Diabetes Type II

Diabetes Type II: Overview

There are two major types of diabetes, Type 1 and Type 2.

TYPE 1, also known as Juvenile Diabetes or Insulin-Dependent Diabetes Mellitus (IDDM), is an autoimmune-related disease that usually strikes between the ages of 5 and 20 years.  In these cases, the patient does not produce enough insulin.

TYPE 2, also known as Adult Onset or Non-Insulin Dependent Diabetes mellitus (NIDDM), represents 90-95% of all diabetes, and is caused by a combination of insulin resistance (loss of sensitivity to insulin) and a relative insulin deficiency.  Physical health is key to this syndrome: 80% of sufferers are overweight and physically inactive.  This was once thought to be a middle-aged disease, but since childhood obesity has been on the rise, cases of Type 2 diabetes are being diagnosed at every age.  The majority of Type 2 diabetics are still over 55.

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A newer classification, Type 1.5, is discussed elsewhere.

Insulin resistance is also found in a variety of other common disease states including hypertension, atherosclerosis, obesity and polycystic ovarian syndrome.  In some of these conditions insulin resistance has been shown to be an independent risk factor contributing to the disease and its complications.

Incidence; Causes and Development; Contributing Risk Factors

IGT (insulin resistance) is very common in Western society, afflicting an estimated 20 million individuals in the United States alone.

IDDM occurs equally among males and females, but is more common in whites than in nonwhites.  NIDDM is more common in older people, especially older women who are overweight.  Native Americans have the highest rates of diabetes in the world.  Among Pima Indians living in the United States, for example, half of all adults have NIDDM.

Although the pancreatic beta cells of patients with NIDDM usually continue to produce insulin, for some reason the body does not respond to the insulin effectively.  Beta cells are the cells that regulate glucose levels in the body by producing insulin.  The first step towards Type 2 diabetes is insulin resistance, a condition in which the key target tissues for insulin (muscle and fat) do not respond normally to that hormone.  Both genetic traits and acquired factors (such as aging, diet and obesity) play a role in the development of insulin resistance.  Beta cells compensate for insulin resistance with increased insulin secretion resulting in hyperinsulinemia.  In this compensated, insulin-resistant state known as impaired glucose tolerance (IGT), blood glucose remains normal throughout most of the day, but may become high after meals.

Over time, beta cells are unable to continue to secrete the high levels of insulin needed to maintain normal glucose levels in the face of chronic ingestion of simple sugars and refined carbohydrates.  When this occurs, the patient develops elevated blood glucose throughout the day, indicative of Type 2 diabetes.  Progression to Type 2 diabetes occurs in approximately 7% of patients with IGT every year; the end result being the same as for insulin-dependent diabetes (IDDM) – an unhealthy buildup of glucose in the blood and an inability of the body to make efficient use of its main source of fuel.

People who have family members with diabetes (especially NIDDM), who are overweight, or who are African American, Hispanic, or Native American are all at greater risk of developing diabetes.  Interestingly, women who have given birth to a baby weighing more than 9 pounds are at increased risk, as are women who have had diabetes during pregnancy (gestational diabetes).  Even apparently healthy people, especially if they are overweight, sedentary or over 25, lose sensitivity to insulin.

Signs and Symptoms

The symptoms of NIDDM develop gradually and are not as noticeable as those of IDDM.  The main symptoms include feeling tired or ill, frequent urination (especially at night), unusual thirst, weight loss, blurred vision, frequent infections, and slow wound healing.

Diagnosis and Tests

Early diagnosis is important for this disease – one that is spiraling out of control.

Treatment and Prevention

Lifestyle options which include weight loss, rigid restrictions of grains, sugars and root vegetables along with one hour of daily aerobic activity seems to control Type 2 diabetes in a majority of people unless they have serious damage in their pancreas or insulin receptors.

Elimination of Insulin Use for Type 2 Diabetes
In the late 1990s, Dr. David Bell, a clinician and researcher in Birmingham, Alabama, wanted to see if he could eliminate insulin use in a group of people with Type 2 diabetes who were already on insulin by using a combination of oral medications.  These people had in many cases been put on insulin without first trying oral medications because today's array of medications were not available when they were diagnosed.

Dr. Bell first tested C-peptide levels and chose only those who had normal levels.  Of the 130 people with adequate C-peptide levels in his study, 100 were able to discontinue insulin use altogether and control their diabetes on various doses of glyburide and metformin.  He found that their overall control, measured by their HbA1c levels, was actually better on two oral medications than it had been previously on two daily doses of insulin.  Others in the study were able to improve their hemoglobin levels by using glyburide and metformin with a single dose of insulin at dinner or bedtime.

