February/March 2008

Everybody Wants to Rule the World
Ted Glick

A Better World is Possible
John Cavanaugh & Jerry Manders

Cultivating Wholeness and Community in a Fragmented World
Kim Corbin interviews Bill Plotkin

Relearning What We've Forgotten
Chris Maser

The Welcome Home Project
Jody Woodruff

Diabetes: Inherently Treatable and In Many Cases Preventable
Daniel Smith, MD

Riding the Age Wave
Gaea Yudron

Radient Mind: Intervuew wuth author Peter Fenner
Carrie Grossman

Cosmic Calendar
Salina Rain

BACK TO TOP

Diabetes: Inherently Treatable abd In Most Cases Preventable

By Daniel Smith, MD

Close to sixty million Americans are currently at risk for developing adult onset diabetes. The truth of the matter is, however, that this disease is not inevitable—diet and lifestyle changes can go a long way to help prevent it. In fact, a study reported in the journal Diabetes Care declared that earlier intervention could prevent at least 37 percent of new cases of diabetes (about 22 million people). With diabetes rates rising along with the rates of obesity, preventing this disease should be a national priority.

Like any chronic disease, diabetes mellitus exacts extra-ordinary personal costs. Each year, thousands of Americans lose their eyesight or are placed in dialysis due to com-plications of diabetes. Heart disease, strokes, kidney disease, amputations, periodontal disease and severe damage to the nervous system are amongst the most common complications of this condition. Diabetes, currently the third leading cause of death by disease in the United States, costs the economy around $100 billion dollars a year to manage.

Diabetes is a condition in which the pancreas’ ability to produce insulin becomes compromised resulting in high glucose levels in the blood. In non-diabetics, the presence of insulin in the bloodstream allows cells to eat glucose, their primary food. Without insulin, cells will starve, even if they are bathed in glucose. Long term, the presence of high blood sugar causes a cascade of serious physiologic problems that, if left untreated, will result in death. While there are four types of diabetes this article will apply primarily to Types I and II. Type I diabetics can produce no insulin at all and must regularly obtain pharmaceutical insulin, almost always by injection. However, over 90% of diabetics are Type II diabetics, and they retain the ability to produce insulin, but at a continually deteriorating capacity.

Individuals with adult onset diabetes (Type II) who are willing to improve their dietary and lifestyle choices can reverse the challenge to their pancreas that was brought on by their current eating habits and lack of adequate exercise. And, while Type II diabetes is very treatable, the notion that diabetic complications are inevitable is quite erroneous. Why, then, is our country willing to pay the astronomical personal and financial price tag that diabetes demands? Diabetes is a convoluted issue, both physiologically and socially, so there are many answers to those questions. A small part of the problem lies with our limited understanding of the physiology of diabetes. Also, problems exist with a medical paradigm that is brilliant at identifying and treating disease, but terribly inadequate at nourishing and improving health. Volumes could be written on the shift over the past century from a whole food, home cooked, organic, locally grown diet to one based on processed, nutrient-poor, sugar rich, fast food. Nevertheless, the idiosyncrasies of our society not withstanding, diabetes is an inherently treatable, and in many cases preventable, condition.

Anyone with difficulty regulating their blood sugar should consult a physician, even those people who consider themselves to be healthy eaters and exercisers. If you are at a point in your life that you are not willing to consider basic lifestyle changes, or if your diabetes is seriously advanced, see a mainstream physician. Prescriptions will be essential for your health. However, if you are a pre-diabetic or early stage diabetic; if you are looking for effective and inexpensive methods of restoring optimal health; if you wish to minimize or eliminate the need to use prescriptions, then you should strongly consider seeking out the services of an alternative practitioner. Although naturopaths, acupuncturists and homeopaths all offer valuable assistance, this article will focus on naturopathic treatment of diabetes.

From a naturopathic perspective, there is a crucial word that a diabetic must keep in mind—regularity. Like any pet or child used to a schedule, the pancreas functions optimally when one adheres to a regular pattern of activity throughout the day. This means waking, sleeping, eating and exercising at the same time every day, whether working or vacationing. All of these aspects of the day are significant to the pancreas because the pancreas plays an active role in the regulation of all of these activities. Structuring your day according to a reasonably consistent rhythm will allow your pancreas to “predict” and “prepare for” the arrival of food and times of stress, sleep and activity, and go a long way to help stabilize blood sugars.

Insulin is an anabolic hormone, meaning it promotes building and storage of tissue, so exercise is also important. No diabetic can hope for long term regulation of blood sugar without exercise. This does not necessarily mean training to cross-country ski uphill with a fifty pound pack. A regular (there’s that word again) two mile walk through the neighborhood is an adequate form of exercise, and a fine place to begin. The benefits of exercise upon the progression of diabetes are probably not news to anyone but here they are: exercise lowers blood sugar, increases insulin sensitivity, increases blood flow to the extremities, regulates inflammation and decreases the likelihood of heart attacks.

What might be news, however, is the philosophy on how to select an exercise program. Using exercise to condition the body to respond appropriately to the presence of sugar and insulin is a bit like training a puppy. How does one train a puppy? Repetition is one important factor. Communicating to the dog in a way it understands is another. The prudence of rhythm and repetition has already been discussed. Communicating with your pancreas in a way it “understands” is accomplished by creating an environment that facilitates the production of insulin by incorporating an exercise that is predominantly anabolic—muscle building—at least twice a week. In this way you create a milieu that the pancreas is familiar with: an anabolic environment. Such an approach continually establishes an atmosphere that trains the pancreas to regularly produce insulin under conditions that insulin was best designed to function. The selected exercise program does not need be exclusively anabolic in nature, but anabolic activity should be a mandatory part of a larger program.

