Conditions

Diabetes Mellitus

Diabetes mellitus is a chronic disorder characterized by insufficient or defective production of insulin, a hormone produced by the pancreas. Insulin plays an essential role in the metabolism of carbohydrates. Insulin controls the amount of glucose (sugar) in the blood and the rate at which glucose is absorbed by into the cells. The cells need glucose to produce energy.

In people with diabetes, glucose builds up in the bloodstream instead of being taken into and used by the cells, leading to hyperglycemia (abnormally high levels of glucose in the blood). Eventually, hyperglycemia leads to damaged blood vessels, which in tun, may cause eye disease, heart disease, peripheral and autonomic neuropathy (nerve damage in the limbs and internal organs), and diabtic nephropathcy (kidney disease).

There are two types of diabetes mellitus, type I and type II. Type I diabetes, also sometimes called insulin dependent diabetes or juvenile-onset diabetes, is usually diagnosed in childhood and involves such a severe lack of insulin that it must be taken by injection every day. Type I diabetes is an autoimmune disease in which the body's immune system attacks and destroys the insulin-producing cells in the pancreas. Experts believe this may result from an immune response after a viral infection.

Type II diabetes, also known as noninsulin-dependent diabetes or adult-onset diabetes, is the most common form of diabetes, affecting 90 to 95 percent of diabetes sufferers. In type II diabetes, the pancreas does produce insulin in small quantities, but not enough to fuel the cells. The cells may also become resistant to the effects of what little insulin there is in the bloodstream. Many people have type II diabetes and are completely unaware of it. This type of diabetes usually begins in later years, although, unfortunately, it is now becoming more common in young people. Risk factors for type developing type II diabetes include diet, weight, race, age, lack of exercise, and heredity.

Signs and Symptoms:

• Increased frequency of urination
• Increased and often extreme thirst
• Increased appetite
• Weight loss
• Irritability
• Fatigue
• Leg cramps
• Blurred vision
• Stiffness in the shoulder and upper back
• Numbness or tingling in the hands or feet
• Increased susceptibility to infection

Diagnosis:

The most reliable method of diagnosing diabetes involves a glucose tolerance test. This test measures the concentration of glucose in the blood after an overnight fast.

Treatment Options:

Treatment for diabetes centers on maintaining a normal blood-sugar level so the body will have enough energy to function properly. Components are diet, exercise, blood glucose self-monitoring, oral medication (Type II), and insulin (Type I).

Traditional Treatments:

• If you have type I diabetes, your body is not producing adequate amounts of insulin and you will need either oral supplements or injections to get this essential hormone. Within a few weeks or months of beginning insulin treatment, your insulin needs may decrease significantly. In fact, you may not need insulin at all at this point. You should be aware, however, that eventually, you will need to go back to taking insulin. There are many intricacies involved in dealing with insulin injections. For example, it is important to take the injection in a different spot each day. You should learn about the different types of insulin, as well as the blood and urine tests that are used to monitor sugar and insulin levels.
• Attention to diet is important. Too many carbohydrates can increase blood sugar; too few will lower it. People with diabetes have the same nutritional and caloric needs as other people, but they need a diet that is carefully designed to give them the correct balance of carbohydrates, protein, and fats. Once you are taking insulin, it's important to eat appropriately so that your blood sugar doesn't fall too low and cause a hypoglycemic reaction. Also, you will need to eat at the same times each day. You need to eat a snack at midmorning and midafternoon, and you must eat the same number of calories from one day to the next. Five small meals a day are better than three large ones.
• If you have type II diabetes and are overweight, the treatment of choice is weight loss. If this is not successful, the next step is to try hypoglycemic medicines that are taken orally. These drugs act primarily by stimulating the pancreas to secrete additional insulin. In many cases, however, even this is not enough and insulin, given either orally or by injections, is necessary. As with type I diabetes, appropriate diet and adequate exercise is essential.
• Sulfonylureas are the oral medications that are most often prescribed for Type II diabetes. These drugs work by forcing the pancreas to secrete more insulin. Examples include tolbutamide (Orinase), tolazamide (Tolinase), acetohexamide (Dymelor), chlorpropamide (Diabinese), glyburide (DiaBeta, Glynase, Micronase), glipizide (Glucotrol), and glymeperide (Amaryl). While all these drugs work in a similar way, their strength and duration of action vary. Potential side effects also are similar, and include liver problems, low blood sugar, nausea, and an increased risk of heart disease.
• Metformin (Glucophage), another oral diabetes agent, seems to stabilize both fasting and postprandial (after-meal) levels of blood sugar in adults, though how it works is not understood. It does not cause low blood sugar problems, and is more widely used for obese individuals than the sulfonylureas are. However, side effects of nausea, vomiting, diarrhea, and abdominal pain are common. Cardiovascular problems can be a problem with this drug, too.
• Acarbose (Precose) is an oral agent that lowers blood sugar by competing with carbohydrates for absorption in the intestinal tract rather than by stimulating the release of insulin. Because of this, it can cause a significant increase in bowel gas, diarrhea, and abdominal pain. Especially when carbohydrates are ingested.
• Troglitazone (Rezulin) can resensitize the body to insulin. About 15 percent of patients involved in the testing of this drug no longer needed insulin shots once they started taking it. Most patients still needed insulin but required fewer injections. If you have type II diabetes, you may wish to consult your doctor about the possibility of trying this drug.

Complementary and Alternative Therapies:

Alternative therapies have an important role in preventing vascular damage and some of the serious complications that may be involved with DM. A combination of herbs and nutrition, along with lifestyle changes, can be quite helpful.