Researchers have determined that the Type 2 patients most likely to control their blood sugars on combination oral agents are those least overweight (with a BMI of 30 or less), with shortest duration of diabetes, and C-peptide levels normal or only slightly low.

The best prevention for any of the complications of diabetes, including leg artery disease and foot infections, is a heart-healthy lifestyle, combined with so-called "tight control" of diabetes.

Complications

Chronic complications typically take five to ten years to manifest themselves, are generally irreversible, and are predominantly caused by sustained high levels of blood glucoseDiabetes is widely recognized as one of the leading causes of death and disability in the United States, and it is associated with long-term complications that affect almost every major part of the body.  It can lead to blindness, heart disease, strokes, kidney failure, amputations and nerve damage.  Uncontrolled diabetes can complicate pregnancy, and birth defects are more common in babies born to women with diabetes.  Due to these complications, the life expectancy of a diabetic is 30-50% less than for a non-diabetic person from the time he or she is diagnosed.  People diagnosed with adult-onset diabetes before the age of 40 could expect to die eight years earlier than healthy contemporaries.

Excessively low glucose (from too much injected insulin or too little food) can cause the affected individual to lose consciousness, experience seizures or even die.

Roughly 1-in-7 diabetics develop the serious complication of chronic non-healing diabetic foot ulcers (DFUs), which precede 84% of all diabetes-related lower leg amputations.

Signs, symptoms & indicators of Diabetes Type II:

Lab Values - Common

High systolic blood pressure

Blood pressure that is consistently at or above 140/90 is a sign of Type 2 Diabetes.

Symptoms - Food - Beverages

Symptoms - Gas-Int - General

Symptoms - Glandular

Symptoms - Head - Eyes/Ocular

(Severe) vision disturbances

High blood sugar can cause two problems which affect vision, namely blurred vision and retinopathy – a disease of the back of the eye.  Blurred vision is one of the first signs of elevated blood sugar.  The shape and size of the lens in your eye changes when your blood sugar fluctuates.  This swelling of the lens can cause blurred vision.

If you notice blurred vision, you should have your blood sugar checked.  The acceptable range for fasting glucose is 80-110mg.  If your blood sugar is substantially higher or lower than the acceptable range, contact your doctor.  When your blood sugar is controlled, your vision will return to its previous state.

Symptoms - Head - Mouth/Oral

Gradual/rapid decline in speaking ability

Difficulty speaking can occur during diabetic attacks; it is a warning sign that blood sugar levels are too low.

(Slight/significant) bitter taste in mouth

The bitter taste experienced by a Diabetes patient may be due to diabetic damage to the tongue.  This 'phantom taste' may last until blood sugar levels have been normalized for a long time.

Symptoms - Metabolic

Moderate/major/very great unexplained weight gain

Weight loss can indicate uncontrolled diabetes, while weight gain suggests an increased risk of getting it.

Moderate/major/very great unexplained weight loss

Weight loss can indicate uncontrolled diabetes, while weight gain suggests an increased risk of getting it.

Occasionally/regularly/often/always feeling unusually cold

The coldness caused by diabetic hypoglycemia is usually accompanied by weakness and, in severe cases, disorientation and fainting.

Symptoms - Nails

Symptoms - Nervous

Symptoms - Reproductive - Female Cycle

(Very) long menstrual cycles

Researchers at Brigham and Women's Hospital have found that women who have long or very irregular menstrual cycles may have an increased risk of developing Type 2 diabetes mellitus.  According to the results, women whose menstrual cycles were at least 40 days long were twice as likely to be diagnosed with diabetes, compared with women whose cycles lasted 26 to 31 days, regardless of body weight.  However, the risk was even greater for obese women.  "These findings... suggest that women with this history might particularly benefit from lifestyle approaches to reduce risk, such as weight control and exercise." [JAMA, Nov 21, 2001]

Very irregular menstrual cycles

Women with long or very irregular menstrual cycles may be at increased risk of developing type 2 diabetes mellitus.

Symptoms - Sleep

Regular/frequent bizarre dreams

Diabetes disrupts REM sleep and affects the brain's ability to separate dreams from waking perceptions.

