Diabetes and Insulin Resistance

Diabetes is a metabolic disorder characterised by a decreased ability or complete inability of the body to utilise carbohydrates. The end result is a reduced clearance of glucose from the blood or a decreased uptake of glucose by muscle & fat cells.

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Diabetes and insulin resistance

Diabetes is a metabolic disorder characterised by a decreased ability or complete inability of the body to utilise carbohydrates. Carbohydrates are normally broken down within the body in the form of glucose, the body's main energy source. An elevation in blood glucose is then detected by the pancreas.

Insulin, a hormone secreted by the pancreas, then acts on muscles and the liver to clear glucose from the blood. Insulin itself is essential for the delivery of nutrients into a cell.

In the diabetic, there may be either an insufficient production of insulin, the production of an incomplete hormone, or a decrease in the number and affinity of insulin receptors. Therefore, the end result is reduced clearance of glucose from the blood or a decreased uptake of glucose by muscle and fat cells.

In the eight years from 1990-98, diabetes increased 70% in the 30-39 year age group. Researcher S.P Wolff recently reported "The individual with diabetes has a 25-fold increase in the risk of blindness, a 20-fold increase in the risk of renal failure, a 20-fold increase in the risk of amputation as a result of gangrene and a 2 to 6-fold increased risk of coronary heart disease and ischemic brain damage. Almost half of those diagnosed as diabetic before the age of 31 die before they reach 50, largely as a result of cardiovascular or renal complications, often with many years of crippling and debilitating disease beforehand."

There are however three prediabetic stages a Type 2 goes through prior to becoming diabetic. All of these stages are associated with excessive insulin outpouring when carbohydrates are consumed and are preventable.

Long-term complications of diabetes

An increase in blood sugar leads to interactions with proteins, which changes their properties and impairs tissue functions. These are known as A.G.E's. An increase in blood glucose is associated with decreased uptake of vitamin C. Insulin is required for vitamin C uptake.

A lack of insulin and associated increase in blood glucose results in:

(1) Increased viscosity of blood due to rigidity of cell membranes

(2) Over activity of smooth muscle cells leading to coagulation and potential arteriosclerosis

(3) High blood glucose instigates free radicals, leading to further complications

(4) The thickening of certain cellular membranes gives rise to retinopathy, neuropathy and kidney damage

When we think of diabetics, we commonly think of individuals who can't make insulin and therefore need daily injections of this hormone. These are Type 1 diabetics. It is estimated that 5-10% of diabetics are Type 1. This type of diabetes is associated with the actual destruction of the beta cells of the pancreas, which manufacture insulin. Recent evidence implicates a viral cause in some cases of this disorder.

Type 2 diabetics however, produce more than enough insulin, but their cells are not responsive to it.

There are three stages a type 2 diabetic will encounter before they reach full-blown diabetes

Stage One - Insulin resistance develops as a result of poor glucose control. The pancreas can produce insulin, however muscle and fat cells are not sensitive to insulin and the nutrients insulin transports. The causes of insulin resistance range from genetic to dietary factors (excessive carbohydrates and fat in the diet). Nutrient deficiencies are common with insulin resistance, eg magnesium, chromium, zinc, fatty acids and lipoic Acids.

Stage Two - As cells become desensitised to insulin, an excessive amount of insulin is produced. This is circulated, causing an increase in free fatty acid production and an increase in glucose production. This leads to hyperinsulinaemia. Hyperinsulinaemia or elevated insulin levels further cause neurological, cardiovascular, endocrine and immune complications.

Stage Three - Blood sugar abnormalities are now common for the individual. In fact there is very little difference between typical Type 2 diabetes and stage three. Some of the major symptoms are hour-by-hour changes in energy levels, moods, brain function and irritability brought on by hunger and relieved by food or caffeine.

Stage Four - Diabetologists who confuse Type 1 with Type 2 diabetes are justified in their error only when this stage is reached. By this point in a Type 2 diabetic's life, his or her insulin output has finally become subnormal. At this stage, strict dietary measures are needed, in conjunction with essential nutrients that are so desperately needed to support the pancreas and various systems within the body.

