Diabetes

General Description

Diabetes affects the way your body uses food for energy. The sugar you take in is digested and broken down to a simpler type sugar, called glucose. The glucose circulates in the blood and waits to enter cells to be used as fuel. Insulin, produced by the pancreas, helps move the glucose into cells. The pancreas can adjust the amount of insulin based on the level of glucose. If you are diabetic, there is a problem with this function, and the glucose will not be used sufficiently and levels become too high.

One of two things happens in diabetics. The body fails to properly respond to its own insulin, this causes glucose to accumulate in the blood, often leading to various complications. This is commonly referred to as Type 2 diabetes. The other option is that the pancreas does not make enough insulin with the same adverse results. This is commonly the case in Type 1 diabetes.

Sometimes a diabetic will experience both these problems at the same time.

The main three types of Diabetes are Type 1, Type 2 and Gestational Diabetes and the precursor diagnosis call Pre-Diabetes.

Type 1 Diabetes:

A person with Type 1 diabetes does not create any insulin. It is most commonly developed before the age of 30, but can be developed at any age. Type 1 can be caused by a genetic disorder. The origins of Type 1 are not fully understood, but all of the possible causes still have the same result: The pancreas produces little or no insulin. Insulin injections therefore are needed. 5–10% of people who are diagnosed with diabetes have type 1 diabetes. Most persons with Type1 diabetes take insulin injections.

Type 2 Diabetes:

Type 2 diabetes is caused by insulin resistance, where the cells fail to use insulin properly, sometimes combined with insulin deficiency. Most Americans who are diagnosed with diabetes have type 2 diabetes. Many people who develop type 2 diabetes have experienced a build up of these issues over years in what is called Pre-diabetes

A person with Type 2 diabetes may have adequate insulin, but the cells are resistant to it. Type 2 diabetes occurs in adults over 35 years old, but can affect anyone, including children. 95 percent of diabetes cases are Type 2. It is understood that this condition is a lifestyle disease, triggered by weight issues, lack of exercise, increased age and in some cases, genetic predisposition.

Click here to read more about the 2010 Diametrix Murine Model In Vivo Study for Type-2 Diabetes

Gestational Diabetes:

Gestational diabetes develops during pregnancy and effects about 4% of pregnant women. It may precede development of type 2 (or rarely type 1).

This occurs usually at around 28 weeks or later  A diagnosis of gestational diabetes doesn't mean that the person had diabetes before they conceived, or that they will have diabetes after giving birth

Pre-Diabetes

What is considered America's largest healthcare problem pre-diabetes occurs when a person's blood glucose levels are elevated but not high enough for a diagnosis of type 2 diabetes. Most type 2 diabetics spend many years with what is known as Pre-diabetes: There are an estimated 57 million Americans who have pre-diabetes.

A diagnosis of pre-diabetes is sign that diabetes can develop later on in life. Most people with pre-diabetes can prevent development of Type 2 diabetes exercising and dieting which has the end result of losing weight.

What happens is that the cells in the body are becoming more and more resistant to insulin or your pancreas is not producing as much as required. Blood glucose levels are higher than normal, but not high enough to be called diabetes. This is known as impaired glucose tolerance.

Other forms of Diabetes

Some other forms of diabetes mellitus are categorized separately from these. These include congenital diabetes due to genetic defects, cystic fibrosis-related diabetes, steroid diabetes induced by high doses of glucocorticoids, and several other forms.

Symptoms

Symptoms of Diabetes Type 1

Unusual weight loss

Frequent urination

Excessive thirst

Extreme hunger

Increased fatigue

Irritability

Blurry vision

Symptoms of Diabetes Type 2

Need to urinate often

Blurry vision

Slow to heal cuts or sores

Itchy skin, yeast infections

Increased thirst

Dry mouth

Leg pain

Diagnosis Methods for Diabetes

The following tests are used for diagnosis:

A fasting plasma glucose (FPG) test measures blood glucose in a person who has not eaten anything for at least 8 hours. This test is used to detect diabetes and pre-diabetes.