(Often) taking naps

It was reported in 2010 that a Chinese study of 19,567 people found a correlation between increased napping and increased risk of developing type 2 diabetes.  Participants reporting frequent naps (4-6 days per week or daily) were 42% to 52% more likely to have diabetes.

Conditions that suggest Diabetes Type II:

Autoimmune

Counter-indicators
Diabetes Type I

Adults who develop Type 1 diabetes, will never develop Type 2.

Counter-indicators
Diabetes Type I

Adults who develop Type 1 diabetes, will never develop Type 2.

Circulation

Coronary Disease / Heart Attack

Cardiovascular disease is the leading cause of diabetes-related death.  People with diabetes are two to four times more likely to develop cardiovascular disease.  At least 65% of people with diabetes die from heart disease or stroke.

Stroke

Cardiovascular disease is the leading cause of diabetes-related death.  People with diabetes are two to four times more likely to develop cardiovascular disease.  At least 65% of people with diabetes die from heart disease or stroke.

Poor/Slow Wound Healing

People with diabetes often have impaired wound healing.  Even a tiny sore may remain unhealed and/or infected for months or even years.  In severe cases, overwhelming infection and lack of oxygen and nutrients leads to gangrene.

Poor Circulation

Up to 50% of all people with leg artery disease have diabetes; for them, controlling both conditions is crucial.  Diabetes increases your risk for leg artery disease fourfold, and accounts for nearly half of all amputations in the U.S.  that aren't related to accidents.

Diabetes makes hardening of the arteries much more dangerous (especially in the feet and toes) through several different mechanisms, and it's still not fully understood which ones matter most.  People with diabetes are prone to nerve damage in the legs and feet, which means they often may overlook minor injuries.  This, combined with poor circulation that slows wound healing, can cause small wounds to develop into more serious infections.  Diabetes also makes people more likely to develop blockages in smaller vessels far from the heart, and those blockages tend to be more widespread and harder to treat.

Cardiomyopathy

People with diabetes have been reported to be at increased risk of being diagnosed with DCM.

Dental

Periodontal Disease - Gingivitis

If you are diabetic, you are at higher risk of developing infections, including periodontal diseases.  These infections can in turn impair the body's ability to process and/or utilize insulin, creating a vicious circle in which your diabetes may be more difficult to control and your infection more severe than in a non-diabetic.  [Journal of Periodontology November 1999]

Digestion

General

Hormones

Low Sex Drive

Lack of sexual desire can be a consequence of diabetes.

Infections

Boils, Abscesses, Carbuncles

People with certain illnesses, including diabetes, are more at risk of developing boils.

Lab Values

Metabolic

Gestational Diabetes Tendency

Previous gestational diabetes has been established as an additional risk factor for developing adult onset diabetes.

Musculo-Skeletal

Nervous System

Nutrients

Magnesium Requirement

Hypomagnesemia has been demonstrated in both insulin-dependent and non-insulin-dependent diabetic patients.  A low intake of magnesium, which is a common deficiency, has been associated with insulin resistance and diabetes in several studies.  Magnesium deficiency in diabetes is most likely the result of increased urinary magnesium losses secondary to chronic glycosuria.  However, short-term improvement in glycemic control has not been shown to restore the serum magnesium level.  Long-term studies may be needed to resolve this discrepancy.

Organ Health

Retinopathy

Diabetic retinopathy will occur in 65% of persons with type II diabetes within about 10 years of the beginning of diabetes.

Chronic Renal Insufficiency

Type II diabetes mellitus is the leading cause of chronic kidney disease, accounting for 35% of the new cases each year and 25% of all cases in the U.S.

Respiratory

Pneumonia

Diabetes is a risk factor for the development of pneumonia.

Symptoms - Glandular

Counter-indicators

Symptoms - Mind - General

(Major) mood swings

Diabetic mood swings can be caused by fluctuating blood glucose levels, or simply the frustration of dealing with the disease.

Tumors, Malignant

Pancreatic Cancer

There have been a number of reports that have suggested diabetics have an increased risk of developing pancreatic cancer.  The reasons for this are not clear.

Uro-Genital

Risk factors for Diabetes Type II:

Diet

Excess Sugar Consumption

A high-fat, high-sugar diet that contains refined flour products is probably the most important risk factor for diabetes.  Such a diet tends to be low in chromium content and also causes more insulin to be produced, which requires even more chromium.

Family History

Habits

Hormones

Lab Values - Chemistries

Counter-indicators

Laboratory Test Needed

Elevated Insulin Levels

Hyperinsulinemia and insulin resistance are both factors that increase the risk of developing type 2 diabetes.  Hyperinsulinemia often predates diabetes by several years.

