What is diabetes and what are the different types of diabetes?
Diabetes is a serious medical condition in which the body cannot adequately control blood sugar levels because it lacks insulin, or does not respond properly to insulin.
Diabetes is a serious medical condition in which the body cannot adequately control the blood sugar level because it does not have enough insulin, or does not respond properly to insulin.
Diabetes mellitus is a group of metabolic disorders in which a person has high blood glucose levels. The resulting problem is hyperglycaemia – the medical term for high blood glucose. The foods we eat provide us with a sugar called glucose. The body produces insulin to transfer glucose into cells for energy.
Unfortunately, diabetes is fast becoming a worldwide chronic disease. Diabetes is Australia’s sixth most prevalent cause of death.
Different pathogenic processes result in several different forms of diabetes, including inadequate insulin production, impaired cellular response to insulin, increased hepatic glucose output, or a combination of all three.
The end-effect of diabetes is a lack of glucose within cells, which increases fatty acid catabolism for energy production, which leads to increased intracellular production of ketoacids. The resultant fall in intracellular pH inhibits the citric acid cycle, causing reduced ATP production and sodium pump activity, which alters the transmembrane sodium-potassium balance.
This alteration induces intracellular fluid retention, impedes cellular metabolism, and interferes with the activity and regulation of other hormones.
What are the different types of diabetes?
Type 1 diabetes or insulin-dependent diabetes
Type 1 diabetes is an autoimmune disease that usually develops before 40 years of age. The body destroys insulin-producing beta cells in the pancreas. A person with Type 1 diabetes can’t produce insulin and so needs daily insulin injections for the rest of his or her life, to regulate blood sugar levels.
Type 2 diabetes or noninsulin-dependent diabetes
Type 2 diabetes develops as the end result of many years of insulin resistance and hyperinsulinaemia (too much insulin), or because either the pancreas does not produce enough insulin or the body’s cells ignore the insulin, which is called insulin resistance. Both problems lead to abnormally high blood glucose levels.
How to treat diabetes
In conventional medicine, the management of diabetes is usually based on a combination of caloric restriction and increased exercise, in order to reduce body fat-weight, decrease pharmacological therapy, and control blood sugar levels.
The current Australian dietary guidelines recommend a diet high in fibre, complex carbohydrate foods like whole grains, fruit and vegetables, and legumes. Complex carbohydrate foods should make up approximately 50-60% of total intake, preferably from lower GI foods, which are absorbed more slowly, have a cardio-protective activity, and help prevent or delay the onset of diabetes.
The goals of treatment are to improve insulin sensitivity by reducing fat intake, losing weight, and increasing physical exercise, which all improve insulin sensitivity and peripheral glucose dispersal.
A person can control blood sugar and insulin levels by limiting the quantity and improving the quality of dietary carbohydrates, in order reduce the insulin response to meals and reduce post-meal blood glucose concentration.
Prevent and retard development of complications by improving body fat-weight and blood lipid levels, to reduce the vascular pathology associated with insulin resistance and diabetes, while high dietary antioxidant intake retards oxidative damage in blood vessels, brain, and retinal tissues.
Too much food and too little exercise means dietary energy and fat intake exceeds physical exercise requirements – or eating more food for energy than a person’s level of physical activity needs. The excess energy is stored as body fat, which leads to excess body weight and obesity.
Recent research shows that dietary nutrient intake, physical exercise, gene-related IRS activity, and beta cell function are all involved in the development of insulin resistance, obesity, and diabetes.
Type 1 diabetes is treated with insulin, regular exercise, and a diabetic diet. Type 2 diabetes is treated first with weight reduction, and then medication, a diabetic diet, and regular exercise.
Alternative dietary management
During the past two decades, there has been increasing evidence that human physiology is genetically unsuited to a diet that contains a high level of carbohydrates, particularly those foods that exhibit a high Glycaemic Index. Dietary consumption of refined and simple carbohydrates, above 40% of dietary energy, has been shown to induce a strong insulin response, hyperinsulinaemia that apparently encourages intra-abdominal and systemic fat deposition and inhibits lipolysis.