An oral glucose tolerance test (OGTT) measures blood glucose after a person fasts at least 8 hours and 2 hours after the person drinks a glucose-containing beverage. This test can be used to diagnose diabetes and pre-diabetes.

A random plasma glucose test, also called a casual plasma glucose test, measures blood glucose without regard to when the person being tested last ate. This test, along with an assessment of symptoms, is used to diagnose diabetes but not pre-diabetes.

Test results indicating that a person has diabetes should be confirmed with a second test on a different day.

A1C Tests. The hemoglobin A1C blood test is an essential tool in diabetes care because it shows a person’s average blood glucose level over the past 2 to 3 months. Although it is not yet used as a primary diagnosis tool it is fast becoming a popular method. Physicians base their treatment decisions on A1C test results.

Who Should be tested?

If you are experiencing any of the symptoms below or a combination of these you may want to be tested for diabetes.

•increased urination

•increased thirst

•unexplained weight loss

A blood glucose level of 200 mg/dL or higher, after a blood test may indicate diabetes especially when the person is experiencing the symptoms above.

Other symptoms include fatigue, blurred vision, increased hunger, and sores that do not heal.

The National Institute of health suggests the following testing guidelines.

People aged 45 or older should consider getting tested for pre-diabetes or diabetes. People younger than 45 should consider testing if they are overweight, obese, or extremely obese and have one or more of the following risk factors:

• being physically inactive
• having a parent, brother, or sister with diabetes
• having a family background that is African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander
• giving birth to a baby weighing more than 9 pounds or being diagnosed with gestational diabetes
• having high blood pressure—140/90 mmHg or above—or being treated for high blood pressure
• having an HDL, or “good,” cholesterol level below 35 mg/dL or a triglyceride level above 250 mg/dL
• having polycystic ovary syndrome, also called PCOS
• having IFG or IGT on previous testing
• having a condition called acanthosis nigricans, characterized by a dark, velvety rash around the neck or armpits
• having a history of cardiovascular disease—disease affecting the heart and blood vessels

If results of testing are normal, testing should be repeated at least every 3 years. Doctors may recommend more frequent testing depending on initial results and risk status. People whose test results indicate they have pre-diabetes should have their blood glucose checked again in 1 to 2 years and take steps to prevent type 2 diabetes.

When a woman is pregnant, the doctor will assess her risk for developing gestational diabetes at her first prenatal visit and order testing as needed during the pregnancy. Women who develop gestational diabetes should also have follow-up testing 6 to 12 weeks after the baby is born.

Type 2 diabetes has become more common in children and teens than in the past, and those at high risk for developing diabetes should be tested every 2 years. Testing should begin at age 10 or at puberty, whichever occurs first. Children and teens who are overweight or obese and have other risk factors, such as a family history of diabetes, are at high risk for developing diabetes.

Traditional Treatments

Treatment of Type 1

Type 1 diabetes must be treated with insulin. Injecting insulin under the skin -- in the fat – Insulin must be absorbed into the blood stream where it can then access all the cells of the body that require it. Insulin cannot be taken as a pill. Insulin is a hormone, which means it is a protein and it has a very important 3-dimensional structure which is destroyed by the acid in the stomach.  Even if it did make it through the stomach, the digestive enzymes secreted by the digestive part of the pancreas would digest the insulin protein molecule. New ways of delivering insulin are always being tested. Some new insulin pumps are being developed and tested.

Treatment of Type 2

No single diabetes treatment is best for everyone. There are many drugs used to lower blood sugar levels. See your physician to help you compare the advantages and disadvantages of specific diabetes drugs, and to determine how a specific medication or multiple medications may fit into your overall diabetes treatment plan. Insulin therapy may become necessary.

Medications for type 2 diabetes come in various classes — alpha-glucosidase inhibitors, amylin agonists, dipeptidyl-peptidase 4 (DPP-4) inhibitors, meglitinides, sulfonylureas and thiazolidinediones. Each class contains one or more specific drugs. Some of these drugs are taken orally while others must be injected.

