. (11)