Many people with certain genotypes, common throughout all communities but also clustering strongly within certain ethnic populations, appear to have an enhanced insulin response to high dietary carbohydrate consumption and become progressively more insulin resistance. This process appears to be enhanced by a concomitant low intake of dietary fibre, omega-3-fatty acids and plant-derived antioxidants, and high intake of saturated fatty acids and trans-fatty acids.
Adherence to a diet that complies with the recommended Australian and American standards may reduce insulin resistance and body fat-weight, especially when combined with an exercise program. However, contemporary studies indicate that the insulin response to such meals remains elevated, despite good blood sugar control, and lean-weight loss continues, thereby further impairing insulin sensitivity.
Thus, attention has returned to the use of low-carbohydrate, high-protein diets, with additional supplementary antioxidants, EFAs and minerals, to reduce insulin responses and control blood sugar levels. Preliminary clinical case reports and small studies indicate that this form of diet produces good fat-weight loss, obviates lean-weight loss, and improves hyperinsulinaemia response to meals.
However, as these low-carbohydrates may induce ketosis, especially in diabetic patients, they are generally avoided in orthodox treatment programs, but are particularly useful in achieving good blood sugar control and improving insulin sensitivity, when employed by knowledgeable practitioners.
If low-carbohydrate diets are employed, careful monitoring of patient response is required, with daily measuring of blood glucose and urinary ketone levels. Diabetic medication, particularly insulin, will need to be adjusted downwards to avoid hypoglycaemia episodes.
Nutritional medicine treatment for diabetes
A nutritional medicine specialist can control progress of the disease and prevent the development of complicating disease, through an understanding of genetic and nutritional factors that induce and maintain diabetes.
A nutritional medicine specialist can control progress of disease and prevent the development of complicating disease, through an understanding of the genetic and nutritional factors that induce and maintain diabetes.
The main treatment methods are lifestyle interventions designed to reduce excess body fat and improve body composition, through regular moderate exercise and dietary intervention.
Exercise should combine mild aerobic and anaerobic weight resistance, approximately 3–4 times a week for 40–50 minutes. Regular exercise has been repeatedly shown to improve muscle cell insulin resistance, improve peripheral glucose dispersal, and aid in weight loss, in particular central abdominal fat deposits.
Maintain a diet that improves the nutritional quality of dietary fats, reduces insulin response, and reduces inflammation. The daily calorie intake should be reduced to 500 kilocalories or 2092 kilojoules.
Change the carbohydrate:protein:fat ratio of food eaten to approximately 60:20:20
The carbohydrates eaten should include only unrefined low-GI carbohydrates and whole fruits
Reduce saturated fat intake and increase the dietary intake of olive oil, flax seed oil, and EPA from fish.
Eliminate trans-fatty acids, also called partially hydrogenated vegetable oils on food labels, from the diet. Eating too much trans fatty acids will lead to insulin resistance, because they interferes with cell membrane fluidity. Trans fatty acids reduce delta-6-desaturase activity, which then reduces DHGLA and PGE-1 production and leads to cell membrane fluidity. More about trans fatty acids. MORE http://www.mayoclinic.com/health/trans-fat/CL00032
Maintain a high-quality protein intake but, if using animal proteins, ensure that visible fat is removed prior to consumption. Increasing vegetable proteins, such as nuts and soy, has been reported to benefit blood lipid control and reduce arterial endothelial damage
Increase fibre intake, both soluble and insoluble, and incorporate more onion, garlic, legumes as part of a lipid management program
Limit alcohol (in some instances no alcohol). Alcohol can increase free fatty acid levels and, by inhibiting peripheral glucose utilization, lead to increased insulin production.
Limit or eliminate stimulants such as coffee and cocoa, as these foods stimulate the Sympathetic Nervous System and enhance basal catecholamine activity, thereby increasing blood glucose levels and insulin production
Limit intake of sodium in salt-sensitive hypertension as this disorder is associated with reduced insulin sensitivity. Salt-sensitivity affects 20-30 percent of patients with essential hypertension and about 15% of the general population
The oxidative effects from smoking cigarettes enhance vascular endothelial damage, reduce arterial compliance, damage peripheral tissue perfusion, and impair hepatic HDL lipoprotein metabolism. All of these effects contribute to worse outcomes for people with diabetes or at risk for diabetes. MORE http://www.quitnow.gov.au