Medical Procedures

Counter-indicators

Metabolic

Problems Caused By Being Overweight

Scientists have discovered a hormone that may explain the link between diabetes and obesity – a tantalizing finding that could someday lead to new treatments for the disease.  The hormone, dubbed resistin, is produced by fat cells and prompts tissues to resist insulin, the substance the body needs to process blood sugar, researchers reported in the scientific journal NatureDiabetics produce too little insulin or cannot use it efficiently.  This will probably result in new drug treatments, but emphasizes the need for weight reduction.

Hemochromatosis (Iron overload)

Iron deposits in the pancreas decrease insulin production which can lead to insulin dependent diabetes mellitusHemochromatosis is also called bronze diabetes because those sufferers with diabetes can express a bronze-colored tint to their skin.

Patients with hemochromatosis can also be diagnosed with liver disease, diabetes, heart disease and arthritis without the physician realizing that these diseases are the result of iron-overload.  Thus, the hemochromatosis might itself go undiagnosed and untreated.

Syndrome X / Metabolic Syndrome

In advanced stages of Syndrome X, when the pancreas can no longer keep up, diabetes II may develop.

Nutrients

Manganese Requirement

People with diabetes often have low manganese levels and this deficiency contributes to an inability to process sugars.  Supplementation improves glucose management in diabetics.  [Nature, 1962; 194: pp.188-89]

Personal Background

Latin / Hispanic/African ethnicity

African-Americans have higher rates of diabetes, prostate cancer, hypertension and coronary heart disease than whites.

Reproductive

Polycystic Ovary Syndrome (PCOS)

By the age of 40, up to 40% of women with PCOS will have Type II diabetes or impaired glucose tolerance.

Supplements, Medications, Drugs

Prednisone use

A side-effect of treatment with prednisone can be high blood sugar levels.

Symptoms - Environment

High air pollution exposure

Traffic fumes and cigarette smoke contain tiny, irritating particles that trigger widespread inflammation and disrupt the body's ability to burn calories for energy and control blood sugar levels.

A study of the medical records of 62,000 people in Ontario, Canada over a 14-year period found that the risk of developing diabetes rose by about 11% for every 10 micrograms per cubic meter of air of fine particles; many cities around the world have levels of 100-200.

A Swiss study found signs of significantly increased insulin resistance, hypertension, and waist-circumference in a sample of nearly 4,000 people living among dense pollution.

University of Michigan researchers in Beijing, China found during a two-year study that extreme air pollution adversely affects blood pressure (hypertension) and insulin resistance.

Symptoms - Food - General

Severe/extreme calorie restriction

Extreme calorie restriction can increase one's risk of developing serious health problems such as diabetes.

Symptoms - Food - Intake

(High) processed meat consumption

August, 2011: A study by researchers at Harvard University and published in the American Journal of Clinical Nutrition indicates that consuming red meat – in particular, processed meats – can drastically increase one's risk of developing diabetes.

The researchers examined the health records and diets of more than 440,000 men and women spanning a period of between 14 and 28 years and found that people who ate 100gm of red meat a day were 19% more likely to develop type 2 diabetes.

More importantly, processed meats such as bacon, products made from mince, and cold meats such as ham and salami, had a far greater effect: Just 50gm a day, the equivalent of two slices of bacon, one sausage or one small burger, increases the risk of developing diabetes by 51%.

There is widespread evidence that red meat drastically increases the likelihood of major health problems including heart disease, strokes and some types of cancer.  Until now, however, there has been little evidence that relatively small amounts of processed red meat could increase the chance of diabetes.

Previous research has found that just 100gm of red meat every day – or half a normal size steak – increases the likelihood of developing type 2 diabetes by 20%.

Counter-indicators
High/moderate legume consumption

A study of 9,600 Americans found that those who ate plenty of legumes were less likely to be diagnosed with diabetes.  Legumes are rich in soluble fiber, which has been shown to help improve insulin resistance, the study authors note.  [Archives of Internal Medicine 2001;161: pp.2573-8].

Symptoms - Food - Preferences

Omnivorous diet

August, 2011: A study by researchers at Harvard University and published in the American Journal of Clinical Nutrition examined the health records and diets of more than 440,000 men and women spanning a period of between 14 and 28 years and found that people who ate 100gm of red meat a day were 19% more likely to develop type 2 diabetes.

