Diabetes has recently risen to become one of the leading causes of death in Canada, with over 2 million affected. Ninety-five percent of diabetics have type II diabetes, a form caused by obesity and a sedentary lifestyle. Type II diabetes typically develops over time due to physical inactivity, heredity and poor diet.
Increasingly we are beginning to see younger adults and even children developing this disease. Inactivity and high-calorie/high-fat diets are the two main reasons why type II diabetes is on the rise, striking people at younger and younger ages. The prevalence of type II diabetes in our public schools is on the rise at an alarming rate and action can and must be taken to reverse and ultimately prevent this disease.
Type II diabetes develops when cells do not recognize or properly use the insulin that the body produces. This is called insulin resistance and leads to increased glucose levels in the blood. Sugar or glucose that hasn't been converted into energy by the cells can damage the heart, nerve endings, the kidneys and the eyes. The implications of this disease are horrendous if left untreated or poorly managed. Complications of diabetes can result in blindness, kidney disease, loss of sensation in hands and feet, cardiovascular disease, and in extreme cases, amputations of the limbs.
The key concepts in the prevention and management of type II diabetes are quite simple - nutrition and physical activity, resulting in healthy body weight maintenance. However the standard approach of care to diabetics include a prescription of hypoglycemic (blood sugar lowering) medication or insulin injections to regulate blood sugar levels, as well as several other medications to delay the complications of the disease. Even with this treatment regime type II diabetes remains poorly controlled in many individuals and the side effects/long term effects of the medication are often detrimental. The possibility of managing and even reversing type II diabetes with lifestyle changes and natural therapies is a readily attainable option without the negative side effects. With space limitations this article will examine the impact of lifestyle modification and nutritional and botanical supplementation in the management of type II diabetes.
Let’s begin by discussing how a diagnosis of type II diabetes is made. Laboratory tests including fasting glucose and HbA1c (a marker of glucose regulation over time) are essential for diagnosing and monitoring diabetes. Cholesterol and homocysteine (a marker for heart disease) are also regularly monitored to assess cardiovascular disease risk. Routine physical exams focusing on weight and height, blood pressure, pulses in the extremities, foot exams, and neurological exams should also be preformed regularity to monitor any complications that may arise.
The foundations of treating type II diabetes are diet and exercise. These together are commonly recommended lifestyle changes for the management of type II diabetes, and if strictly adhered to may be all that are needed to reverse the disease. A ‘must read’ book that highlights and details treatment for type II diabetes is written by Dr. Richard K. Bernstien MD, and is titled “Diabetes Solutions: A Complete Guide to Achieving Normal Blood Sugars”.
Recent evidence shows that moderately high-protein diets have beneficial effects for diabetes, including weight loss and decreasing markers of cardiovascular disease. One study examined the effects of a high protein diet on people with untreated type II diabetes. A high-protein diet was followed by half of the participants, and the other half of the participants consumed a regular diet for five-week period. The ratio of protein to carbohydrate to fat was 30:40:30 in the high-protein diet and 15:55:30 in the regular diet. The study showed a 40% decrease in fasting glucose levels in the high-protein diet participants compared to the regular diet participants. Those on the high-protein diet also showed a significant decrease in HbA1c and lower cholesterol levels compared to those following the regular diet (American Journal of Clinical Nutrition, 2003; 78: 734-741).
Exercise has been shown to influence blood sugar control. In a study involving nine postmenopausal women with type II diabetes, the effects of an exercise program on blood sugar control was examined over a four-month period. Each week the women did two weight strengthening sessions consisting of three sets of 12 repetitions, and two aerobic sessions for 60 minutes at moderate to high intensity. The results showed significant reductions in blood glucose and HbA1c after the 16-week period (European Journal of Applied Physiology, 2004; 92: 437-447).
A variety of nutrient and botanical medicine therapies have been shown to aid in diabetic control.
Studies with cinnamon have shown improvement in glucose regulation and in slowing the absorption of carbohydrates in the small intestine. Substantial reductions in blood glucose levels have been found with the addition of cinnamon into the diet in appropriate doses (Diabetes Care, 2003; 26: 3215-3218).
Gymnema Sylvestre leaves (a herb native to India) can regulate blood glucose levels. Gymnema works by two mechanisms; it inhibits absorption of glucose at the intestines, and it acts at the pancreas to regulate the release of insulin. It has been shown to have an anti-diabetic effect in patients with type II diabetes (Journal of Ethnopharmacology. 1990; 3:295-300).
Viscous, water-soluble fibre (those found in psyllium and oat bran) have been shown to decrease blood glucose levels and decrease cholesterol. A study showed addition of psyllium to the diet significantly improved blood sugar and cholesterol control in type II diabetics over an 8-week period (American Journal of Clinical Nutrition, 1999; 70: 466-473).
Chromium is an essential trace mineral for human nutrition. It has been shown to aid in activating insulin. A study showed that high dose chromium decreased both fasting glucose levels, as well as HbA1c and cholesterol levels after a 2-month period (Diabetes, 1997; 46: 1786-1791).
Jambul is a fruit native to India, Nopal (prickly pear), a fruit native to South America, and Devil’s Club (Oplopanax horridus), a shrub native to North America have all been traditionally used for the treatment of diabetes. Studies show they have significant blood sugar lowering and cholesterol lowering effects (Journal of Ethnopharmacology, 2004; 91: 209-213; Journal of Ethnopharmacology, 2006; 108: 228-235; Archives of Latinoam Nutrition, 2002; 52: 387-392).
Apha lipoic acid is a well-studied antioxidant that not only has been shown to influence glucose control levels (Free Radical Biological Medicine, 1999; 27: 309-314), but has also been shown to prevent and reverse nerve damage associated with diabetes (Diabetic Medicine, 1999; 16: 1040-1043)
Last but not least, essential fatty acids found in fish oil must be mentioned as they have been shown to reduce inflammation, blood pressure and cholesterol thus reducing cardiovascular disease risk in diabetics (Circulation, 2003;107:1852).
Space limitations prevent a more thorough examination of treatments for diabetes, however be aware that along with the key treatment of diet and exercise, medical research has identified many other safe and effective alternative treatments for blood sugar regulation and diabetes control. These treatments can be used in combination with conventional medications under the supervision of a physician knowable in alternative approaches. Management and even the reversal of type II diabetes is attainable with lifestyle changes and nutritional and herbal supplementation in people of all ages.
Inactivity, obesity, and high sugar and fat diets for extended periods may eventually lead to type II diabetes. With childhood obesity on the rise, people will continue to be diagnosed with this disease at younger and younger ages. Even simpler than the management and treatment of this disease is its prevention, which begins healthy food choices, weight management, and physical activity.
Dr. Oxbro completed her undergraduate science degree in Biology and Psychology at Trent University and then completed a Masters of Science Degree in Pharmacology at Queen’s University in Kingston, Ontario. Upon completion of her Masters degree, Dr. Oxbro entered the 4-year Naturopathic Medical Program, obtaining her Doctorate of Naturopathic Medicine upon graduation in 2008. She currently treats patients, at her naturopathic medicine clinic Nova Health Naturopathic Centre in Kingston, Ontario.