These drugs work in a variety of ways.

Stimulating the pancreas to produce and release more insulin.

Inhibiting the production and release of glucose from the liver.

Blocking the action of stomach enzymes that break down carbohydrates or make tissues more sensitive to insulin.

There is more to diabetes treatment than medication. Controlling weight with eating healthy foods, including physical activity in your daily routine can help you control your diabetes.

Changes in lifestyle may reduce or eliminate the need for diabetes medication.

Wellness Programs

Dieting and Exercise

Dieting and Exercise is the only way to naturally control your blood sugar levels.  The importance of these two things can not be overstated. People have actually gotten off

insulin after 20 years of insulin dependency.   You can take good care of yourself and your diabetes by learning what to eat ,how much to eat and when to eat.  Making wise food choices can help you feel good everyday, lose weight if you need to,lower your risk for heart disease, stroke, and other problems caused by diabetes.

Healthful eating helps keep your blood glucose, also called blood sugar, in your target range. Physical activity and, if needed, diabetes medicines also help. The diabetes target range is the blood glucose level suggested by diabetes experts for good health. You can help prevent health problems by keeping your blood glucose levels on target.

Use the Glycemic Index

The glycemic index, invented in 1981 by David Jenkins and Thomas Wolever of the University of Toronto, is a new system for classifying carbohydrate-containing foods, according to how fast they raise blood-glucose levels inside the body. In simple terms, a food with a higher glycemic value raises blood glucose faster and is less beneficial to blood-sugar control than a food which scores lower. The glycemic index method of classifying carbohydrates according to their effect on blood-glucose, replaces the older method of classifying carbohydrates according to their chemical structure of either "simple" or "complex" carbohydrates. You can find the Glycemic Index anywhere on the internet.

Supplements

As of now there is no known natural approach to treating Type 1 diabetes however many Type 2 diabetics are controlling their blood sugar levels herbal supplementation.

Over 90% of all drugs are derived from plants in the rainforest. Less than 5% of the plants in the rainforest have been studied.

In all early civilizations, herbs have been considered to be a powerful tool in treating illnesses. In places where physicians cannot reach, people have invented their own concoction of herbs and plants to deal with the common afflictions of daily life. Sometimes, these herbal treatments are far more superior and effective the pharmaceuticals derived from them and they can be safer and less expensive.

Because of the expensive treatment for diabetes as well as the contraindications and side effects that these medications produce, people are turning to herbal treatments for diabetes. Below you will find an overview of some of the more heavily researched herbs and supplements as they effect blood sugar levels.

Gymnema Sylvestre

Gymnema sylvestre is a woody climbing plant that grows in the tropical forests of central and southern India. The leaves lamina is ovate, elliptic or ovate-lanceolate, with both surfaces pubescent. The flowers are small bell-shaped yellow color. The leaves of gurmar are used medicinally, for its unique property to directly mask the tongue’s ability to taste sweet foods; at the same time suppresses glucose absorption from the intestine. This is the reason it is known in Hindi as gurmar, or "destroyer of sugar".

The hypoglycemic extract of Gymnema sylvestre brings about blood glucose homeostasis, which in turn prevents increased glycosylation of proteins thus reversing the onset of changes leading to micro and macroangiopathy. Control of Diabetes mellitus and the associated complications are mediated through the revival or regeneration of the insulin, producing beta-cells in the islets of langerhans. The glucose-like molecules in Gurmar known as the gymnemic acid fills the receptor locations in the absorptive external layers of the intestine, thereby preventing the intestine from absorbing the sugar molecules. Due to the change in the absorption level of sugar, there is a consequent change in the blood sugar level.

Cinnamon

Studies have shown that cinnamon extracts can increase glucose metabolism, triggering insulin release -- which also affects cholesterol metabolism. Researchers speculated that cinnamon might improve both cholesterol and glucose.

