Statistics suggests today about 11 million of Canadians are diabetic or pre-diabetic. Diabetes reduces the life expectancy about 10 years. Diabetes is a chronic disease which is related to the production and the function of Insulin hormone made by pancreas. Insulin controls the blood sugar level. Body needs sugar to produce energy, however excessive amount of circulating sugar could damage organs, blood vessels, and nerves. Common complications related to high blood sugar include chronic kidney disease, liver disease, eye disease, heart disease, high blood pressure, stroke, Alzheimer's, poor circulation, slow wound healing, neuropathy and associated pain, fertility problems, and poor sexual performance.
Pancreas is a vital gland that is located behind the stomach. It not only produces hormones but also makes digestive enzymes. Pancreatic hormones such as insulin are secreted to the blood, while the pancreatic digestive enzymes are secreted to the digestive tract and curtail for digesting variety of the nutrients.
There are two main types of diabetes. Type 1 diabetes is due to damage or poor function of the beta cells of the pancreas causing very low or no production of insulin. It also could be due to production of a dysfunctional insulin. This condition results in accumulation of glucose in the blood rather than being used for energy production. Diabetes type 1 is diagnosed in about 10 percent of the cases with diabetes. Type 1 diabetes generally develops in childhood or adolescence, but can also develop in adulthood. Genetic factors and having a family member with this condition may increase the risk of developing diabetes.
Diabetes type 2 occurs due to insufficient production of insulin or body's lack of response to insulin which is also known as insulin resistance. Type 2 diabetes is mainly caused by acquired resistance to the insulin hormone. About 90 percent of the diabetic cases are falling under this category. Type 2 diabetes more often develops in adults, but children can be affected as well. Those with conditions such as weight gain, high blood lipid profile, high blood pressure, polycystic ovary syndrome, psychiatric disorders, depression, insomnia, and those on corticosteroids are more likely to develop diabetes.
Other type of diabetes is observed in up to twenty percent of pregnant women. This type of diabetes is also known as gestational diabetes. Although this is a temporary condition, it is associated with higher risks of developing diabetes in both mother and baby.
Signs and symptoms of diabetes include; unusual thirst, frequent urination, lack of energy, fatigue, blurred vision, frequent or recurrent infections, numbness or tingling sensation in hands or feet, slow healing cuts and wounds, and weight change.
Key Contributing Factors to Blood Glucose Levels:
Diet high in processed and refined carbohydrates like processed sugars and starches significantly impact the blood glucose level. This is found to have a greater effect on the after-meal blood glucose level. It is suggested that sudden increase in blood glucose and insulin level following meals play an important role in development of related adverse effects. Many evidence based studies collectively suggest that the higher readings of after meal blood glucose levels is an independent risk factor for cardiovascular disease in type 2 diabetes.
Weight gain and higher fat deposits specially abdominal fat (visceral fat) result in elevated inflammatory markers which interrupt the insulin function contributing to insulin resistance condition. Weigh loss improves the inflammatory profile and insulin sensitivity. Chronic inflammation is one of the main causes of the health conditions related to obesity. Wight gain and fat tissue also, cause resistance to the effects of the leptin hormone which regulates appetite.
Liver through a process known as glycogenolysis releases glucose to the blood from its carbohydrate reserves providing temporary source of energy and keeping balanced blood glucose level. This process is in particular important during sleep to provide brain with energy it needs to provide its vital functions, as well as during exercise to provide muscles with the energy they need.
After eating when the blood glucose increase, insulin is secreted by the pancreas to take up the excessive glucose and transport it to the cells which the burned to produce energy. Insulin also slows down and inhibits the glycogenolysis in the liver.
However, in insulin resistance conditions such as in pre-diabetes and diabetes, liver and other tissues are less responsive to the insulin's signal, therefore the liver continues to release glucose in spite of already high blood levels from food.
Liver is also able to produce glucose from non carbohydrate sources such as proteins. This process is called Gluconeogenesis. Gluconeogenesis is considered one of the contributors to a high fasting blood glucose in type 2 diabetics. Yet again the Insulin resistance situation liver does not respond to insulin’s signal to turn off gluconeogenesis, and the blood sugar stays high.
Gluconeogenesis is encouraged by the activity of an enzyme known as glucose-6-phosphatase which help finalizing the creation and release of glucose in the liver from non carbohydrate sources.
Hormones & Blood Glucose:
Insulin resistance causes the pancreas to keep on producing insulin to reduce elevated blood glucose levels. In chronically elevated blood insulin (hyperinsulinemia) environment, the body's cells more and more become resistant, while at the same time, higher glucose levels pushes the insulin producing beta cells of the pancreas to their maximum production capability. Under such pressure eventually beta cells will burn out and no longer able to produce insulin.
