Diabetes and Metabolism

            The current situation in America and many other developed countries is ripe for the development of diabetes. Roughly 75% of Americans are overweight (1), and about 25% of Americans have a pre-diabetic condition termed syndrome X. Syndrome X consists of four different diseases: hypertension (high blood pressure), diabetes, high triglyceride (fat) levels, and obesity (2). Interestingly, there may be one single connecting factor between all four ailments: excess sugar intake. 

            There are two main types of diabetes, at least as classified conventionally: type I (insulin-dependent), and type II (non-insulin-dependent). Type I diabetes is the result of an autoimmune disease, which usually begins in childhood. In type I diabetes, the immune system mistakes the insulin-producing pancreatic cells for an intruder, and then destroys them. A type I diabetic most often needs insulin injections, so that they can bring the sugar in their bloodstream into their cells to use as an energy source. Type II diabetes is much more influenced by environmental factors than type I. Two of the main contributors to type II diabetes are lack of aerobic exercise and excessive intake of simple sugars. However, since type II diabetes has environmental causes, it can also be helped greatly by a change in the diabetic’s environment. Aerobic exercise is very important for a diabetic, as long as they are healthy enough for this routine. Aerobic exercise turns on genes that help the body utilize food sources more properly. Before you begin an aerobic exercise regimen, consult your family physician, especially if you have any serious physical conditions. Eating several small meals throughout the day may also help stabilize insulin and blood sugar levels.

            When too many simple sugars are taken in, by either food or drink, blood sugar rises. The hormone insulin is then secreted in order to bring the blood sugar into the body’s cells, so that it can be used for energy. When the blood sugar remains high for long periods, the body’s cells often adapt to this situation by lowering the sensitivity of the insulin receptors. When this happens, there needs to be more insulin released to accomplish the same amount of action for helping the blood sugar enter the body’s cells. This is known as insulin resistance, or glucose intolerance. Symptoms of diabetes include: vomiting, frequent urination, nausea, constant thirst, blurred vision, marked weight loss, and fatigue (3). Long-term complications of diabetes include: cardiovascular (heart) disease, hyperglycemia (high blood sugar), hypoglycemia (low blood sugar), eye problems, overly acidic blood, kidney disease, and nerve damage (4).

            Most doctors and researchers recommend complex carbohydrates to diabetics. Complex carbohydrates are usually foods like whole grains, which have more branched-chain sugars, and take longer to break down into simple sugars (glucose, fructose, sucrose, etc.). However, there is clinical evidence that even complex carbohydrates can worsen diabetes. If the diet consists of more than 55% of complex carbohydrates (not to mention simple carbohydrates), the result can be a worsening of blood sugar control, an increase of damaging fats in the blood, and a decrease of healthy fats in the blood (5). Unfortunately, the American Diabetic Association recommends that diabetics have about 60-70% of their food as carbohydrates (3). For many (if not most) diabetics, carbohydrates are part of the problem, not the solution. There are many different reasons why people can develop type II diabetes, and there are also many possible solutions. A 60-70% carbohydrate diet may help some diabetics with their condition, and may worsen the condition of others. This is why a diabetic needs to find out what type of metabolism they have, in order to tailor their diet and supplements to their unique needs.

            Diabetics need to limit their intake of fats as well as sugars. High blood sugar causes insulin to also raise the amount of fats in the blood. A high fat diet, more than 30% of total calories, can contribute to insulin resistance and glucose intolerance (6). However, there needs to be some fat intake, since it is essential for life, and also because it’s one of the three energy sources for people, along with carbohydrates and protein. Fat and protein are usually found together in foods. Fat has a little over twice as many calories per weight as protein, and many foods are composed of roughly equal calorie amounts of fat and protein. So, if a diabetic chooses to limit carbohydrates to around 50% of their total calories, then they may end up taking in about 25% protein and 25% fat. For most people, it is probably wise to avoid getting more than 25% of their calories from protein, since too much protein can over-acidify certain parts of the body, as well as being hard on the kidneys. Some people choose to drink diet sodas in order to limit their sugar intake. However, the aspartame sweetener in sugar substitutes such as Nutrasweet can also raise insulin levels (2).

            Diabetics tend to be deficient in many vitamins and minerals. Low vitamin D levels are correlated with glucose intolerance (7). Middle-aged diabetics tend to be low in the mineral magnesium (8). If you choose to supplement with magnesium, have your family doctor first test for proper kidney function. The mineral chromium is very important in helping the function of insulin. Between 25-50% of Americans are deficient in chromium (9). There is some evidence that milk binds up chromium before it can be absorbed (9), which is a good reason for diabetics to limit dairy products in their diet. In fact, childhood allergy to a specific milk protein called BSA may contribute to the development of type I (autoimmune) diabetes (10).

            Both chromium and vitamin E can reduce insulin requirements. If a diabetic is on oral or injected medication, and chooses to supplement with either chromium or vitamin E, they should start slowly, with the knowledge of their physician and guidance of a consultant. It’s recommended that diabetics do not supplement with any potassium, unless directed by their physician. Unfortunately, supplementation with fish oil can have unpredictable effects on the functions of insulin, blood sugar levels, and cholesterol levels (11,12). Megadosing (taking more than 10 times the RDA-Recommended Daily Allowance) of vitamin B3 (niacin) may raise blood sugar levels (13). The study looked at supplementing with niacin at more than 1000 mg/day. Niacinamide is a safer form of niacin that does not raise blood sugar levels, and may help several other diabetes-related problems.

References

1          Eades, M., & Eades, M. The Protein Power Life Plan. New York, NY: Warner Books, 2000.

2          Kristal, H., & Haig, J. The Nutrition Solution. Berkeley, CA: North Atlantic Books, 2002.

3          Reavley, N. The New Encyclopedia of Vitamins, Minerals, Supplements, and Herbs. New York, NY: M. Evan & Co., 1998.

4          Litin, S., ed. Mayo Clinic Family Health Book, 3rd Ed. New York, NY: HarperCollins Books, 2003.

5          Reaven, GM. (Ed.)(1988). Dietary therapy for non-insulin-dependent diabetes mellitus. N Engl J Med, 319 (13): 862-64. 

6          Nagy, K., et. al. (1990). High-fat feeding induces tissue-specific alteration in proportion of activated insulin receptors in rats. Acta Endocrinol (Coph), 122 (3): 361-68.

7          Baynes, KC., Bouchcer, BJ, Feskens, EJ, & Kromhout, D. (1997). Vitamin D, glucose tolerance and insulinaemia in elderly men. Diabetologia, 40 (3): 344-7.

8          Ma, J., et. al. (1995). Associations of serum and dietary magnesium with cardiovascular disease, hypertension, diabetes, insulin, and carotid arterial wall thickness. The ARIC study: atherosclerosis risk in communities. J Clin Epidemiol, 48 (7): 927-40.

9          Haas, E. Staying Healthy with Nutrition. Berkeley, CA: Celestial Arts, 1992.

10        Holford, P. The Optimum Nutrition Bible. Berkeley, CA: Crossing Press/Ten Speed Press, 1999.

11        Vandongen, R., et. al. (1988). Hypercholesterolamic effect of fish oil in insulin-dependent diabetic patients. Med J Aust, 148: 141-43. 

12        Glauber, H., et. al.(1988). Adverse metabolic effect of omega-3 fatty acids in non-insulin-dependent diabetes mellitus. Ann Intern Med, 108 (5): 663-68.

13        Balch, P. Prescription for Nutritional Healing, 3rd Ed. Avery Books/Penguin Putnam Inc., 2000.