Symptoms - Muscular

Being very skinny or having excess body fat

Being too slim can actually increase our chances of developing diabetes.  In 2011 it was discovered that a gene called IRS1 – which keeps some people skinny – is linked to a raised risk of Type 2 diabetes and cardiovascular disease.

Counter-indicators
Being lean or underweight

Being slim (but not too slim), eating wholesome food, and regular exercise all lower the chances of getting diabetes.

Symptoms - Sleep

Sleeping more than necessary

An Australian study of 230,000 subjects reported in 2016 that prolonged sleep – especially when combined with a sedentary lifestyle – increases risk of premature death from diseases such as heart disease, diabetes and cancer by up to 300%.

Long-term sleep surplus

An Australian study of 230,000 subjects reported in 2016 that prolonged sleep – especially when combined with a sedentary lifestyle – increases risk of premature death from diseases such as heart disease, diabetes and cancer by up to 300%.

Uro-Genital

Consequences of Vasectomy

Diabetes is a risk factor for post-operative infection.

Diabetes Type II suggests the following may be present:

Autoimmune

Autoimmune Tendency

Type 2 diabetes is in the process of being redefined as an autoimmune disease rather than just a metabolic disorder.

Habits

Need For Routine Preventative Health Measures

Persons with diabetes must take extra care to be sure to have thorough, periodic eye exams (at least yearly), especially if early signs of visual impairment are noticed.  Anyone experiencing a sudden loss of vision, decrease in vision or visual field, flashes of light, or floating spots should contact their eye doctor right away.

Metabolic

Problems Caused By Being Overweight

Scientists have discovered a hormone that may explain the link between diabetes and obesity – a tantalizing finding that could someday lead to new treatments for the disease.  The hormone, dubbed resistin, is produced by fat cells and prompts tissues to resist insulin, the substance the body needs to process blood sugar, researchers reported in the scientific journal NatureDiabetics produce too little insulin or cannot use it efficiently.  This will probably result in new drug treatments, but emphasizes the need for weight reduction.

Nutrients

Manganese Requirement

People with diabetes often have low manganese levels and this deficiency contributes to an inability to process sugars.  Supplementation improves glucose management in diabetics.  [Nature, 1962; 194: pp.188-89]

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Diabetes Type II can lead to:

Aging

Alzheimer's Disease

According to a new study in Neurology, diabetes mellitus may not only damage the function of the eye, limbs, kidneys, and heart – it may also impair the function of the brain and hasten the process of senile dementia.

Researchers found that diabetes mellitus nearly doubles the risk of developing both vascular dementia and Alzheimer's disease, according to the Rotterdam Study, a large prospective analysis which tracked dysglycemia and dementia in over 6,000 individuals over the age of 55.  Diagnosis of diabetes was based on World Health Organization criteria using a glucose tolerance test.

A related editorial called Alzheimer's a possible "brain-type diabetes".  Besides damaging important blood vessel networks and increasing the risk of small "silent" strokes deep inside the brain, dysglycemia may be directly involved in the development of the neurofibrillary tangles, the clumping of nerves and fiber tissue inside the brain characteristic of Alzheimer's.

The researchers noted that advanced glycation endproducts (AGE), proteins damaged by chronically high blood sugar levels, are commonly found inside these tangles.  "In brains of AD patients the receptor for AGE appears overexpressed," they noted.  "Activation of this receptor leads to increased oxidative stress that may result in cellular damage."

Diabetes also disrupts insulin signaling to other cells in the body.  This altered signaling may increase the activity of a neuronal enzyme that stimulates phosphorylated tau proteins to build up, a key trigger mechanism cited as one of the earliest signs of Alzheimer's.

NOTE: This study strongly suggests the important potential role of glycation products and insulin response, not just glucose levels, in the etiology of degenerative disease.

Circulation

Poor Circulation

Up to 50% of all people with leg artery disease have diabetes; for them, controlling both conditions is crucial.  Diabetes increases your risk for leg artery disease fourfold, and accounts for nearly half of all amputations in the U.S.  that aren't related to accidents.

Diabetes makes hardening of the arteries much more dangerous (especially in the feet and toes) through several different mechanisms, and it's still not fully understood which ones matter most.  People with diabetes are prone to nerve damage in the legs and feet, which means they often may overlook minor injuries.  This, combined with poor circulation that slows wound healing, can cause small wounds to develop into more serious infections.  Diabetes also makes people more likely to develop blockages in smaller vessels far from the heart, and those blockages tend to be more widespread and harder to treat.

