Diabetes is a costly disease, placing a high financial burden on the patient and the healthcare system. If poorly managed or left untreated, it can cause blindness, loss of kidney function, and conditions that require the amputation of digits or limbs. The CDC reports that it’s also a major cause of heart disease and stroke and the seventh leading cause of death in the United States.
In the picture to the right you can see the lunch that I was unbelievably served at the 11th International Congress on Obesity in Stockholm 2010. This is a major international conference for obesity doctors and scientists. The food contains almost exclusively energy from sugar and starches, things that are broken down to simple sugars in the stomach.
The fact these improvements can happen independently of weight loss should also signify a shift in how we conceptualize both obesity and diabetes, according to Peter Billings, the Seattle bariatric surgeon who operated on Benari. Billings, a nearly 20-year veteran in the field, has started to perform surgery on other lower-BMI patients similar to Benari, though they often pay out of pocket.
I bring this up because sleep apnea increases a person’s risk for developing type 2 diabetes. Also, sleep-disordered breathing is also related to proper nutrition throughout life. And perhaps most importantly, the first line of defense in catching sleep-disordered breathing in patients early, are dentists. This is another area where dentists must get involved if we want to tackle the issue of pervasive type 2 diabetes with any success.
In 2017 the results of the DIRECT study were published, where obese type 2 diabetic were put on a 830 Cal diet for 6 month by their GPs (the two former studies were led by medical specialists), mean weight loss 15% ≈ 15 kg Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. The more weight one lost, the higher the success rates
This is the advice that diabetics received a hundred years ago. Even in Sweden, with the high fat-Petrén diet that included fatty pork cuts, butter and green cabbage. And when diabetics start eating this way today the same thing happens as it did in the past. Their blood sugar levels improve dramatically from day one. This makes sense, as they avoid eating what raises blood sugar.
According to TCM, the major activity of the blood is to circulate through the body, nourishing and moistening the various organs and tissues. Disharmonies of the blood may manifest as “deficient” blood or “congealed” blood. If deficient blood exists and affects the entire body, the patient may present with dry skin, dizziness, and a dull complexion. Congealed blood may manifest as sharp, stabbing pains accompanied by tumors, cysts, or swelling of the organs (i.e., the liver).4 The key organs associated with blood are the heart, liver, and spleen.
The accepted view has been that the β-cell dysfunction of established diabetes progresses inexorably (79,82,83), whereas insulin resistance can be modified at least to some extent. However, it is now clear that the β-cell defect, not solely hepatic insulin resistance, may be reversible by weight loss at least early in the course of type 2 diabetes (21,84). The low insulin sensitivity of muscle tissue does not change materially either during the onset of diabetes or during subsequent reversal. Overall, the information on the inhibitory effects of excess fat on β-cell function and apoptosis permits a new understanding of the etiology and time course of type 2 diabetes.
Although the promises are big, these technologies are still far from the market. First, clinical trials will have to show they do work. Then, the price could be steep, as cell therapy precedents for other applications, such as oncology, come with price tags that reach the six figures and are finding difficulties to get reimbursed. Considering that compared to cancer, diabetes is not an immediately life-threatening disease, health insurers in some countries might be reluctant to cover the treatment.
Dr. Mona Morstein is a naturopathic physician with a medical practice focused in integrative diabetes treatment. Her clinic, Arizona Integrative Medical Solutions, is located in Tempe, Arizona, where she sees patients of all ages and genders for acute and chronic conditions. An expert on prediabetes and diabetes, she is a frequent lecturer at conferences and webinars, and is the founder and executive director of The Low Carb Diabetes Association. Dr. Morstein is also a member of the Arizona Diabetes Coalition. Visit her website lowcarbdiabetes.org
Dr. Steven Lin is a dentist who focusses on the mouth-body connection. Through ancestral nutrition, the oral and gut microbiome, and epigenetics, his programs aim to prevent chronic dental and systemic disease. His book 'The Dental Diet', will be released on January 18'. To receive free updates on functional oral health from Dr. Lin, subscribe to his newsletter below.
Gupta says that with her patients, “we typically emphasize cutting out processed food and sugary drinks to begin with, and exercise recommendations include 150 minutes of moderate-intensity cardiovascular exercise per week, and two to three days per week of strength training, which is consistent with exercise guidelines from the Centers for Disease Control and Prevention.” The American Diabetes Association recommends replacing high-fat, high-sugar, high-salt foods with a mix of fiber, protein, fruits, and vegetables to keep blood sugar levels steady.