Recent human studies indicate that consuming roughly one half of a teaspoon of cinnamon per day or less leads to dramatic improvements in blood sugar, cholesterol, LDL-cholesterol and triglycerides. Intake of cinnamon, at these levels, is very safe and there should not be any side effects. There are also companies selling water soluble components from cinnamon that contain the active ingredients with minimal amounts of the components that could be toxic at elevated levels.

Garcinia cambogia

Garcinia cambogia is often added to dietary supplements containing several different herbs, and is often found exclusively with chromium picolinate in capsule form. HCA inhibits lipogenesis, lowers the production of cholesterol and fatty acids, increases the production of glycogen in the liver, suppresses appetite, increases the body's production of heat by activating the process of thermogenesis. It is also used as a dietary supplement for weight loss and appetite control.

Bitter melon

Scientists have uncovered the therapeutic properties of bitter melon, a vegetable and traditional Chinese medicine, that make it a powerful treatment for Type 2 diabetes. Teams from the Garvan Institute of Medical Research and the Shanghai Institute of Materia Medica pulped roughly a ton of fresh bitter melon and extracted four very promising bioactive components. These four compounds all appear to activate the enzyme AMPK, a protein well known for regulating fuel metabolism and enabling glucose uptake. "We can now understand at a molecular level why bitter melon works as a treatment for diabetes," said Professor David James, Director of the Diabetes and Obesity Program at Garvan. "By isolating the compounds we believe to be therapeutic, we can investigate how they work together in our cells."

Banaba

Banaba is a variety of crepe myrtle that grows in the Philippines, India, Malaysia and Australia. A tea made from the leaves is used to treat diabetes. Active ingredients include corsolic acid and tannins, including lagerstroemin. These ingredients are thought to stimulate glucose uptake and have insulin-like activity. The latter activity is thought to be secondary to activation of the insulin receptor tyrosine kinase or the inhibition of tyrosine phosphatase. Banaba has been used for diabetes and weight loss, although information regarding long-term human use is not available. No adverse effects have been reported with its use.

Fenugreek

Fenugreek which has comparable antidiabetic potency to cinnamon, is one of the most valuable spices for the control of glucose metabolism and thus the prevention and treatment of Type II diabetes. Owing to its many properties it helps in the prevention and treatment of diabetes in several ways.
Working in a similar way to the common antidiabetic drug glibenclamide, fenugreek lowers cellular insulin resistance and controls blood glucose homeostasis. It has been shown to lower blood glucose levels of Type II diabetics by as much as 46 percent.
It also increases the levels of several important antioxidants and reduces the damaging oxidation of lipids associated with diabetes.

Vanadium

Vanadyl sulfate is one of the element vanadium's colorful forms, and it is sometimes called a vanadium salt. Vanadium (atomic No. 23) is an "ultratrace" mineral. Humans need it in tiny amounts, about five to 10 micrograms a day. The element is found in whole grains, shellfish, mushrooms, black pepper, parsley and soy. In the 19th century, vanadium salts were first explored as a treatment for diabetes. A product called Vanadyl is sold to treat diabetes; and in Italy, vanadium is among the 10 most frequently recommended dietary supplements by herbalists for diabetes treatment.

Research conducted almost one hundred years ago by French physician B. Lyonnet demonstrated that when a vanadium salt was administered to diabetic subjects, the concentration of glucose in urine dropped sharply. Within the past 20 years a resurgence of vanadium research has taken place in areas such as pharmacodynamics and toxicity.

Biotin

Biotin is involved in the metabolism of both sugar and fat. In sugar metabolism, biotin helps move sugar from its initial stages of processing on to its conversion into usable chemical energy. For this reason, muscle cramps and pains related to physical exertion, which may be the result of the body's inability to use sugar efficiently as fuel, may signal a biotin deficiency. The role of biotin in fat metabolism is discussed below under the heading "Synthesis of Fat (Fatty Acids)."

In several studies, biotin supplementation has been shown to enhance the performance of insulin, the hormone that plays a critical role in helping your body incorporate blood sugar. The supplements can also increase the activity of an enzyme, glucokinase, which the liver uses early in the process of utilizing blood sugar, says Michael Murray, N.D., a naturopathic doctor and co-author of The Encyclopedia of Natural Medicine.

