With Diabetes Surging Some Look For Alternative Treatment

20 October 2006
by Wyn Snow, Managing Editor

With over a third of American adults—73 million—either suffering from or at risk for diabetes, the disease has become pandemic and cannot be ignored.

In the past, Type II diabetes was typically diagnosed in middle age. It is now increasingly found in young adults, adolescents, and even children. Women who develop diabetes during pregnancy, over 200,000 every year, are at higher risk of developing Type II diabetes later in life. African-Americans are from two to four times as likely to have diabetes than their non-Hispanic white counterparts. And in a few populations such as the Pima Indians, diabetes now affects 50 percent of the adults in the US who have adopted the Western lifestyle and diet.

Diabetes—both Types I and Type II—can be a killer, appearing as a risk factor or direct cause in heart disease and glaucoma. Further complications associated with the disease include stroke, early onset dementia and Alzheimer’s disease. Diabetes also leads to kidney failure, blindness and amputation of the feet and legs.

What causes diabetes?

All cells need energy. To get it, they burn glucose, which is the simplest form of sugar. The sugars and starches that we eat (carbohydrates) are converted in the digestive tract into glucose, which is then absorbed into the bloodstream and circulated throughout the body. Insulin, which is created in the pancreas, transports glucose through the cell wall into the cells.

Type I, or insulin-dependent diabetes, is an autoimmune disorder in which the body attacks and destroys the cells that make insulin. For these diabetics, the body no longer makes enough insulin, and therefore must be supplied with more.

In Type II or non-insulin-dependent diabetes, there’s plenty of insulin, but the cell walls have become resistant to the signal. During the “silent” period when the disease is developing and no symptoms are apparent, insulin levels rise higher and higher in order to move glucose out of the bloodstream and into the cells. This early phase of the disease also leads to high blood pressure (insulin constricts the blood vessels) and obesity (the body insists on removing extra glucose from the bloodstream; glucose that won’t go into the cells gets stored in fat tissue).

What are the treatments—and is there a cure?

Artificial insulin plays a positive role in controlling diabetes. Recently developed, long-acting varieties have taken much of the risk and bother out of self-administering this valuable drug. Some of the newer medications target other aspects of insulin resistance rather than supplying insulin itself.

Insulin is especially vital for those who suffer from Type I diabetes. But the self-administration of insulin and other diabetes-related drugs has a down side, including both the potential for hypoglycemic shock due to excessive dosage (and consequent low blood sugar), and the fact that prescriptive medications for diabetes may control blood sugar levels and slow the progression of the disease, but cannot cure or reverse it.

Diet and exercise are the best treatment

Even with these drugs, diabetes cannot be halted—much less cured or reversed without a change in lifestyle, most notably in diet and exercise. However, numerous research studies have conclusively shown that Type II diabetes can be healed with lifestyle changes. Insulin resistance can be reduced; fasting glucose levels can return to normal. Diet and exercise can also help Type I diabetics obtain better control of blood glucose with a reduced amount of insulin, although dependence on insulin will always be lifelong—unless and until research succeeds in regenerating the pancreatic cells that produce insulin.

For exercise, any amount is better than none! However, the recommendation is at least 30 minutes a day of aerobic exercise that raises one’s heart rate to specific, age-related levels. A moderate amount of strength training and stretching is also valuable.

For diet, the mantra is

• eliminate all refined sugars and starches
• eat a plentiful “rainbow” of high-fiber, colorful vegetables and fruits
• for starchy foods, eat only a small amount, and/or eat only low-glycemic index starches, and use whole grains only for breads, pastas and cereals
• for protein sources, emphasize poultry, fish, eggs, beans, and raw nuts
• restrict red meats to range-or-grass-fed animals
• eliminate trans-fats
• reduce saturated (mostly animal) fats
• eat heart-healthy mono-saturated fats (such as olive oil) and omega-3s

Devote approximately half the plate to fiber-rich vegetables, one-quarter to protein, and no more than one-quarter to a starchy food.

Can supplements play a role?

Those with an interest in alternative treatment options have asked whether dietary supplements can play a constructive role in managing diabetes. Given the disease’s positive response to changes in diet and exercise, this question is worth considering.

However, just as prescriptive drugs do not cure or reverse diabetes, use of dietary supplements without the lifestyle changes described above will have little or no impact on the progression of the disease.