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The first hint that type 2 diabetes is a fully reversible syndrome came from bariatric surgery. Almost a quarter century ago, Pories et al. (12) demonstrated that blood glucose levels normalized in obese people with type 2 diabetes undergoing bariatric surgery and that 10 years later, almost 90% remained free of diabetes. The phenomenon was more recently tested in a randomized prospective study comparing gastric banding with intensive medical therapy for type 2 diabetes (13). This least invasive type of surgery was most suitable for the randomized study, although it was associated with lower rates of diabetes reversal than other procedures. Mean fasting plasma glucose fell to normal levels in the surgically treated group but declined only modestly in the intensive medical treatment group despite oral agents and insulin (Fig. 1) (13). Remission of diabetes was related to the degree of weight loss rather than to group allocation and was achieved in 73% of the surgical group and 13% of the intensive medical treatment group because surgery was more effective in achieving weight loss as previously described (14). Type 2 diabetes can be reversed by applying a surgical procedure that diminishes fat mass.
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A new study from the Faustman Lab at Massachusetts General Hospital suggests that a nearly 100 year old tuberculosis vaccine called BCG may hold cure-like promise for people with Type 1 diabetes. The bacillus Calmette-Guérin (BCG) vaccine, one of the oldest vaccines in the world, was developed for tuberculosis protection and for early stage bladder cancer therapy.
Garlic: Potent, but effective. Garlic is known as one of the oldest medicines in the world…and with good reason. An animal study that administered high doses of raw garlic to rats for 4 weeks found that it had a profound effect of reducing blood glucose levels, as well as cholesterol and triglycerides compared to rats who did not receive raw garlic (2). They also tested rats with boiled garlic, and saw no changes in blood glucose, so the benefit comes from raw garlic.
Curcumin. The compound curcumin, which is found in the spice tumeric, has been shown to both boost blood sugar control and help prevent the disease. In a nine-month study of 240 adults with pre-diabetes, those who took curcumin capsules (which are available over-the-counter) completely avoided developing diabetes while a sixth of patients in the placebo group did.
Alternative: “I’m a fat-atarian,” says DeLaney, who tells her patients to avoid low-fat foods. She encourages them to eat whole-fat dairy products, egg yolks, butter, olive oil, and avocado. “Restoring healthful fats to our diets as well as eliminating trans fats and all refined oils that help deplete our fat and vitamin stores will help nourish the body and reduce the need for diabetes medication.”
Thiazolidenediones can increase risk of heart failure and should not be used in patients with symptoms of heart failure. Liver enzymes should be checked regularly with use. Other side effects include weight gain, fatigue, swelling of the legs or ankles, increased risk for fractures in female patients. Avandia may have a potential increased risk for heart attack.
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One of the lesser known herbs that lower blood sugar, Marjoram, is high in polyphenols, which aids in stabilizing blood glucose levels. A 2012 study in the Journal of Evidence Based Alternative and Complementary Medicine found that Marjoram reduced formation of Advanced Glycation End (AGE) products. AGE is the smoking gun that researchers today say is responsible for a lot of the complications that diabetics face, like damage to arteries and eyes. Try sprinkling marjoram on your dinner every night to help add variety in flavor. It can often be used as a substitute for oregano in cooking and brings in a distinct flavor to dishes.
Mechanism of interaction between excess amounts of fatty acids, diacylglycerol, and ceramide and insulin action within the hepatocyte. Diacylglycerol activates PKCε and inhibits activation of IRS-1 by the insulin receptor. Ceramides cause sequestration of Akt2 by PKCζ and inhibit insulin control of gluconeogenesis. These mechanisms have recently been reviewed (99). FFA, free-fatty acid; TG, triacylglycerol.
Meanwhile, other scientists are studying fenugreek seeds, a folk remedy for diabetes. Several studies, including one published in 1990 in the European Journal of Clinical Nutrition suggest that this herb can lower blood sugar. Researchers found that type 1 diabetics who took 50 grams of fenugreek seed powder twice daily had significantly lower blood sugar levels than those who took a placebo.
Does acupuncture for diabetes work? Acupuncture has many uses, and some research has suggested that it may work for diabetes, although how it would help has not yet been explained. Find out about the types of acupuncture that might help, the risks, and some evidence of its benefits. Anyone considering acupuncture should first check with their doctor. Read now
Peripheral neuropathy, one of the most common complications of type 2 diabetes, occurs most often in the distal extremities and typically affects the sensory, motor, and autonomic systems. Acupuncture has been demonstrated to exert a beneficial effect on neuropathic pain.2 The effects of acupuncture, particularly on pain, are mediated in part by the release of endogenous opioids from the spinal cord, brainstem, and hypothalamus. In addition, it has been demonstrated that neurotransmitters, such as serotonin and substance P, are released during acupuncture treatments. Increases in local blood flow and vasodilation and increased levels of cortisol have also been demonstrated.10 A 300% increase in plethysmographic recordings of blood flow has been demonstrated in the digits of limbs stimulated with electroacupuncture.10
An unbalanced microbiome composition, known as dysbiosis, has been found in patients with diabetes, for whom the diversity of the gut microbiome is often reduced as compared to healthy people. Researchers from the University of Amsterdam recently showed that fecal transplants, used to transfer the microbiome of a healthy person to the gut of one with diabetes, can result in a short-term improvement of the insulin resistance found in obese patients with type 2 diabetes.