Diabetes Type II could instead be:

Autoimmune

Sarcoidosis

It is often difficult to diagnose Sarcoidosis as signs may mimic diabetes, hypopituitarism, optic neuritis, meningitis, tumors, or other neurologic disorders.

Recommendations for Diabetes Type II:

Amino Acid / Protein

Acetyl-L-Carnitine

The amino acid L-carnitine improves insulin sensitivity in type 2 diabetes.

Botanical

Gymnena Sylvestre

Gymnena sylvestre has been used for centuries in India to treat diabetes.  It is also useful in weight loss regimens.

American Ginseng

American ginseng may help control the blood sugar surge that generally occurs after eating.  Researchers tested the effects of American ginseng on 10 non-diabetic adults and nine adults with type 2 diabetesDiabetics experienced a significant reduction (20%) in blood glucose two hours after treatments, regardless of whether they took the herb before or during the meal.

Cinnamon

Dr. Richard A.  Anderson, lead scientist at the Beltsville, Maryland-based Human Nutrition Research Center, explained that his mostly unpublished research shows that a compound in cinnamon called methylhydroxy chalcone polymer (MHCP) makes fat cells more responsive to insulin by activating an enzyme that causes insulin to bind to cells and inhibiting the enzyme that blocks this process.

While it is too soon to recommend the spice as a regular treatment for type 2 diabetes, Dr. Anderson said patients could try adding 1/4 – 1 teaspoon of cinnamon to their food.  "The worst that will happen is it won't do any good and the best is that it will help dramatically" he stated.  [Preliminary findings announced by the USDA August, 2000]

Update, November 2003 (New Scientist):
Just half a teaspoon of cinnamon a day significantly reduces blood sugar levels in diabetics, a new study has found.  The effect, which can be produced even by soaking a cinnamon stick your tea, could also benefit millions of non-diabetics who have blood sugar problem but are unaware of it.

The discovery was initially made by accident, by Richard Anderson at the US Department of Agriculture's Human Nutrition Research Center in Beltsville, Maryland.  "We were looking at the effects of common foods on blood sugar," he told New Scientist.  One was the American favorite, apple pie, which is usually spiced with cinnamon.  "We expected it to be bad.  But it helped," he says.

Cayenne Pepper

Cayenne used topically may benefit diabetic neuropathy.

Detoxification

Supplemental Fiber

Higher fiber diets may have additional benefits for those people with diabetes, including reducing blood sugar, lowering insulin and lowering cholesterol.  Researchers studied 13 diabetes patients whose daily dietary fiber intake was 50gm and recorded reduction in total cholesterol, triglycerides, pre- and post-meal glucose levels, and measures of insulin sensitivity compared to those on a 24gm per day diet.  [Chandalia, M., et al., Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus.  N Engl J Med, 2000.  342(19): pp.1392-8.]

Vegetables, whole grains, nuts and legumes (beans and peas) remain the single best sources of fiber in the diet and – not coincidentally – these same foods are recommended as the foundation for a healthy diet for people with diabetes.

Diet

Processed Foods Avoidance

Many doctors and researchers agree that the regular consumption of tasty, mostly modern, commercially processed foods is the primary cause of adult-onset diabetes.  Consuming anything sweet, regardless of its calorific content, may be sending a signal from the mouth to the brain that more insulin is needed.

Plant-Based Nutrition

(Reuters, July 27, 2006) "People who ate a low-fat vegan diet, cutting out all meat and dairy, lowered their blood sugar more and lost more weight than people on a standard American Diabetes Association diet... They lowered their cholesterol more and ended up with better kidney function, according to the report published in Diabetes Care, a journal published by the American Diabetes Association."

Dr. Neal Barnard's team and colleagues at George Washington University, the University of Toronto and the University of North Carolina tested 99 people with type-2 diabetes, assigning them randomly to either a low-fat, low-sugar vegan diet or the standard American Diabetes Association diet.  After 22 weeks on the diet, 43% of those on the vegan diet and 26% of those on the standard diet were either able to stop taking some of their drugs such as insulin or glucose-control medications, or lowered the doses.  The vegan dieters lost 14 pounds (6.5 kg) on average while the diabetes association dieters lost 6.8 pounds (3.1 kg).  An important level of glucose control called a1c fell on average by 1.23 points in the vegan group and by 0.38 in the group on the standard diet.

