from victim to victor
© Mona Morstein, ND, DHANP
Diabetes mellitus is an epidemic condition in the US and across the globe. It affects nearly 30 million Americans and 300,000,000 million people worldwide. While that statistic is alarming, what is saddest about it is that there is nothing more preventable than the main form of diabetes. No one ever has to “get” it.
However, there are a lot of “pre-diabetic” patients as well—in the US, nearly 90 million people have pre-diabetes and time is ticking for them. It is likely that without good naturopathic care, most of them will become full blown diabetic patients.
So, statistic-wise, 1 out of every 3 people in the US is either a pre-diabetic or diabetic!
What is diabetes? Diabetes is diagnosed when one’s blood sugar is too high.
There are several types of diabetes, but the two main forms are due either to lack of insulin production from the pancreas, the organ in our body which makes and secretes that hormone, or a resistance to using insulin by our body cells. Type 1 diabetes is an auto-immune disease than can happen to younger people (where it tends to come on very quickly) or in adults (where it tends to come on more slowly). Auto-immune means a person’s own immune system attacks and destroys the beta cells in the pancreas, so those cells can no longer produce insulin. Typically, Type I Diabetes mellitus. (T1DM) children need to be on insulin, and over time, depending on how they are treated, most T1 adults will need insulin as well. Etiological factors of T1DM are being studied. Some may include low vitamin D3 status, low omega-3 oil status, Celiac disease (especially not being caught), environmental pollution and toxicity, dairy intake, and dysbiosis of the bacteria in one’s intestine.
Historically, type 2 diabetes has been seen only in adults, but it is now seen in pediatric patients as well. Type 2 diabetes creates a situation in the body whereby even though the beta cells make insulin and secrete it into the blood, the body cells--typically reactive to it--become resistant to its signals. Insulin tells cells to take in fat and glucose, store the fat, transform the glucose to fat and then store it, and not to work metabolically to burn the fat. When the cells are resistant to insulin, the glucose levels stay high in the blood and when they are high enough, we call it diabetes. Many factors make a person insulin resistant, but the first is abdominal adiposity, that is, fat around one’s mid-belly area. Etiological factors associated with insulin resistance and weight gain around the middle include: genes, certain ethnic groups, over-eating, eating problematic food (junk food, fast food, soda pop, high sugary foods, lack of vegetables and fruit), becoming overweight/obese, lack of exercise, environmental pollution and toxicity, abnormalities of the bacteria in your intestine, poor sleep or sleep apnea, poor stress management, nutrient deficiencies, hormonal imbalance. The list of factors that can lead to an increased risk of insulin resistance is quite comprehensive.
A good physician will ask about, and investigate, these etiological factors and ensure they are all being treated effectively.
Standard care treatment recommends, typically, a higher carb diet. The ADA website recommends eating 45-60 grams of carbohydrates at a meal. Then the main source of treatment is medications. There are many oral hypoglycemic agents used in T2DM, but they are all mostly designed to lower the glucose levels, when the real disease is eradicating insulin resistance. These medication categories are: Biguanides, Sulfonylurea, SGLT2 inhibitors, DPP-IV inhibitors, meglitinides, and TZDs. Most of the medications have side effects, and some are very serious, such as: hypoglycemic risk, water retention, weight gain, increased risk of diabetic ketoacidosis, intestinal upset, and bladder or thyroid cancer. Metformin is a good drug, and can usually be safely used with patients; across the world, Metformin is the drug which all physicians start using with patients.
There is another class of non-insulin injectables called GLP-1 drugs, used in T2DM and off label with T1DM patients, which help reduce the appetite in people with diabetes, slow stomach emptying, increase insulin output from the pancreas, and thus help lower glucose levels after meals.
Insulin injections are required in (nearly all) T1DM patients and in T2DM patients who are very insulin resistant, or who have had uncontrolled diabetes for years destroying their pancreatic cells. The main types of insulin include Basal insulin which covers the glucose made by the liver and kidneys between meals, and Bolus insulin, designed to cover meals and make corrections (that is, bring down glucose levels that are too high). Injecting insulin is a complicated but understandable and manageable therapy. Patients can use a syringe and vial, insulin pens, or a pump. A pump is a unit inserted into a person that dispenses insulin as directed by its controls.
Naturopathic physicians work with diabetes in a more comprehensive manner. We recommend low carb diets, and there are several options in that category to choose from, so a patient can be sure they are on a diet that best resonates with themselves and their family. We discuss exercise, how much, how often and what types are best for weight loss and glucose reduction. We discuss sleep, perhaps doing a sleep study if analysis of sleep apnea (the stopping of breath during sleep) may be occurring. We discuss sleep hygiene to ensure patients are getting good solid sleep each night. We make homes, work and life as green and clean as possible, to reduce exposure to environmental toxins that can cause insulin resistance and also increase risk of auto-immunity. We recommend eating organic foods as much as a budget can afford. We recommend detoxification programs, and even, occasionally, recommend fasting. We work on stress management to ensure people know how to live a calm, cool, collected, happy life and teach techniques that help bring a patient back to mental/emotional balance. We recommend patients engage in creative and fun hobbies. We work on a patient’s gut microbiome (their collection of trillions of gut bacteria) to ensure it is filled with good healthy bacteria. We recommend supplementation, knowing which supplements really are the most effective, and prescribe them at therapeutic doses. And, yes, when necessary, we recommend medications, when the patients’ health requires their prescription.
When diabetes is poorly controlled, the hyperglycemia causes oxidative damage leading to the development of devastating complications over time. As most standard care diabetic patients are poorly controlled and are not on protective supplements, in the US diabetic patients are the #1 group of adults who: go blind; suffer kidney damage and require dialysis, and require amputations (outside of trauma victims). Uncontrolled diabetic patients also have a 4-6X increase risk of dying of cardiovascular disease.
It is extremely important to understand that a well controlled diabetic patient on antioxidant supplements can live a full, rich life, doing all they want, and never develop diabetic complications. The last reason to seek naturopathic care of your diabetes is because naturopathic physicians offer more office time to patients, so they get all their questions answered and set up and monitor comprehensive treatment protocols. We combine expertise with compassion and caring. A pre-diabetic patient has the best chance of never becoming a diabetic, and a diabetic patient has the best chance of reversing their diabetes or at least excellently controlling it, so it never causes any complications by following a comprehensive alternative medicine regimen.
If you, a friend, or loved one has diabetes, please seek the care of your nearest naturopathic physician. You will be directing them to the biggest benefit of their lives!
Mona Morstein, ND, DHANP
4657 S. Lakeshore Dr. Ste 1
Tempe, AZ 85202