Chromium

USDA study reference on chromium and diabetes highly refined diet that contains too few micronutrients has been recognized as the dominant factor in the rising incidence of diabetes and other insulin related conditions. Among the missing micronutrients, chromium has the greatest impact on insulin response. Until recently, few physicians recognized the importance of supplementing chromium in the management of diabetes. However, research at the US Department of Agriculture (USDA) has revealed that chromium plays an important role in amplifying insulin response in diabetics.

Vitamin C

Vitamin C is vitally important for many functions throughout the body - a big one being metabolism. Glucose and Vitamin C are similar in the way they enter the cells. Both molecules require help from insulin. The name for the process that brings glucose and Vitamin C through cell membranes is insulin-mediated uptake. The insulin-mediated uptake of glucose and vitamin C uses white blood cells. White blood cells have more insulin pumps and they may contain 20 times the amount of vitamin C as ordinary cells.

Resveratrol

Even relatively low doses of resveratrol--a chemical found in the skins of red grapes and in red wine--can improve the sensitivity of mice to the hormone insulin, according to a new report.  As insulin resistance is often characterized as the most critical factor contributing to the development of type 2 diabetes, the findings "provide a potential new therapeutic approach for preventing or treating" both conditions, the researchers said.

Garlic and Onion

Onion and garlic have significant blood sugar lowering action. The principal active ingredients are believed to be allyl propyl disulphide (APDS) and diallyl disulphide oxide (allicin), although other constitutents such as flavonoids may play a role as well. 
Experimental and clinical evidence suggests that APDS lowers glucose levels by competing with insulin for insulin-inactivating sites in the liver. This results in an increase of free insulin. APDS administered in doses of 125 mg/ kg to fasting humans was found to cause a marked fall in blood glucose levels and an increase in serum insulin. Allicin doses of 100 mg/kg produced a similar effect.  Onion extract was found to reduce blood sugar levels during oral and intravenous glucose tolerance. The effect improved as the dosage was increased; however, beneficial effects were observed even for low levels that used in the diet (eg., 25 to 200 grams). The effects were similar in both raw and boiled onion extracts. Onions affect the hepatic metabolism of glucose and/or increases the release of insulin, and/or prevent insulin's destruction. 
The additional benefit of the use of garlic and onions are their beneficial cardiovascular effects. They are found to lower lipid levels, inhibit platelet aggregation and are antihypertensive. So, liberal use of onion and garlic are recommended for diabetic patients.

Licorice

Licorice flavonoids suppress abdominal fat accumulation and decrease blood glucose level in obese diabetic mice.

According to recent research published in the journal Biological and Pharmaceutical Bulletin, "Licorice, the root of the Glycyrrhiza species, is one of the most frequently employed botanicals in traditional medicines. In this study, we investigated the effects of hydrophobic flavonoids from Glycyrrhiza glabra LINNE on abdominal fat accumulation and blood glucose level in obese diabetic KK-Ay mice.

Aloe

Recently aloe vera juice was given to diabetic patients to see if it could have any effect in reducing levels of fasting blood glucose. The study showed a lower blood glucose level within two weeks and reduced triglycerides (fat) within four weeks. Aloe vera juice had no effect on cholesterol levels and had no toxic effects on kidney or liver function as assessed by blood chemistry. According to the authors of the study (see below), the results were significant enough to recommend the use of aloe vera to assist with blood sugar regulation.

Vitamin K

Your pancreas is responsible for regulating your blood sugar levels, and normally has one of the highest concentrations of vitamin K in your body - this is why vitamin K plays such an important role in this process.
Japanese researchers have found that a deficiency of vitamin K has clinical effects similar to those of diabetes - high blood sugar, low insulin and problems with sugar molecules entering your cells where they are needed for increased energy production. This has prompted intense research into the use of vitamin K for treating diabetes - however, more proof is needed before standard recommendations can be made.

Alternative Treatments