High/Increased Fiber Diet

Research has shown that fiber helps to stabilize and lower blood sugar levels.  Both soluble and insoluble fibers delay the emptying of food from the stomach, slow the absorption of glucose into the bloodstream, and thus moderate insulin levels.  A diet high in complex carbohydrates and fiber helps increase tissue sensitivity to insulin, and a diet high in fiber-rich foods should also help those with diabetes to lose and maintain a healthy body weight.

Any form of fiber will be beneficial, so choose those that you most easily tolerate.  When soluble fiber ferments during digestion it produces 'short chain fatty acids' that increase the metabolism of glucose and thus may add to the beneficial effects of dietary fiber on diabetes.

Increased Fruit/Vegetable Consumption

Eating carbohydrate-containing foods, including some fruits, temporarily raises blood sugar and insulin levels.  On the other hand, a diet rich in the soluble fiber found in fruit may lower the risk of type 2 diabetes, despite the high carbohydrate content of most fruit.

High-fiber supplements, such as pectin from fruit, have been found to improve glucose tolerance in some studies.  A review of the research revealed that the extent to which moderate amounts of fiber help people with diabetes in the long term is still unknown, and the lack of many long-term studies has led some researchers to question the importance of fiber in improving diabetes.  Nonetheless, most doctors advise people with diabetes to eat a diet high in fiber.  Focus should be placed on fruits, vegetables, seeds, oats and whole-grain products.

Weight Loss Surgery

Weight loss surgery is increasingly being used to manage type 2 diabetes.  Controlling diabetes is directly related to losing weight; surgery has been shown to improve type 2 diabetes for most obese people and it can help patients normalize their blood sugar levels without diabetes medications.

Aspartame (Nutrasweet) Avoidance

The American Diabetes Association (ADA) is actually recommending this chemical poison to persons with diabetes.  According to research conducted by H.J.  Roberts, a diabetes specialist, a member of the ADA, and an authority on artificial sweeteners, aspartame:

1) Leads to the precipitation of clinical diabetes.
2) Causes poorer diabetic control in diabetics on insulin or oral drugs.
3) Leads to the aggravation of diabetic complications such as retinopathy, cataracts, neuropathy and gastroparesis.
4) Causes convulsions.

In a statement concerning the use of products containing aspartame by persons with diabetes and hypoglycemia, Roberts says: "Unfortunately, many patients in my practice, and others seen in consultation, developed serious metabolic, neurologic and other complications that could be specifically attributed to using aspartame products.  This was evidenced by:

"The loss of diabetic control, the intensification of hypoglycemia, the occurrence of presumed 'insulin reactions' (including convulsions) that proved to be aspartame reactions, and the precipitation, aggravation or simulation of diabetic complications (especially impaired vision and neuropathy) while using these products.

"...dramatic improvement of such features after avoiding aspartame, and the prompt predictable recurrence of these problems when the patient resumed aspartame products, knowingly or inadvertently."

Roberts goes on to say:
"I regret the failure of other physicians and the American Diabetes Association (ADA) to sound appropriate warnings to patients and consumers based on these repeated findings which have been described in my corporate-neutral studies and publications."

Environmental

Sunlight Exposure

October 2014: A study by scientists at Edinburgh and Southampton universities and published in the journal Diabetes has shown that moderate sunlight exposure causes the skin to release a gas called nitric oxide, which in turn helps control the metabolism and slow weight gain.  Rubbing a cream containing nitric oxide on to the skin can have the same effect.  The researchers commented, "Our observations indicate that the amounts of nitric oxide released from the skin may have beneficial effects not only on heart and blood vessels but also on the way our body regulates metabolism."

Habits

Aerobic Exercise

Aerobic exercise reduces the risk of diabetes and improves the diabetic condition through several different mechanisms.

Tobacco Avoidance

Diabetics should control blood sugar and blood pressure closely and should refrain from smoking.

Hormone

Insulin Therapy

On average, insulin is required in half of those with Type 1.5 diabetes within four years of diagnosis, compared to over ten years in those with true Type 2 diabetes.

Mineral

Chromium

Chromium combines with niacin to form Gluten Tolerance Factor (GTF), which works with insulin to help the body use glucose.  Insulin is the hormone that takes glucose from blood and puts it into cells where it is used for energy.  Chromium helps reduce the amount of insulin needed to maintain blood sugar.  Some studies report that people who have diabetes can get better glucose control by taking chromium supplements.

