Diabetes Type II

Diabetes Type II: Overview

Alternative names: Adult Onset Diabetes, Non-Insulin Dependent Diabetes Mellitus (NIDDM)

Type 2 Diabetes is a metabolic disorder that leads to sugar (glucose) accumulating in the blood rather than being used as fuel by cells in the body.  It is caused by a combination of insulin resistance (loss of sensitivity to insulin) and insulin deficiency.  Over time, elevated blood sugar levels can lead to very serious complications.

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Type 2 Diabetes represents some 90-95% of all diabetes cases.  The other main type of diabetes is Type 1 Diabetes, also known as Juvenile Diabetes or Insulin-Dependent Diabetes Mellitus (IDDM), in which the body does not produce enough insulin.  This is an autoimmune-related disease that usually strikes between the age of 5 and 20 years.

A third and newer type of diabetes, unofficially classified as Type 1.5 Diabetes, has features in common with both Type 1 and Type 2 diabetes.

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

Type 2 Diabetes was once thought to be a disease of middle age, but with childhood obesity being on the rise, cases are being diagnosed at every age.  The majority of Type 2 diabetics are still over 55.  About 1-in-4 people with Type 2 Diabetes are unaware that they have it.

Impaired glucose tolerance and insulin resistance is very common in Western society, afflicting tens of millions of individuals in the United States alone.

Type 2 Diabetes 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 it.

Highly magnified cell showing insulin, receptors, and glucose
Insulin (yellow) attaches itself to insulin receptors (green) on cells and acts as a 'key' to allow glucose (blue) in.

Foods containing carbohydrates and sugars are broken down into glucose, which is an important source of fuel for our bodies.  Insulin, which is produced by the pancreas, is a chemical messenger (hormone) that facilitates the entry of glucose molecules into our cells, where they are used as fuel.  Insulin is released into the bloodstream when blood sugar levels begin to rise, triggering cells to remove glucose from the blood.

In Type 2 Diabetes, our muscle, fat, and liver cells become resistant to insulin and start to ignore its message to absorb glucose.  As this insulin resistance (IR) increases, the pancreas is unable to produce enough insulin to trigger these cells to accept the glucose, which now remains in the bloodstream.

Both genetic traits and acquired factors such as aging, diet and obesity play a role in the development of insulin resistance.  The pancreas compensates for insulin resistance with increased insulin production, resulting in hyperinsulinemia.  In this compensated, insulin-resistant state known as impaired glucose tolerance (IGT), blood glucose levels remain normal throughout most of the day, but may become high after meals.

Over time, the pancreas is unable to continue to secrete the high levels of insulin needed to maintain normal glucose levels in the face of continued 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 an unhealthy buildup of glucose in the blood and an inability of the body to make efficient use of its main source of fuel.

Physical health is key to this syndrome: 80% of sufferers are overweight and physically inactive.  In addition, people who have family members with diabetes (especially Type 2), or who are African American, Hispanic, or Native American are at greater risk of developing Type 2 Diabetes.  Interestingly, women who have given birth to a baby weighing more than 9 pounds are also 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 Type 2 Diabetes develop gradually and are not as noticeable as those of Type 1 Diabetes.  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.

The first step is to test for glucose in the urine.  It is not normally present, but in diabetics it can overflow through the kidneys and into the urine.

HbA1c testing device with built-in small screen and printer
HbA1c testing device with on-screen readout and printed result.

If glucose is found in the urine then a blood test known as glycated hemoglobin (HbA1c) can be used to determine whether the patient has diabetes.  In diabetics, this test also shows how well the diabetes is being controlled.

Diabetics are advised to have the HbA1c test at least twice a year in order to make sure the methods used to control the diabetes are working.

A common but less useful test is the Glucose Tolerance Test (GTT), also known as an Oral Glucose Tolerance Test (OGTT), which can show if the body is having problems processing glucose.  This requires that the patient not eat and drink certain fluids for 8-12 hours before the test.

Treatment and Prevention

Aside from those recommendations listed below, lifestyle changes which include weight loss, rigid restriction of sugars, replacing refined-grain foods by whole-grain foods, and 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.

The best prevention for 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 glucose.

Diabetes is widely recognized as one of the leading causes of death and disability in the United States, and 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 Type 2 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 14090 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.

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.

Dental / Oral

Digestion

Eyes / Ocular

Retinopathy

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

Infections

Boils, Abscesses, Carbuncles

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

Metabolic

Gestational Diabetes Tendency

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

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

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.

Sleep

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.

Risk factors for Diabetes Type II:

Circulation

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.

Family History

Female-Specific

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.

Glandular

Habits

Lab Values - Chemistries

Counter-indicators

Lab Values - Nutrients

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.

Syndrome X / Metabolic Syndrome

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

Organ Health

Gallbladder Disease

Factors that increase the risk of developing gallstones include diabetes, and being overweight, obese or pregnant.