The use of any of the following supplements can lower blood sugar levels. Therefore, it is vital to monitor your blood glucose closely and to be supervised by your physician in order to prevent episodes of hypoglycemia—low blood sugar.

Nutrients

Chromium

A substance isolated from pork kidney in 1957 was given the name Glucose Tolerance Factor because it helps insulin transport glucose into the cells. Its active component was later identified as chromium, a trace mineral. Chromium makes insulin more effective, and thus helps reverse insulin resistance. Chromium levels in the body tend to decline with age, which may be one factor affecting older people’s risk of developing Type II diabetes. Dosage levels between 100-500 mcg/day have been shown to reduce blood glucose, insulin and cholesterol. Safety studies show no toxicity or adverse effects with high levels of chromium intake, although it can irritate the stomach at extremely high levels. Surveys indicate that many Americans do not get even as much as 50 mcg/day in their diets.

Vanadium

Research indicates that this mineral acts similarly to insulin in transporting glucose into the cells, and is therefore valuable for both Type I and Type II diabetics. Dosages ranging from 45-150 mg/day can be useful for improving fasting glucose levels (how much sugar is in the blood when one wakes up in the morning). Toxicity studies show these dosage levels to be safe and well tolerated by most people. Some individuals experience mild gastrointestinal distress, either during the first week of use or at higher dosage levels (up to 400 mg/day).

Magnesium

While this mineral is not directly implicated in the mechanisms of diabetes, it helps to protect patients from complications of the disease. Magnesium acts to relax smooth muscle tissue, including those lining the arteries, and therefore helps lower blood pressure and reduces the risks of heart attacks and strokes. Deficiencies in magnesium are also linked to diabetic retinopathy; diabetics with the lowest levels of magnesium had the worst retinopathy. For people with diabetes or heart disease, the recommended daily intake level of magnesium is 1000 mg/day. However, because the actions of calcium and magnesium are so strongly connected, one needs an intake ratio of 2:1 or more—for each 1000 mg of calcium, one should also get 500-1000 mg of magnesium.

Vitamin C

Vitamin C helps prevent “glycosylation” of proteins—meaning that sugar gets attached to proteins. These substances are associated with diabetic complications in the eyes, kidneys and circulatory system as well as with increased levels of free radicals. Vitamin C is one of the safest of all supplements even at high levels; loose stools may occur in some individuals at dosage levels reaching 2000 mg

Vitamin E

High levels of Vitamin E (1350 IU/day) have been shown to improve insulin sensitivity.

Biotin

This B vitamin is crucial to the metabolism of carbohydrates, fats and proteins. Biotin is especially important for improving insulin sensitivity and the activity of glucokinase, the enzyme that starts the use of glucose by the liver. Diabetics have low concentrations of this enzyme. Research shows that supplementation with biotin improves blood glucose control in both Type I and Type II diabetics. Biotin is also helpful for treating diabetic neuropathy, which is damage to the nerves in the feet that causes numbness, burning sensations, and pain. A recommended dosage level for diabetics is 9 mg/day.

Omega 3 fatty acids

Fatty acids are an integral “building block” of our cell walls. In order for glucose to get into our cells and provide energy, that wall must be fluid and flexible. Omega-3 fatty acids—because of their chemical and physical structure—are exactly what our cell walls need. (See our article on Omega-3s.) However, the body cannot make omega-3 fatty acids, so must get them from dietary sources. The best sources are fatty fish (such as salmon, mackerel, sardines, herring, tuna), flaxseed, evening primrose, borage, walnuts and wheat germ. A recommended intake level of flaxseed oil is 1-2 tablespoons/day (or 1/4 cup freshly ground flaxseed). A recommended level of fish oil intake is two 1000 mg capsules per day (containing 360 mg of EPA).

Alpha-Lipoic Acid

This substance is a potent anti-oxidant, soluble in both fats and water, which means it can act in virtually all areas of the cell to neutralize free radicals. It also improves insulin sensitivity. Dosage levels of 600-1800 mg/day have been shown to improve the transport of glucose into cells by as much as 63%. Lipoic acid is also useful for improving circulation and reducing glycosylation of proteins. In Germany, it is the treatment of choice for regenerating nerves that are damaged by diabetic neuropathy. The recommended dosage level is 200-600 mg/day.

Conjugated Linoleic Acid (CLA)

Linoleic acid is another of the “essential fatty acids”—fats that our bodies need but cannot make on their own. The conjugated form appears to improve glucose uptake in Type II diabetics. It has also been shown to be useful for weight loss. Plentiful in range-fed and wild animals, recommended dosage levels for CLA range from 500-3000 mg/day.