Glucagon is glucose regulating hormone which is produced by pancreases alpha cells. Glucagon helps to maintain healthy blood glucose level by promoting liver's glycogenolysis and Gluconeogenesis. This hormone is especially important during times when the blood glucose falls too low.
Cortisol from adrenal glands is released in response to stress. Cortisol raises blood glucose by activating the enzyme glucose-6-phosphatase during gluconeogenesis in the liver. Chronic elevated cortisol level and stress also contributes to of insulin resistance. Long term adverse health effects of high cortisol from chronic physical or psychological stress in part due to promoting insulin resistance and accumulation of visceral fat.
The catecholamines group of hormones including; epinephrine (adrenalin), norepinephrine, and dopamine. Elevated catecholamines in the blood is in response to physical or emotional stress. Catecholamines increase blood pressure, increase hear rate, and increase blood glucose levels to support “fight-or-flight” condition. Catecholamines raise blood glucose via initiating glycogenolysis and gluconeogenesis in the liver, and by inhibiting the glucose uptake.
Incretins are group of hormones secreted by the cells of digestive tract into the bloodstream within minutes after food. Incretins stimulate insulin secretion from the pancreas and they are responsible for 70% of after-meal glucose-stimulated insulin secretion. They play role in suppressing appetite, and slowing glucose production in the liver.
Adiponectin and leptin are hormones secreted from fat tissue. Adiponectin encourages the usage of glucose and fat burning in muscle and liver, while reduces glucose production in the liver.
Adiponectin activates an enzyme called AMPK. AMPK is a critical cellular energy sensor. Studies found high concentrations of adiponectin in long-lived people suggesting this may contribute to their longevity.
Leptin is mainly produced by the adipose cells (fat Tissue). Leptin helps to regulate energy by inhibiting hunger, reducing appetite and encouraging fat burning. Leptin main centre of action is hypothalamus in the brain. Over weight individuals usually have higher concentration of leptin in their blood due to the higher body fat percentage, but these individuals develop Leptin resistance causing the body to fail to respond adequately to leptin’s satiety-inducing, fat-burning signals.
Leptin resistance is a major contributor to weight gain and makes it difficult to lose weight. Individuals with Insulin resistant condition generally have elevated leptin levels, but are resistant to its effects. The inflammatory marker CRP binds with leptin and reduces its signaling capability, causing leptin resistance and weight gain.
How Does High Glucose Level Cause Other Health Conditions?
High blood glucose affects the body and healthy cells mainly in three co-related processes; glycation, which is referred to as the process of glucose binding to protein and fat molecules in the blood creating highly toxic and damaging compounds known as advanced glycation end products (AGEs). AGEs cause structural and functional damage to the proteins such as collagen, elastin and much more.
The second major feature of diabetes is inflammation. It is well documented that long term inflammation is the cause of many chronic diseases such as cardiovascular disease. However, the short term increase in blood sugar after meals is also can also contributes to inflammation.
The third main adverse effect of high blood sugar on the organs and tissues is due to its contribution to increased free radicals. Free radicals are highly reactive molecules and could impact the cells from within and that leads to degenerative diseases.
How to Support Normal Blood Sugar Level?
A great number of individuals are not aware of their chronic high blood sugar or frequent spikes in their post-meal glucose levels. Frequent episodes or long term high levels of blood sugar enhances the possibilities of cellular and tissue damage and developing insulin resistance exposing the individuals to the risk of developing degenerative disease.
Regardless of whether or not being diagnosed with diabetes it is very important that everyone aim for improving glycemic control. Natural integrative medicine helps to improve glucose level and the conditions related to the type 2 diabetes. It may also help to reduce the severity of the damage to the tissues in type 1 diabetes. General goal is to minimize complications, to improve the diabetic patient’s overall quality of life, and help to keep blood sugar under control. In addition, controlling blood pressure and blood lipids is considered very important for treatment and prevention of diabetes or other metabolic conditions.
Type 2 diabetes is usually significantly improves with diet and lifestyle changes, especially at the early stages. Incorporating Mediterranean diet rich in fresh vegetables, whole grains, and healthy fats while avoiding dairy, alcohol, sweets, refined sugar, highly processed foods, and saturated fats is proven to improve glucose metabolism and reduce risks of cardiovascular disease. Results from analysing multiple studies which involved over 136 000 participants showed that those with high compliance with the Mediterranean diet had reduced risk of type 2 diabetes by 23%. Improving diet is associated with a lower risk of degenerative conditions from diabetes and age.
Caloric restriction is other factor which provides several health benefits; and it is shown to be an effective way to prevent and treat diabetes. Studies confirm that caloric restriction improves glucose metabolism and reduces diabetic adverse effects.