Nutritional Supplementation:

• In general, a good multivitamin and mineral supplement is useful for people with diabetes. Follow the label directions.
• Chromium helps stabilize blood sugar. Take 100mcg of chromium twice a day. Studies have shown that doses up to 1,000mcg (or 1mg) can be very effective for managing type II diabetes. Chromium does not appear to be toxic even in very high doses, but you should discuss this approach with your doctor before taking megadoses.
• Beta-carotene and vitamin D can be helpful for people with diabetes. Take 10,000 IU of beta-carotene twice a day and 200 to 400 IU of vitamin D daily.
• Gamma-linolenic acid (GLA), found in black currant seed oil, borage oil, and evening primrose oil, has been shown to be helpful for improving damaged nerve function, which is common in diabetes. Take 500 to 1,000mg of any of these oils twice daily.
• Lipoic acid has shown considerable promise in protecting the cells in the pancreas that manufacture insulin. Take 100 to 500mg daily.
• Garlic decreases and stabilizes blood sugar levels. Follow label directions.
• Vanadium, or vanadyl sulfate, may reduce the need for insulin. What is unique about this nutrient is that its effect may persist even after you stop taking it. Take 250mcg two or three times daily.
• Take a good vitamin-B complex supplement daily. The B vitamins are necessary for the processes that convert glucose into energy and for a healthy nervous system.
• Vitamin C and bioflavonoids may be useful for preventing damage to the nerves caused by excessively elevated blood sugar. Take 500 to 1,000mg of vitamin C and 500mg of mixed bioflavonoids two to three times daily.
• Vitamin E improves insulin activity and acts as an antioxidant and a blood oxygenator. Begin by taking 400 IU each morning. After two weeks, add another dose of 400 IU in the evening. After two more weeks, add another 400 IU in the afternoon.
  Warning: If you have high blood pressure, limit your intake of supplemental vitamin E to a total of 400 IU daily. If you are taking blood thinners consult your doctor before taking supplemental vitamin E.
• Zinc is helpful in regulating insulin metabolism. Take up to 50mg of zinc daily from all sources, including your multivitamin and mineral supplement. Take with meals. Warning: If you take over 30mg of zinc on a daily basis for more than one month, you should also take 1 or 2mg of copper each day to maintain a proper mineral balance.

Alternative Therapies:

• Beanpod tea, made up of kidney, white, navy, lima, and northern beans, detoxifies the pancreas.
• Blueberry leaf tea has been used historically for insulin regulation. This herb also contains anthocyanidins, which help to protect the eyes. Take a cup of blueberry leaf tea two or three times daily ­ with repeated use, your need for insulin may be reduced.
• Bitter melon (Mormordica charantia), gudmar (Gymnema syvestra), and gulvel (Tinospora cordlife) are herbal remedies used in Ayruvedic medicine to regulate blood sugar levels.
• Cedar berries are excellent nourishment for the pancreas.
• Dandelion root protects the liver, which converts nutrients into glucose.
  Warning: If you suffer gallbladder problems, avoid large quantities of dandelion.
• Fenugreek seeds have been shown to reduce cholesterol and blood sugar levels.
• Ginseng tea is believed to lower the blood sugar level.
  Warning: Do not use Ginseng if you have high blood pressure.
• Huckleberry helps to promote insulin production
• Juniper berries have been found to lower blood glucose levels.
• Other herbs that may be beneficial for diabetes include bilberry, buchu, dandelion root, goldenseal, and uva ursi.
  Warning: Do not take goldenseal on a daily basis for more than one week at a time, and do not use goldenseal during pregnancy. If you have a history of cardiovascular disease, diabetes, or glaucoma, use it only under a doctor's supervision.

General Recommendations:

• Monitor your insulin levels and keep a diary of everything you consume and the energy you expends. You may find ways to regulate your insulin levels, naturally.
• Monitor your blood-sugar level carefully. Insulin requirements change over time.
• Keep your weight down.
• Exercise. Both types of diabetes can be greatly improved with a regular moderate exercise program. Remember, however, that you must carefully monitor your blood sugar during exercise in order to avoid possible overdoses of insulin.
• Supplement your diet with spirulina. Spirulina helps to stabilize blood sugar levels. Other foods that help normalize blood sugar include: berries, brewer's yeast, dairy products (especially cheese), egg yolks, fish, garlic, kelp, sauerkraut, soybeans, and vegetables.
• Do not take supplements containing the amino acid cysteine. It has the ability to break down the bonds of the hormone insulin and interferes with absorption of insulin by the cells.
• Do not take extremely large doses of thiamine and vitamin C. Excessive amounts may inactivate insulin.
• If you have a child with diabetes, be sure his or her teacher knows how to respond to the warning signs of hypoglycemia and hyperglycemia.
• If symptoms of hypoglycemia develop, immediately consume fruit juice, soda pop, or anything else that contains sugar. If that fails to help within twenty minutes, repeat this regimen. If the second treatment fails, or if you cannot ingest food, seek immediate medical attention and/or administer a glucagon injection. Anyone who has insulin-dependent diabetes should always carry a glucagon kit and know how to use it.

Warnings:

• Do not use Ginseng if you have high blood pressure.
• Do not take goldenseal on a daily basis for more than one week at a time.
• Do not use goldenseal during pregnancy.
• If you have a history of cardiovascular disease, diabetes, or glaucoma, use goldenseal only under a doctor's supervision.
• If you suffer gallbladder problems, avoid large quantities of dandelion.
• If you take over 30mg of zinc on a daily basis for more than one month, you should also take 1 or 2mg of copper each day to maintain a proper mineral balance.
• If you have high blood pressure, limit your intake of supplemental vitamin E to a total of 400 IU daily.
• If you are taking blood thinners consult your doctor before taking supplemental vitamin E.