Diabetes is a very common group of metabolic disorders that are associated with high blood sugar, either due to lack of insulin being produced by the pancreas or due to insulin resistance which refers to the cells of the body not responding appropriately to insulin.
- Types of Diabetes
- Type I Diabetes which is a rare form of diabetes that typically occurs early in life.
- Type 1.5, known as Latent Auto-Immune Diabetes of the Adult (LADA)
- Type II Diabetes which is the most common form of diabetes.
- Gestational Diabetes is high blood sugar that develops at any time during pregnancy in a woman who is does not normally have diabetes.
- Metabolic Syndrome
- Mature Onset Diabetes of Youth
- Neonatal Diabetes
Type I Diabetes
Type I Diabetes, also known as insulin-dependent diabetes or juvenile diabetes is characterized by the body’s inability to produce sufficient amount of insulin. In the vast majority of Type I Diabetic patients, insulin production is decreased due to autoimmune destruction of insulin-producing beta cells of the pancreas. Insulin is a hormone that facilitates transportation of glucose into cells, when this is absent glucose levels can rise to dangerous levels. The onset of this disease is typically between 7-15 years, but may present at any age. Type I Diabetes accounts for about 10% of all diabetes.
Causes
- Genetics: Certain genes increase susceptibility to Type I Diabetes, however, less than 10% of individuals with those genes actually develop this condition thus indicating the importance of environment and diet.
- Dietary factors: Food allergies to proteins in milk or early introduction of cows milk prior to age and wheat may increase the risk of Type I Diabetes.
- Stress: Stressful events in early life, such as the death of a pet, conflict with teachers, quarrels between parents, failure in a competition etc were associated with increased risk of Type I Diabetes
- Infections: Gastrointestinal viral infections may trigger Type I Diabetes by increasing intestinal permeability or activating immune cells
Assessment
The assessment of type I diabetes typically occurs due an abrupt change in a person’s health, especially the young. It’s onset is typically associated with key symptoms such as weight loss, increased thirst and urination and fatigue. The aim of the assessment is to determine the factors that contributed to the abrupt change and to address accordingly.
Diagnostic Testing
- Blood tests are generally used to diagnose Type I Diabetes.
- Fasting plasma glucose ≥7.0 mmol/L
- Random plasma glucose ≥11.1 mmol/L + symptoms of diabetes OR
- Oral glucose tolerance test ≥11.1 mmol/L
- C-peptide, Insulin, Blood Ketones
- Urine Tests include urinary glucose, urinary ketones.
Additional tests that are often used in the assessment or management of diabetes include Hemoglobin A1C (Hb1aC), Cholesterol Panel, Kidney Function Test, Amylase, Lipase and blood insulin levels, Liver Function Tests
Symptoms
Type I Diabetes generally starts with an abrupt onset of symptoms. Typically, there is a long asymptomatic period while beta cells are being destroyed. Once destruction reaches a certain threshold, the following symptoms develop quickly:
- weight loss
- typically lean body build
- increased urination (polyuria)
- increased thirst (polydipsia)
- increased hunger
- fatigue
- .loss of feeling or tingling in the feet
- blurry eyesight
- urinary, genital or skin infections (bacterial or fungal).
Lifestyle Changes That Can Assist
- To regulate blood sugar and prevent complications – normalise your weight
- Diet: Avoid processed foods, sugars, dairy and gluten.
- Consume a diet high in dietary fibres and complex carbs.
- Ensure hydration is adequate as diabetes worsens if one is chronically dehydrated
- Identify food intolerances and allergies
- Exercise: to maintain body weight, muscle mass and improve insulin sensitivity, one must exercise
- Sleep: getting sufficient uninterupupted sleep is important as lack of sleep can alter insulin and glucose levels
Mainstream View
Type I diabetes is considered an autoimmune disease which involves destruction of the pancreatic beta cells which results in absolute insulin deficiency and dependence on exogenous insulin for life.
Type II Diabetes
Type II Diabetes, which used to be called non-insulin dependent diabetes mellitus or NIDDM, accounts for about 90% of all types of diabetes. It is a condition of disordered carbohydrate, fat, and protein metabolism. Cells throughout the body become insensitive to the action of insulin and blood glucose levels rise as a result. Glucose is then unable to enter muscle or fat cells which results in serious complications throughout the body
Causes
- Dietary Factors: Poor diet – low in fibre, high in refined sugars and excess consumption
- Increased alcohol intake is a major risk factor as it is associated with hypoglycemia, hyperglycemia and insulin resistance.