Personal Background

Latin / Hispanic/African ethnicity

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

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 - Beverages

Sugar-free soft drink/high low-calorie soda consumption

2016: Studies found that drinking just 2 diet drinks a day more than doubled the risk of developing diabetes and drinking 5 or more sugar-free drinks a day increased the risk by 4.5 times.

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 large 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.

September, 2017: A further study analyzing 63,257 subjects and published in the American Journal of Epidemiology reported that those eating the most red meat have a 23% increased risk of developing Type 2 Diabetes, and those eating the most dark poultry meat are at 15% increased risk.

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%.

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%.

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.

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.

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.

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.

Male-Specific

Consequences of Vasectomy

Diabetes is a risk factor for post-operative infection.

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 the Rotterdam Study of 6,370 subjects over age 55, diabetes mellitus may not only damage the function of the eye, limbs, kidneys, and heart – it also appears to impair the function of the brain and hasten the process of senile dementia. [Neurology. 1999 Dec 10;53(9): pp.1937-42]

The researchers found that diabetes mellitus nearly doubles the risk of developing both vascular dementia and Alzheimer's disease.  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 end products (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.

Cardiomyopathy

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

Dental / Oral

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]

Lab Values

Reproductive

Low Sex Drive

Lack of sexual desire can be a consequence of diabetes.

Respiratory

Pneumonia

Diabetes is a risk factor for the development of pneumonia.

Sleep

Urinary

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 / Herbal

Cinnamon

New Scientist reported in November, 2003 a study that found just half a teaspoon of cinnamon a day significantly reduces blood sugar levels in diabetics.  The effect, which can be produced even by soaking a cinnamon stick tea before drinking, 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 Dr. Richard A. Anderson, lead scientist at the 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.

Dr. Anderson explained that his 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.

It seems that cinnamon may help lower blood sugar levels and thereby combat diabetes by imitating the effects of insulin and increasing glucose transport into cells [J Am Coll Nutr. 2001 Aug;20(4): pp.327-36].  It can also lower blood sugar levels by increasing insulin sensitivity, making insulin more efficient at moving glucose into cells.

One study of seven men showed taking cinnamon increased insulin sensitivity immediately after consumption, with the effect lasting at least 12 hours [Diabetes Obes Metab. 2007 Nov;9(6): pp.895-901].  In another study, eight men demonstrated increases in insulin sensitivity following two weeks of supplementing with cinnamon [Eur J Appl Physiol. 2009 Apr;105(6):969-76].

A review of 543 people with type 2 diabetes found that taking cinnamon was associated with an average fasting blood sugar level decrease of over 24 mg/dL (1.33 mmol/L) [Ann Fam Med. 2013 Sep; 11(5): 452-459].

Further studies have found that cinnamon can help reduce harmful after-meal blood sugar spikes.  The mechanism is not clear, but is thought that cinnamon either slows stomach emptying and/or blocks digestive enzymes in the small intestine that break down carbohydrates.

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.

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 (6.5kg) on average while the diabetes association dieters lost 6.8 pounds (3.1kg).  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.

Aspartame (Nutrasweet) Avoidance

According to research conducted by H.J. Roberts, a diabetes specialist, a member of the American Diabetes Association (ADA), and an authority on artificial sweeteners, aspartame:

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."

Unfortunately for diabetics, the ADA accepts the FDA's conclusion that the consumption of Aspartame is safe and can be part of a healthy diet – and is actually recommending this chemical poison to persons with diabetes.

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."

Drug

Conventional Drug Use

Glyburide and Metformin are oral diabetes medicines that help control blood sugar levels in some people with Type 2 Diabetes, generally in conjunction with proper diet, exercise, and/or other medications.

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.

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.

Invasive / Surgery

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.

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.

Oxygen/Oxidative Therapies

Supplements

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]

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.756-60]

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

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.  Most newly-diagnosed diabetes patients have in the past been told that it is a disease they will have for life.  This is now known to be untrue.

In 2018, exciting new research at Newcastle and Glasgow Universities showed that radical diet can reverse type 2 diabetes.  A low-calorie diet caused remission in 90% of the 298 adult subjects who lost 15kg (33 pounds) or more – even in those who had been diabetic for six years. [The Lancet, Volume 391, No. 10120, pp541-51, 10 February 2018]

Lead researcher Professor Roy Taylor stated, "Substantial weight loss results in reduced fat inside the liver and pancreas, allowing these organs to return to normal function.  What we're seeing ... is that losing weight isn't just linked to better management of type 2 diabetes: significant weight loss could actually result in lasting remission."

The diet consisted of restricting calorie intake to 825-853 per day for 3-5 months, followed by gradual reintroduction of food over 2-8 weeks.  Relying on weight loss alone, none of the subjects took any medications during that time to control their diabetes.

Effectiveness of weight loss among long-term diabetics was not known at the time of the study.  During the first few years, insulin-producing cells slowly shut down, entering a so-called resting state.  At this stage, those cells can still be re-activated through weight loss.  As the disease continues, however, these cells start to die off permanently.

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.

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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