Herbs & Foods

Gymnema sylvestre

This Indian plant has traditionally been used to treat diabetes—and is helpful for both Type I and Type II diabetics. Research indicates that it acts to reduce fasting blood glucose levels and make insulin more effective. There are indications that it may stimulate regeneration of the pancreas in Type I diabetics. There is no reported toxicity. A recommended dosage level for gymnema extract, standardized to 24% gymnemic acid, is 200 mg twice a day.

HCA

Hydroxycitric acid (HCA) is a compound found in brindle berry (garcinia cambogia) that is touted both as an aid to weight loss and—for diabetics—an aid to blood sugar control. Research shows excellent results with rats and mice; however, studies with people show mixed and inconclusive results, possibly due to differences in the formulations and potency levels of various products, or to variations in research design. Curiously, a supposedly more potent form of HCA showed no difference from the placebo group controls. However, some other studies have indicated that HCA makes insulin more effective and reduces a craving for sweets. HCA slows the rate at which carbohydrates are converted to fat, and reduces appetite by increasing the production of glycogen.

Fiber supplements

While it’s best to get your fiber from “the real deal”—vegetables and fruits, both raw and cooked—adding a fiber supplement to the mix can be useful. Examples are pectin, psyllium, glucomannan, guar gum, defatted fenugreek seed powder, and seaweed fibers (alginate, carrageenan) and the patented product PGX. Taken with water before meals, these products both slow down the absorption of glucose and make one feel more full. Choose products with little or no sugar, and be sure to drink the recommended amount of water!

Touchi extract

Two of the prescriptive drugs used to treat diabetes (Precose and Gyset) act by inhibiting an enzyme that helps break complex starches into glucose. This reduces the rise in blood sugar and insulin that follows a meal. However, these drugs have a fairly high incidence of gastrointestinal side effects, such as flatulence, bloating, and diarrhea. Touchi extract is a natural alternative with similar health benefits and none of these side effects. Touchi is a fermented soybean product used for thousands of years in China and Japan; the extract is concentrated. An effective dosage level is 300 mg before each meal.

Mulberry extract

The mulberry plant has a long and respected history in Chinese and Japanese medicine—as well as being food for silkworms! Research indicates that mulberry extract is more effective than glyburide (another drug prescribed for treatment of diabetes) in lowering fasting glucose levels. Study subjects also showed significant reductions in cholesterol and triglycerides. Recommended dosage levels are 100-200 mg before each meal.

Onions and garlic

These two foods contain allicin and APDS, both of which act directly to reduce blood sugar levels. While garlic is apparently more potent (no surprise there!), the compounds in onion appear to be more stable. Also, the higher the intake, the stronger the reduction in blood sugar. Unless one is allergic to either of these foods, the only toxic effect is possible minor damage to one’s social life. Garlic and onions have also been shown to reduce cholesterol and blood pressure. A recommended level of allicin intake would be 4000 mcg.

Unusual effects

People using supplements to improve blood sugar control who notice any unusual effects are urged to discontinue use and consult with their health care provider. Because any of these supplements can lower blood sugar levels, either in the short or long term, one’s health care provider should also be consulted prior to starting supplement use, as well as for several months thereafter to see if adjustments in medication are needed.

Likewise, prescriptive treatments, especially the use of insulin and related medications for controlling insulin levels in the body, should always be monitored by a health care professional and never reduced or discontinued without prior consultation.

Sources and Recommended Reading

Arthur Agatston, MD. The South Beach Diet. Rodale Books, 2003. St. Martin’s Paperbacks, 2005.

Vern Cherewatenko, MD, and Paul Perry. The Diabetes Cure. Harper Perennial/Cliff Street Books, 1999.

Medline. Abstracts of research on HCA.

Michael Murray, ND, and Michael Lyon, MD. How to Prevent and Treat Diabetes with Natural Medicine. Penguin Group/Riverhead Books, 2003.

Nicholas Perricone, MD. The Perricone Weight-Loss Diet. Ballantine Books, 2005.

Barry Sears, MD. Enter The Zone. Harper Collins, 1995.

Barry Sears, MD. The Anti-Inflammation Zone. Regan Books, 2005.

Julian Whitaker, MD. Reversing Diabetes. Warner Books, 2001.

Wikipedia.com. Articles on several of the substances mentioned above.