Diabetes and a More Natural Approach to
Controlling Blood Sugar
On these pages, I will add nutraceutical interventions that the diabetic can perform to better control blood sugars.
Diabetes is more than a disease of elevation in blood sugar. The vast majority of cases result from a disorder of insulin receptor chemistry, and not from an inadequate supply or level of the hormone ‘insulin.’ For purposes of this newsletter, we will concentrate on Type II Diabetes, or what is sometimes referred to as ‘adult-onset’ diabetes.
Adult Onset Diabetes
Adult onset diabetes, or Type II Diabetes, occurs most commonly in middle-age. In recent years, however, Diabetes seems to be presenting earlier and earlier in life. Traditional diagnosis focuses on elevations in blood glucose, or ‘blood sugar,’ because traditional testing has looked at blood sugar as being the hallmark of the disease. More recently, advances have demonstrated that the disease may not only be a shortage of insulin, but rather an acquired abnormality of the insulin receptor.(5,6) As the receptor becomes ‘broken’ or ineffective, more and more insulin is required to control blood sugar. Insulin levels must rise in order to keep blood sugars ‘within normal limits.’
Insulin has physiological actions other than blood sugar control. Less well recognized is the involvement of insulin in fat physiology and weight management. The physiological action of insulin is to ‘push’ fatty acids into the cell. As insulin levels rise, fat deposition worsens.
It follows, that if insulin levels rise due to insulin receptor problems, that is, insulin levels rise even as blood sugar levels stay relatively low, these elevated levels of insulin result in fat deposition. Insulin levels must rise to keep blood sugar within normal limits, and this extra insulin increases body fat. This may be the reason that weight goes up before blood sugar elevation becomes noticeable, and more interestingly, it is precisely the reason why it is so hard to lose weight to control the diabetes.
The
diabetes may have caused the weight problem, the weight problem may not have
been the cause of the diabetes.
Diagnosis
Traditional medical approaches to the diagnosis of diabetes include:
(a) Fasting blood sugar, (b) Glucose tolerance testing, (c) Hemoglobin A1C, and (d) urinalysis. By the time that urinalysis demonstrates abnormality, it is quite late in the game. Hemoglobin A1C test results provide information to the physician as to the duration and severity of the blood sugar abnormality. Glucose tolerance testing may catch things a little earlier, and fasting blood sugar may be normal until the disease has been present for 10 years or more.
To diagnose diabetes earlier, examine the insulin to glucose ratio. A ratio of less 1:10 is desirable. As insulin levels climb above 10 µUnits/ml, assuming a blood sugar of less than 100 mg/dl, fat is pushed into the cell. As insulin continues to climb, the fat deposition worsens, the weight gain becomes progressive and largely refractory to diet-control. Once the insulin climbs above 20 µUnits/ml, the weight gain is well underway. As it is with most medical conditions, earlier diagnosis leads to a far less complicated and costly treatment regimen.
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David S. Klein, MD
Pain Center of Orlando, Inc.