Chromium and GTF are used in the treatment of both hypoglycemia and diabetes mellitus, two problems of blood sugar utilization and metabolism.  Preventing chromium deficiency is the key here.  The earlier treatment is begun, especially with potential diabetes, the more helpful it may be.  Preformed GTF is not readily available, though formulas that contain all of its components seem to work better than chromium alone, and small amounts given daily have been shown to both increase glucose tolerance and decrease blood fats, both cholesterol and triglycerides, as well as to raise HDL.  Chromium also does this and has been used along with niacin (also a part of GTF) in the treatment of high blood cholesterol.

Nutrient

Alpha Lipoic Acid

Numerous additional studies have indicated that ALA is useful for the treatment of diabetes mellitus.  It stimulates increased glucose utilization in muscle cells and significantly reduces human insulin resistance.

600mg of alpha lipoic acid tid was found to improve polyneuropathy symptoms in patients with type II diabetes.  A maintenance dose as low as 100mg tid may be sufficient to provide benefits.  [Diabet Med 1999;16; pp.1040-1043]

Oxygen / Oxidative Therapies

Vitamins

Vitamin C (Ascorbic Acid)

Dr. Fred Klenner, MD has used large amounts of Vitamin C for many ailments, and says that diabetics are so deficient they should be considered as having scurvy.  10gm per day, according to Dr. Klenner, cures many diabetics and enhances their well being in other cases.

Vitamin E

In a study published in the July 11, 2000 issue of Circulation, Drs. Ishwarlal Jialal and Sridevi Devaraj found that increased inflammation caused by white blood cells – monocytes – was reduced when diabetics were given 1,200 IU per day of natural vitamin E (alpha-tocopherol) for three months.

Another study showed that vitamin E (680 IU) along with vitamin C (1200mg) will reduce the albumin excretion rate in urine which reduces the risk of end stage renal disease associated with diabetes.  [DiabetMe 2001;18: pp.756-760]

Vitamin A

Recent research shows that Type II diabetics who consumed foods high in vitamin A were the most efficient insulin users.  [Facchini, F., et al.  "Relation between dietary vitamin intake and resistance to insulin-mediated glucose disposal in healthy volunteers," Am J of Clin Nutr 63: pp.946-9, June 1996]

Vitamin Niacinamide

Niacinamide improves ATP mitochondrial production in the face of diabetogenic chemicals and thus allows insulin-producing cells of the pancreas to stay alive longer.  In one trial, newly diagnosed patients were given niacinamide at 25mg per kg of body weight.  This restored the insulin-producing cells of the pancreas in some, slowed the cellular destruction in others and left a number no longer diabetic.  Use in diabetic patients should always be monitored by a physician as insulin requirements may change.

Vitamin B3 (Niacin)

Although niacin increases low levels of high-density lipoprotein cholesterol, which frequently accompanies diabetes, past guidelines did not recommend the use of niacin in patients with diabetes because of concerns about adverse effects on glycemic control; however, this was based on limited clinical data.  A 2000 study suggests that lipid-modifying dosages of niacin can be safely used in patients with diabetes and that niacin therapy may be considered as an alternative to statin drugs or fibrates for patients with diabetes in whom these agents are not tolerated or fail to sufficiently correct hypertriglyceridemia or low HDL-C levels.  [JAMA.  2000;284: pp.1263-1270]

Preventive measures against Diabetes Type II:

Diet

Nut and Seed Consumption

A recent analysis of the well-known Harvard nurses study indicated that increased nut and seed consumption is an effective way to prevent type II diabetes.

Weight Loss

80% of diabetics are overweight.  Obesity is associated with cellular resistance to insulin, thus more insulin is required to maintain normal sugar levels.

Increased Legume Consumption

A study of 9,600 Americans found that those who ate plenty of legumes were less likely to be diagnosed with diabetes.  Legumes are rich in soluble fiber, which has been shown to help improve insulin resistance, the study authors note.  [Archives of Internal Medicine 2001;161: pp.2573-8].

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Weak or unproven link: may be a sign or symptom of; may suggest; may increase risk of; sometimes leads to; is very occasionally misdiagnosed as
Weak or unproven link:
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Strong or generally accepted link: is often a sign or symptom of; often suggests; often increases risk of; often leads to
Strong or generally accepted link:
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Definite or direct link:
is a sign or symptom of; strongly suggests
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Weakly counter-indicative:
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Strong counter-indication:
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strongly contraindicates
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Moderately useful:
often helps with; often prevents
Very useful: is highly recommended for; usually prevents
Very useful:
is highly recommended for; usually prevents