- Smoking: Increases the risk of developing complications from Type II Diabetes especially atherosclerosis
- Lack of movement: lack of exercise and movement i.e. a sedentary lifestyle, increases the risk of Type II Diabetes
- Sleep: sleeping less than six hours or greater than 9 hours a night contributes to weight gain and diabetes
- Stress: manage your stress as various types of stress factors can contribute to Type II Diabetes.
- Environmental Toxins: environmental toxins are linked to obesity and diabetes. Persistent organic pollutants (POPs) are known to cause mitochondrial dysfunction and this in turn is linked to insulin resistance and increased risk of Type II Diabetes as well as Metabolic Syndrome
- Infections: There seems to be a link between systemic fungal infections such as Candida albicans and chronic diseases such as Type II Diabtes
Assessment
Diabetes is often discovered, especially in the elderly, as part of routine annual blood testing. The following are the diagnostic values for diabetes:
- Fasting plasma glucose ≥7.0 mmol/L
- Random plasma glucose ≥11.1 mmol/L + symptoms of diabetes OR
- Oral glucose tolerance test ≥11.1 mmol/L
Additional tests that are often used in the assessment or management of diabetes include Blood Glucose, Hemoglobin A1C (Hb1aC), C-peptide, Insulin, Blood Ketones Cholesterol Panel, Kidney Function Test, Amylase, Lipase and blood insulin levels, Ferritin, Liver Function Tests.
Symptoms
The onset of Type II Diabetes is typically gradual and subtle. It occurs when the body loses the ability to utilize insulin appropriately, which is referred to as insulin resistance. When glucose is unable to enter the cells, hyperglycemia results.
The symptoms that can indicate the need to rule out diabetes include:
- Polyuria (increased urination)
- Polydipsia (increased thirst)
- Hunger
- Central obesity
- Skin tags, dark patches of skin (acanthosis nigricans) are common
- Bladder, kidney or skin infections appear more frequently and heal more slowly
- Vision problems, such as blurred vision
- Erectile dysfunction
Complications
The complications of diabetes include:
- Eye complications
- Nerve damage such as peripheral neuropathy
- Diabetic foot disease
- Kidney damage
- Disease of large blood vessels
- High blood pressure
- Lipid (fat) imbalance in blood
- Skin conditions
- Musculoskeletal and connective tissue disease
- Increased risk of infection such as fungal infections.
Lifestyle Changes That Can Assist
- Normalise body weight. Loosing 10% body weight has been shown to greatly improve blood sugar control
- Exercise: at least 3 – 5 times per week can prevent the development of Type II Diabetes and helps to manage blood sugar levels when you are diabetic
- Physical activity helps to control weight, uses glucose as energy and makes cells more sensitive to insulin
- Diet: change to a diet that focuses on whole, unprocessed foods (whole grains, legumes, vegetables, fruits, nuts and seeds).
- remove sugar, sweets and all foods make from white flour (cakes, biscuits etc)
- Increase dietary fibre
- add cinnamon, onion and garlic to your diet
- Ensure you are well hydrated
- Stress: make sure you make time for rest and relation and that you reduce and manage your stress levels
- Sleep: get sufficient sleep as poor sleeping habits can alter insulin and glucose levels
| DBM COMMENT |
DBM have a few different perspectives on Diabetes. We view Type II diabetes as being both a lifestyle disorder as well as an autoimmune disease. Why? The gut microbiome shapes intestinal immune responses. Nutrition, age, sex and the kinds of pathogens you have been exposed to are all contributing factors to what shapes the gut bacteria. Microbes and parasites in the organs which start a chain reaction of events that causes type 2 diabetes. The immune system may be attacking its own cells because the immune system has been weakened by microbes and parasites in the organs or the damage may be done by microbes and parasites attacking the organs directly.
There is more than sufficient research available that supports the DBM approach of changing to a WFPB Diet. This Whole Foods style of eating encourages one to eat a wide variety of fruits, vegetables, legumes and whole grains. By eliminating animal-based and processed foods from your diet, most, if not all of the degenerative diseases that afflict us can be controlled and/or even reversed.
The importance of optimal nutrition and how it can influence the development, maintenance and restoration of health. Changing from animal products to whole grains-whole wheat, brown rice, barley, and the like, especially in their less-processed forms, research shows that these are more slowly digested than refined grains. So, they have a gentler effect on blood sugar and insulin, which may help keep hunger at bay. The same is true for most vegetables and fruits. These “slow carb” foods have bountiful benefits for disease prevention, and there’s also evidence that they can help prevent weight gain. This means that isolating specific nutrients in the form of supplements to try to bump up a poor diet will NEVER work. Go back to basics. Change what you eat. Nutrient deficiencies are usually at the core of lifestyle diseases.
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