Diabetes Mellitus

Facts

·   Diabetes is one of the fastest growing diseases in both the developed and developing world.

What happens to sugar after it has been broken down into glucose in the digestive system?

Glucose is absorbed through the wall of the small intestine.  It goes into the bloodstream.  A high glucose level in the bloodstream triggers the pancreas to secrete insulin.  Insulin takes the glucose into the cells.



 Insulin is like a key that fits into little locks (called receptors) in the cell wall.  It takes in glucose, amino acids, fatty acids, and potassium. When the blood sugar gets low enough the pancreas stops secreting insulin.  A certain amount of glucose must stay in the bloodstream to constantly supply the brain.  If the brain doesn’t get enough glucose, it causes nervousness, anxiety, irritability, depression, forgetfulness, confusion, indecisiveness, poor concentration, nightmares, and suicidal tendencies.

What is Diabetes Mellitus?

Diabetes Mellitus is a condition is which the body does not produce enough insulin or cannot utilize insulin to take glucose into the cells.

2 Types of Diabetes Mellitus:

1.       Insulin Dependent Diabetes Mellitus:  10% of all Diabetes is IDDM.  It usually occurs in childhood but can occur later.  The pancreas does not produce insulin.  It is thought to be caused by viruses such as mumps, German measles, flu, and infectious mononucleosis that stay in the body and damage the pancreas.  These is a link between milk consumption and IDDM.

      

2.       Non-Insulin Dependent Diabetes Mellitus:  90% of all Diabetes is NIDDM.  It usually occurs in people over 40 yrs. old who are overweight.  About 80% of overweight adults develop diabetes.  More women than men are diabetic.  The amount of insulin produced varies and is often higher than normal.  NIDDM is usually caused by a decrease in the number of insulin receptors on the cells. 

What are some of the purposes of insulin in the body?

• It is responsible for taking glucose, fatty acids, and amino acids into the cells. 
• It also converts excess calories from carbohydrates and protein into fat.

Factors believed to contribute to a decrease in the number of insulin receptors:

When a person overeats or eats high sugar or fat meals the body releases an excess of insulin to compensate—usually more insulin than is needed.  This begins a vicious cycle.  The blood sugar then may fall too low and the person experiences hypoglycemia—he feels weak and wants to eat again to get energy.  Often the person will eat a high sugar snack for energy and the cycle goes on.  Over time this bombardment of excess insulin on the insulin receptors makes them less sensitive to insulin and they may decrease in number.

As a person gains weight their fat cells get more and more full, perhaps to capacity.  These overloaded fat cells may become less sensitive to insulin and the receptors may also decrease.

As the insulin receptors become less sensitive to insulin, the cells signal the pancreas to make more insulin to take the nutrients in because they aren’t getting the nourishment they need.  Again, hyperexcretion of insulin can lead to a greater decrease in sensitivity to insulin and a decreased number of receptors.

In the pancreas, the Islets of Langerhans which produce insulin may become damaged from overuse so that the pancreas cannot meet an excessive demand for insulin.

Note:  Cells of the brain, intestine, renal tubules, and red blood cells are able to absorb glucose without insulin—they use a different transport mechanism.

Signs and Symptoms of Diabetes:

1.       Polydypsia (increased thirst) and Polyuria (increased urination) – Large amounts of glucose are lost in the urine.  Excessive amounts of glucose in the kidneys also cause large amounts of water to be lost.  This leads to excessive urination, thirst and even dehydration.

2.       Polyphagia (increased hunger) – Because of the inability of the cells to be nourished by glucose the diabetic may become very hungry and eat excessively.  Nevertheless, he may lose weight and become weakened by excessive consumption of protein and fat stores.

3.       Headaches

4.       Weakness – The diabetic feels weak because his cells cannot be nourished.

5.       Frequent Infections

6.       Peripheral Vascular Disease (arteries and veins in extremities become rigid)

7.       Irritability

8.       Itching

9.       Poor Wound Healing

10.   Blurred Vision

What happens if Diabetes goes uncontrolled?

• Damage to the arteries
• Aneurysms in blood vessels (a weakened area in the wall of a blood vessel, enlarged by the pressure of blood, which may rupture)
• Kidney damage
• Retinopathy and potential blindness
• Neuropathy (minor pressure on the nerves causes a sharp, stabbing pain and extreme tenderness)

Note:  High blood sugar increases the production of aldolase.  By products of aldolase form lesions in

the nerves, blood vessels and retina.