The macronutrient management of diabetes and insulin resistance

We know that insulin is produced in response to the consumption of carbohydrates. How much and at what rate is determined by what sort of carbohydrate is eaten and if the meal is made up of portions of fat and protein. Protein, fat and dietary fibre slow the rate of sugars entering the bloodstream. Because of this, it makes perfect sense to include these macronutrients in a meal. Good quality protein is the premier insulin regulator due to its relatively low caloric value and its ability to not affect insulin production, but rather increasing the opposing hormone glucagon.

Because of this, it is sensible to:

(1) Consume only small amounts of carbohydrates - breads, grains, pastas and starches and eat carbohydrates containing a low glucose content - fruits and vegetables and some grains

(2) Consume a decent amount (around 20 grams of actual protein) of low-fat protein and a small amount of 'good' fat with every meal

(3) Add a reasonable amount of fibre to each meal - through raw vegetables, nuts

Nutrient support for diabetes and insulin resistance

Soy isoflavones

Soy isoflavones, from soy protein, have been shown to be highly beneficial in the treatment and prevention of both diabetes and insulin resistance. One isoflavone, genistein, acts by regulating triglycerides and cholesterol synthesis, a major problem for diabetics.

Alpha-lipoic acid

Alpha-lipoic acid, a naturally occurring endogenous antioxidant, is used in Germany in the treatment of symptoms of diabetic neuropathy. Nerve damage is one of diabetes' most devastating complications and affects more than 50 percent of all diabetics.

A study recently published in Diabetes Care reports that the antioxidant nutrient, alpha-lipoic acid (ALA), can partly restore diabetic nerve function after only four months of high-dosage oral treatment. ALA's powerful antioxidant effect may be one way it helps heal a diabetic person's damaged nerves.

The healing effect could also be related to ALA's ability to activate key enzymes in the pathways that convert glucose, fatty acids and other energy sources into ATP - the body's main energy-storage and transport molecule.

As well as this, ALA has been shown to help in cataracts, ischemia/reperfusion injury, liver disease and neurodegenerative disease. ALA improves sugar metabolism in diabetes. Research indicates that lipoic acid increases the burning of glucose in a way that is comparable to, but independent of, insulin. More recently, a study of adult diabetic patients showed that ALA increased cellular uptake and oxidation (burning) of glucose by approximately 50 percent. Studies have also reported that ALA stimulates insulin activity, reduces insulin resistance in diabetics and enhances the burning of glucose in obese laboratory animals.

Chromium

Chromium losses through urination occur in the presence of a high carbohydrate diet. Losses have been reported of up to 10-300%. This coupled with a low dietary intake of chromium - the average daily intake is 25-33mcg, may lead to chromium deficiency, which is associated with impaired glucose and lipid metabolism.

Within the past five years, chromium has been shown to improve glucose and related variables in patients with insulin resistance, as well as Type 1 and Type 2 diabetes. Severe neuropathy and insulin resistance in patients receiving the recommended daily intake of chromium were reversed by additional supplemental chromium picolinate.

Chromium increases insulin binding to cells, insulin receptor number and activates insulin receptor kinase, leading to increased insulin sensitivity.

Selenium

Diabetes is also associated with low levels of selenium. Selenium and vitamin E supplementation in experimental diabetes was shown to play a role in controlling oxidative status and altered lipid metabolism in the liver, thereby maintaining favourable fatty acid distribution in the major tissues affected by diabetic complications. Selenium and vitamin E are both powerful antioxidants maintaining cellular membrane integrity.

Vanadium

Diabetes has been reversed with a daily intake of vanadium. Vanadium is a trace element that is present in most body tissue. Studies using rats with diabetes have shown a complete reversal of this disease, when vanadium was given.

As well as this, it inhibits cholesterol synthesis, making it important in the prevention of heart disease.

Zinc

Zinc is also important for people who have diabetes, because of its regulatory affect on insulin in the blood. It has been found that the addition of zinc to insulin prolongs its effects on blood sugar.