One final word of advice regarding exercise: Because exercise can potentially result in a dangerous drop in blood sugar and because of potential complications with circulation to the extremities, please consult a naturopathic physician or medical doctor when designing an exercise program.

Now we come to a huge topic regarding naturopathic management of diabetes: meals and food choices. To begin with, anyone struggling with blood sugar metabolism should consume five small meals a day rather than three large meals. Such an approach places less of a burden upon the pancreas. Next, I recommend that patients take at least thirty to forty minutes per meal. Relax. Chew your food. Eat at least one meal in quiet, perhaps with soft music playing. Stress diverts blood from the gastrointestinal tract, making digesting difficult.

Recognize that foods have powerful effects upon metabolism, inflammation and mood. For example, most diabetics have to contend with excessive inflammation in their bodies which ultimately leads to high blood pressure and an increased risk of heart attacks. Red meat, pork and shellfish contain a substance known as arachadonic acid. Arachadonic acid is the source substance for all inflammatory processes in the body. If one is already dealing with inflammation, it makes good metabolic sense to curtail or eliminate the consumption of these foods, which act like fuel upon a fire. Ideally, these foods would be consumed no more than twice a month. At the same time, consumption of anti-inflammatory foods is crucial—this means vegetables, vegetables and still more vegetables. Veggies are not only full of important vitamins, minerals and fiber but are also (along with fruits) amongst the most anti-inflammatory food you can consume. Additional fiber in the form of psillium husk or ground, organic flax seeds (2-3 tablespoons per day) is an excellent way to excrete excess sugar.

Carbohydrates, proteins and fats require considerable attention. Simple sugars and carbohydrates (desserts, bread, pasta, etc) cause a rapid increase in blood glucose, adding to the stress of a metabolism already struggling with high glucose levels. Turn instead to complex carbohydrates such as brown rice, quinoa and amaranth to help restore balance to one’s blood sugar. Most carbohydrates should be in their whole food form, i.e. whole rice rather that rice pasta. The addition of protein with each meal helps to slow down the absorption of sugar. Fish, white meat chicken, white meat turkey and nuts (preferably raw without added oil) are quality sources of protein that have little or no arachadonic acid in them. Wild, deep sea fish, like salmon and sardines contain omega oils that have repeatedly been shown to lower blood glucose. These oils are also anti-inflammatory in nature, have antimicrobial properties, and promote the healing of tissue, and should be consumed 3-4 times a week.

Fats have been the focus of an unfortunate media campaign that has provoked an unnecessary fear of consuming them. Omega 3 fats are essential for nerve health, form the backbone of the immune system and help to diminish allergic responses. These high quality fats, such as those found in coconut oil, olive oil and avocados, not only slow down the absorption of sugar but also are an additional source of omega oils. Coconut oil has the added benefit of powerful antimicrobial oils, and does not become rancid in the heat of the skillet. A 50-50 mixture of olive oil and coconut oil is recommended for cooking.

Finding an appropriate cookbook is essential. I recom-mend The Anti-Inflammation Diet and Recipe Book by Jessica Black, ND. It is not specifically for diabetics but contains a plethora of easy to cook, extraordinarily tasty recipes that will be a great boon to someone seeking ways to regulate their blood sugar.

Exploring the possibility of forming a community diabetes support group is another recommendation. Setting up a weekly community dinner or suggesting a meeting place from where a daily walk might begin is a relatively easy way to create support around the admittedly challenging process of making lifestyle changes.

Plants and nutrients offer tremendous support. Basic botanical support should involve herbs such as ginkgo, cayenne, garlic, gymnema, bitter melon, fenugreek, and cinnamon, which are supported by clinical research that demonstrates their ability to improve circulation and insulin sensitivity. Vitamins can generally be obtained by designing a menu high in vegetables and complex grains, so supplementation should focus more on minerals, which are much more difficult to absorb from food. The major exception however is B-vitamins, which are critical for nerve support, especially B-6. Be sure mineral supplementation includes chromium (500 mcg/d) and vanadium, both essential for proper glucose regulation.

These protocols represent the fundamentals of naturo-pathic treatment of diabetes that, at best, will eliminate the need to use prescriptive agents, and, at worst, will prolong the amount of time before pharmaceuticals become necessary. Occasionally, additional naturopathic support is needed. Intravenous nutrient therapy, for example, introduces an infusion of highly absorbable vitamins, minerals and amino acids capable of doing everything this article has talked about: increased insulin sensitivity and production as well as increased circulation. This form of therapy readily supplies the constituents that many diabetics, due to gastrointestinal inflammation, may be unable to adequately absorb from their diet. A simple IV infusion is highly stimulating to the immune system. Patients generally note greater vitality, less fatigue, diminished neurologic complaints and a more resilient immune system.

Diabetes does not need to progress to the point that it severely compromises the enjoyment of life—and it is in no way a death sentence. It is, however, an important red flag that lifestyle changes must be considered. Naturopathic medicine, as well as Chinese and Ayurvedic medicine, offer powerful tools for the diabetic and pre-diabetic that should be considered as seriously as those offered by the mainstream physician.

Daniel Smith is a Naturopathic Physician who practices in southern Oregon. He may be reached at (541) 842-4844.

Daniel Smith, MD