Controlling Non-insulin Dependent Diabetes Mellitus

• Eat a diet high in complex carbohydrates.  This means a variety of whole grains, fruits, vegetables, beans, nuts and seeds.  Complex carbohydrates are broken down into sugars and released into the system slowly giving sustained energy all day long without the need for excessive insulin production. 
• Avoid:  Refined products such as white bread, white pasta, white rice, any white flour items, and refined sugars such as white sugar, honey, etc. 
• Eat a high fiber diet.  Fiber reduces insulin requirements and increases insulin sensitivity. Soluble fiber steadies the blood sugar curve by preventing a rapid rise in blood sugar. 
• Eat a low fat diet.  Insulin is needed to take fatty acids into the cells; therefore fat increases the need for insulin.  Diets low in fat and high in fiber improve insulin binding.  Low fat & high fiber keeps blood sugar low, even when fruit is eaten. 
• Avoid:  refined fats such as butter, margarine, mayonnaise, fried foods, salad oils, cooking fats and peanut butter.
• High fat, high protein not good (formerly recommended for diabetics).  High fat and high protein intakes promote kidney disease, eye problems, obesity, osteoporosis, cancer, high cholesterol and high triglycerides, liver disease, atherosclerosis and heart disease, heart attacks and strokes.
• Complete vegetarian diet the best for all diabetics.   Animal products are high in saturated fat and contain no fiber.  Saturated fats cause the body to produce more cholesterol.  Dairy products are high in milk sugar.  Study of SDA men in California:  those that ate meat 6X or more per week were at 3.8X greater risk of dying from diabetes than those that ate meat less than 1X/week.
• Two meals a day is best (for Type II Diabetics):  The ideal pattern for a non-insulin-using diabetic, is to eat a satisfying breakfast and lunch but no supper or snacks.  This increases insulin binding to the cells.  More meals increases production of insulin which results in more insulin resistance.  If a third meal is eaten it should be very small and consist of only whole grains and fruit.
• Eat at exactly the same time every day:  This helps the pancreas recover a regular pattern.  There should be at least 5 hours between meals.    Eat slowly and chew your food well.
• Never eat between meals:  Snacking keeps blood sugars elevated and promotes excessive insulin secretion.
• Do not overeat:  Overeating is a major cause of insulin resistance.  Too much food results in an over-production of insulin which leads to insulin resistance.
• Diabetics manage best on a very spare diet:  1200-1500 calories per day is sufficient if their work is sedentary.
• Lose weight if you are over-weight:  In almost all cases of Type II diabetes, control of the disease is completely determined by control of appetite, weight and exercise.  It is important to achieve your ideal weight—about 5% lower than the average American weight is actually best for controlling diabetes.
• Get regular exercise, especially just following a meal:  Muscle cells become more insulin receptive when they are exercised so less insulin is needed.  Walking or such labors as gardening are generally the best exercise.  An added benefit is that exercise helps control appetite and reduces weight.

SPECIFIC FOODS TO EAT OR AVOID

• Whole Grains:  Cracked or whole kernel grains such as rice, millet, wheat, rye, barley and corn make excellent main dishes.  Starchy pastas such as spaghetti and macaroni may also be eaten as long as the whole grain pasta is used.  Eat bread made only from whole grains.
• Vegetables:  May be eaten in liberal quantities.  Starchy vegetables such as Irish potatoes, corn, split peas and dried beans, may be used as main dishes instead of meat, milk, eggs, and cheese.
• Dairy Substitutes:  Soymilk without sweeteners added and cheeses and creams made from nuts, flours, or vegetables may be used in limited quantities to replace dairy products.
• Nuts and Seeds:  Use all kinds as well as their butters sparingly.  Use nuts raw or lightly roasted.
• Sweet fruits and vegetables:  Dried fruits are concentrated so it is easy to overeat them—use them very sparingly.  Bananas, mangoes, watermelon and sweet potatoes should be avoided by most patients for at least one month, because they are too sweet.  Grapes should be eaten sparingly.
• Fruit Juice:  May on occasion be used as part of the fluid in some recipes but should not be taken regularly at meals in large quantities as they interfere with digestion, dump quickly into the bloodstream and displace other, more important foods.  Two or three ounces could be sipped slowly at an occasional meal.  Never drink any beverage but water or unsweetened herb tea between meals.
• Raw Foods:  Decrease plasma glucose levels in both mild and severe diabetics (as compared to a cooked meal of the same caloric value).
• Herbal tea beverages and roasted grain coffees:  Are a good substitute for tea, coffee, and colas containing caffeine and sugar.  Avoid caffeine which raises blood sugar levels. 
• Jerusalem Artichokes:  Contain inulin, a complex carbohydrate which helps the body absorb and utilize carbohydrates, even when diabetes is present.
• Fenugreek Seeds:  When fenugreek seed powder is incorporated into the diet, fasting blood sugar may be significantly reduced.  Total serum cholesterol is also reduced.  Studies show it helpful in management of Type I diabetes.
• Onions:  Have a component which lowers blood sugar levels in diabetics (but not in normal individuals).
• Raw Garlic:  May help reduce blood sugar levels.
• Stevia:  An herbal sweetener which has no caloric value and may be safely used by diabetics. 
• Ripe olives, avocados, and coconut:  Ripe olives and avocados are nutritious sources of quality oils for the diet.  Unsweetened coconut may be used safely by vegan vegetarians.
• Green beans:  Appear to help lower blood sugar levels.

OTHER FACTORS

• Do not drink fluids with your meals:  Recent studies have shown that the consumption of a single glass of water with a meal significantly increases blood glucose levels compared to the same meal without water.  (This effect also occurs in healthy subjects.)
• Diabetics should avoid stress.  Stress and pain cause your body to break down stores of glucose and put it into your bloodstream.  Stress hormones can damage the cells that produce insulin.
• Alcohol:  The liver gives priority to processing the alcohol.  If the blood sugar is low it will convert glycogen to glucose only after taking care of the alcohol; can result in serious hypoglycemia; there can be a delayed reaction & hypoglycemia can occur as long as 36 hours later.
• Tobacco:  Nicotine is a potent stimulator of insulin production and should be strictly avoided.