Diab? You the critical information you need to know

A patient recently came into my office for a consultation. She was in her early 50s, overweight, and was struggling with constant tiredness and a sense of being overwhelmed. She had tried multiple diets, with little to no success, and when she succeeded in dropping a couple of pounds, they came right back on. She was sick and tired of being sick and tired. She, like countless other baby boomers, is dealing with a physical condition that is nearly epidemic in proportion. If untreated, it has the potential to lead to full blown diabetes. This condition is called insulin resistance.

As I have treated numerous patients who have been diagnosed with diabetes, over and over again the thought occurs to me that the diagnosis of diabetes does not magically happen overnight. It is a process that the body goes through as it compensates for an unhealthy state.


Diabetes and Insulin Resistance

At the outset, we must differentiate between Diabetes Mellitus Type I and Type II. Diabetes Mellitus Type I occurs when the immune system attacks the insulin-producing cells of the pancreas (beta cells) so that an inadequate amount of insulin is secreted and blood sugar rises, with subsequent life-threatening ketoacidosis. Type II Diabetes, on the other hand, is a product of our Western society¡¯s habit of overeating carbohydrates, especially refined carbohydrates (sugar). It is preceded by the condition I described earlier, called insulin resistance.

Before moving on to what procedures I use in my practice to treat diabetes and insulin resistance, let¡¯s look at where this whole problem with diabetes began. This requires us to do some elementary biochemistry. All carbohydrates eventually break down in the body into glucose. As the blood glucose, or sugar, rises, insulin is released from the beta cells in the pancreas. Insulin takes the glucose to insulin receptors on each cell in the body, so that glucose can enter the cell. On the average, 50% of this glucose will be burned as energy, 10% will be stored as glycogen, and 40% is stored as triglycerides. [ii] Glycogen is the storage form of glucose which can be immediately released when the body needs more sugar. Most of the glucose stored as glycogen is in muscle, and the rest is stored in the liver. Triglycerides are a specific type of fat (lipid) molecule that can be burned as energy in the body; however, they are not as easily accessible as glycogen.

When refined carbohydrates (sugar) are ingested (cookies, candies, cakes, Twinkies, PopTarts), especially when taken without fiber, blood glucose levels rise rapidly. This rapid rise in blood sugar is followed by an overshooting of the amount of insulin released from the pancreas, causing the blood sugar to drop or fall below normal. The body does not like the sugar levels to be low, so it triggers a stress response in the adrenal gland. The adrenal gland will release adrenalin, which stimulates the breakdown of glycogen in the liver, slowly causing the glucose levels to rise in the blood.

Another way to relieve the symptoms of hypoglycemia triggered by this overshooting is by the ingestion of another refined carbohydrate. These two corrective mechanisms may cause the blood sugar to overcorrect (that is, the blood sugar¡¯s too high again), with another overcorrection by insulin, and the cycle repeats itself over and over and over ... .

Effects of Diabetes on the Body

After years of these glucose swings, the cell wall thickens (there are approximately 30 trillion cells in our body), insulin receptors become less efficient at glucose delivery into cells, and insulin resistance results. By definition, insulin resistance is seen as high fasting levels of glucose and insulin. Normal healthy fasting level of glucose is between 75-80, although any number in the 80s is acceptable. A healthy level of insulin in the fasting state is 0-5, while 5-10 is borderline. Anything above 10 is cause for concern. A diagnosis of Diabetes Mellitus Type II is made when the fasting glucose level is greater than 126 or 140 on two separate occasions.

To understand the effects of high glucose levels to the body, we need to understand a principle called glycosylation [iii] . This is a fancy term for the binding of glucose to proteins. Glycosylated LDL (¡°bad¡± cholesterol) molecules do not bind to LDL receptors, nor shut off cholesterol synthesis. Glycosylated red blood cells do not carry as much oxygen, are more sticky, and clump together more. Glycosylation of the lens of the eye may lead to cararacts. Glycosylation of the myelin sheath around nerves leads to loss of nerve function, tingling, pain, and numbness called neuropathy. Atherosclerosis (plaque buildup in the blood vessels) is the single biggest complication of diabetes. It may be due to platelet stickiness, glycosylated LDL, glycosylated red blood cells, or glycosylation of proteins in the blood vessel wall.
Atherosclerosis causes a reduction in blood flow, with subsequent organ damage, hypertension, cyanotic feet (with possible gangrene and amputation), retinopathy, and even kidney dysfunction and failure. Poor healing of skin from infection or trauma leads to chronic ulcers or sepsis (bacteria spreading throughout the body through the blood stream). [iv]