A diabetic pancreas contains only about half as much zinc as does a healthy one. Zinc is involved with insulin at several stages, as well as wound healing and in immune response that fights infection. Taking zinc helps eliminate cholesterol deposits and has been successfully used in the treatment of arteriosclerosis.

Magnesium, taurine & carnitine

Magnesium, taurine and carnitine improve insulin sensitivity. Low magnesium levels are a strong predictor of insulin resistance and Type 2 diabetes.

In vitro studies have shown an effect of magnesium on the secretion of insulin by the pancreas and on the responsiveness to insulin by peripheral tissues. Insulin resistance has been shown to be implicated in impairing the ability of insulin to stimulate magnesium or glucose uptake in diabetic individuals. Magnesium is the limiting factor in carbohydrate metabolism.

Taurine improves insulin sensitivity due to its lipid lowering effect.

Recently, carnitine deficiencies in diabetic tissues has received considerable attention concerning its role in the pathogenesis of not only diabetic neuropathy but also retinopathy. It has been reported that treatment with carnitine stimulates glucose uptake in Type 2 diabetics, reducing insulin secretion.

Essential fatty acids

Essential fatty acids from fish and primrose oil are required for normal insulin signalling. It is believed the greater the percentage of polyunsaturated fatty acids in muscle membranes, the better the insulin action.

A recent study concluded, "insulin action was positively correlated with the fatty acid satuaration in membranes. Thus dietary fish oil has beneficial effects on insulin, plasma lipids and insulin-stimulated glucose metabolism in insulin-resistant slightly diabetic patients".

What should a diabetic diet include?

The diabetic diet emphasises fatty fish, poultry and soy products, rather than red meats to meet the protein requirements.

Saturated fats from animal sources should be minimised (less than 10% of the daily food intake), because of its diminishing effect on insulin.

Non-fat dairy products should be used.

Fibre foods, preferably water-soluble kinds like oats and legumes, should make up 30 to 40% of the daily food intake.

Eating as much raw food as possible is recommended.

Vegetables like garlic, onions, lettuce, cabbage, avocado, broccoli and brussel sprouts are good.

Exercise

Exercise is as vital a factor in diabetes treatment as diet is, because it reduces the need for insulin, reduces the cholesterol level and guards against overweight and obesity.

Herbal supplements

There are a number of herbal supplements available that are specific for treating diabetes. These include the following:

Panc-Tea

This is specific for the pancreas and insulin balance. An aid for the pancreas and to support the functioning of the endocrine glands, which affect changes in blood sugar levels. Cedar berries are the most important ingredient in this formula. It is said that these have a specific hypoglycaemic effect.

This formula arrests infection and removes sedimentation and mucous from the pancreas. It contains nutrients that help the pancreas restore itself. It is also used for blood sugar problems. A significant number of people with maturity onset diabetes have reduced or eliminated their insulin requirements by using PC.

Blood Sugar with Gymnema Extract

This is specifically for diabetes, hyperglycaemia and supports pancreas function. It contains Nopal leaves, which help lower blood glucose and insulin levels and can improve insulin's efficiency in moving glucose from the blood into the cells.

This complements the action of Gymnema and bitter melon, whose combined action not only helps to lower blood sugar but can help regenerate the insulin-producing cells in the pancreas (Gymnema).

The mucilaginous, water-retaining fibres of fenugreek reduce fasting blood glucose levels and cholesterol and triglyceride levels in Type 1 & 2 diabetic people.

Caromix and bilberry leaves both help provide a number of active constituents that provide antioxidant protection against the ravages of high blood sugar.

Chromium has also been added to this formulation, as it is a key element that helps process the sugars in our diet and is thought to facilitate the binding of insulin to the cell membrane.

At Ideal Health we stock a wide range of vitamin, mineral and herbal supplements that can help with diabetes and any other health problem. Please phone and we will be happy to advise you.

The information in this document was collected from 'Insulin Resistance and Diabetes' published by Metagenics.