DIABETES or diabetes mellitus is a chronic disorder of glucose (sugar) metabolism caused by inadequate production or use of insulin, a hormone produced in specialised cells (beta cells in the islets of Langerhans) in the pancreas that allows the body to use and store glucose.
The lack of insulin results in an inability to metabolise glucose, and this results in elevated sugar levels in the urine and blood, increased urination, thirst, hunger, weakness and weight loss.
Pre-diabetes
“Pre-diabetes” is a condition in which blood glucose levels are higher than normal but not yet diabetic. People with pre-diabetes have impaired fasting glucose (6.1 to less than 7mmol/l). Diabetics have fasting blood glucose levels of more than 7mmol/L.
Recent research has shown that some long-term damage to the body, especially to the heart and circulatory system, may already be occurring during the pre-diabetes stage. Most individuals may not be aware that they are pre-diabetics; more often than not, such damage is not extensive enough for one to notice or experience.
How diabetes is linked to cardiovascular disease (CVD)
CVD is a major complication and the leading cause of premature death among people with diabetes – at least 65% of people with diabetes die from heart disease or stroke. Adults with diabetes are two to four times more likely to have heart disease or suffer a stroke than people without diabetes.
Lifestyle changes in diabetes
- Wholesome healthy diet
The key to a healthy diet is to consume plenty of fresh fibre-rich fruits and vegetables daily. Try going for a variety of fruits and vegetables. The more colours on your plate, the better. Limit your rice intake and eat brown rice rather than white whenever possible. Choose wholegrain bread over white. - Regular exercise
The recently completed Diabetes Prevention Programme study by ADA (American Diabetes Association) conclusively shows that pre-diabetics can prevent the development of type 2 diabetes by increasing their level of physical activity. They may even be able to return their blood glucose levels to the normal range.
Nutritional supplements
- Alpha Lipoic Acid (ALA)
ALA has been used for over 30 years in Europe to counter nerve damage in people with diabetes. Known as diabetic neuropathy, this often very painful condition tends to develop in people who have had uncontrolled diabetes for a long time. The neuropathy may be caused in part by free-radical damage to nerves resulting from poorly regulated blood sugar (glucose).
As an antioxidant, ALA helps to block such damage. In addition, because of its effect on glucose metabolism, ALA may improve the glucose-lowering action of insulin (the hormone that regulates blood sugar). ALA has also been found to improve blood flow to the nerves.
In a 1995 international meeting on diabetic neuropathy in Munich, Germany, several researchers reported the results on studies in which ALA reversed the damage to the nerves, heart and eyes of diabetics. Most of the studies were from European universities. The opinion was that ALA protects through its antioxidant and antigylcemic actions. The conference concluded that ALA was the agent of choice for prevention of diabetic complications, neuropathy, cardiomyopathy and retinopathy.
ALA also helps improve the utilisation of glucose by muscle cells. ALA increases glucose transport by stimulating the glucose transporters to move from the cell’s interior to the membrane. This action is independent of insulin transport.
The principle dietary source of ALA is spinach, meat (liver) and brewer’s yeast. ALA is also synthesised by our cells, but the amount produced naturally declines as we age. Studies indicate these sources appear to fall below optimum levels for maximum protection, especially as we grow older. - Biotin
Biotin is a water-soluble B vitamin. It assists in the making of fatty acids and in the oxidation of fatty acids and carbohydrates. Diabetics generally have cells that are not sensitive to the effects of insulin. As a result, blood sugar levels increase. Biotin supplementation enhances insulin sensitivity and increases the activity of the enzyme glucokinase.
Glucokinase is the enzyme responsible for the first step in the utilisation of glucose by the liver. Glucokinase concentrations in diabetics are very low. Supplementing the diet with Biotin improves glucokinase activity and helps lower blood sugar levels. - Gamma Linolenic Acid (GLA)
In diabetic neuropathy, as a result of the loss of nerve function, ulceration, gangrene and amputation may follow as well as other serious complications. The lack of blood flow and oxygen supply to nerves (nerve micro-circulation) is thought of by many researchers to be the cause of neuropathy. Various studies on GLA indicate that it can increase blood flow to diabetic nerves and therefore can have a positive effect on diabetic neuropathy.
All three supplements are suitable for diabetics, pre-diabetics and people who are generally concerned about their blood sugar levels. All the supplements mentioned above can be bought separately or in combination.
However, according to Dr Lester Packer, the world’s foremost antioxidant research scientist who is also a senior scientist at the prestigious Lawrence Berkeley Laboratory, and Head of the Packer Lab at the University of California, taking supplemental Alpha Lipoic Acid above 100 mg daily should be accompanied with Biotin as Alpha Lipoic Acid can compete with Biotin and interfere with its activity in the body.