Results from multiple randomised controlled trials using foods with low glycemic index (cause less spike in glucose level after eating) and low glycemic load (contain less amount of carbs) such as beans, vegetables, and unsweetened dairy products have shown to improve metabolic markers in diabetes, and overweight individuals as well as to significantly reduce risk of developing type 2 diabetes, heart disease, and other metabolic conditions.
Verity of natural compounds are shown to effectively regulate blood sugar and improve sugar metabolism through different mechanism of action.
High blood sugar and weight gain in general leads to vitamin B deficiency in particular vitamin B1 ( thiamine) which it also contributes to further tissue damage. Bioavailable form of Vitamin B1 is known as benfotiamine. Oral benfotiamine can reach much higher concentration in the blood than regular B1. Benfotiamine inhibits inflammation, oxidative stress, and AGE formation. In clinical trials benfotiamine showed to reduce pain associated with neuropathy in diabetic patients within six weeks; and results became more impressive during longer period of time and with greater dosage.
Bioactive form of vitamin B6 (Pyridoxal 5’-phosphate) provides anti-glycation properties in both proteins and lipids molecules. In patients with diabetic neuropathy a combination of P-5-P with folate and B12 improved their skin sensation.
Carnosine is a peptide (small protein molecule) which has been shown to be able to block AGEs formation and even reverse protein glycation. In animal studies L- carnosine found to improve cell's survival in high glucose environment and improve wound healing.
AMPK enzyme (adenosine monophosphate-activated protein kinase) is a vital energy sensor in the body. AMPK helps to regulate energy metabolism, increase fat burning and glucose usage; while inhibiting fat and cholesterol production.
EGCG (epigallocatechin-3-gallate) is the main compound from green tea which has been found to reduce glucose level and improve insulin sensitivity. Results from randomized controlled trials on diabetic participants have shown that the green tea group had greatly lower cholesterol, and serum triglycerides, while improved their HDL and insulin sensitivity within two months. Other trials suggests that EGCG help to reduce and control blood pressure and reduced the HbA1C (diabetes marker) in pre-diabetic participants.
Green tea extract is a great antioxidant and provides anti-inflammatory benefits. Green tea helps reducing carbohydrate absorption and may activate AMPK.
Flavonoid Hesperidin from plants specially citrus fruits and their peel provides powerful antioxidant, anti-inflammatory, insulin-sensitizing, and lipid-lowering activities. Research suggest hesperidin’s effects on blood glucose and lipid could be related to its ability to activate AMPK. during a six-week randomized controlled trial, daily supplementation with hesperidin improved glycemic control, enhanced total antioxidant capacity, and reduced oxidative stress and DNA damage in diabetic patients. Other studies suggest higher blood level of Hesperidin decreases the risks of developing diabetes. Data also is indicative of Hesperidin being able to improve endothelial function, reduce inflammatory markers, total cholesterol, while increasing the good cholesterol HDL.
Polyphenols and Anthocyanins, also found in bilberry extract provide antioxidant with anti inflammatory properties and it is shown to reduced blood glucose and enhanced insulin sensitivity by activating AMPK. Animal studies suggests bilberry extract may protect against diabetic retinopathy. Other human studies on diabetic participants found that combination of bilberry with some other micronutrients, improved ocular health and visual acuity. More evidence suggest that bilberry polyphenols help to lower after meal glucose level and that may be due to reduced absorption of carbohydrate and prevention of carbohydrates metabolism into glucose.
The enzyme alpha-glucosidase enzymes in the intestine helps to break down carbohydrates into simple sugars. Inhibiting alpha-glucosidase will reduce the amount of simple sugars to be absorbed and helps to reduce after meal glucose level.
Mulberry leaf extract contains a compound of white mulberry, called 1-deoxynojirimycin, is found to be effectively able to block the alpha-glucosidase activity, slowing carbohydrate absorption and preventing post-meal blood sugar spikes. Positive effects of Mulberry leaf extract has been examined via randomized controlled trials. Results show that Mulberry leaf extract group had lower post meal glucose level, lower cholesterol, and lower serum triglycerides.
L-arabinose is type of sugar found in the cell walls of many plants with minimum absorption rate. Arabinose inhibits the activity of enzyme called sucrase in the intestine. Sucrase breaks down sucrose sugar into its components of glucose and fructose. Arabinose delayes the sucrose brak down and slows down the glucose absorption, resulting in less blood glucose and insulin responses.
Chromium is essential for carbohydrate and fat metabolism. Chromium is found to increase insulin-sensitivity. Chromium deficiency has been associated with insulin resistance and diabetes. According to a study, per-diabetic people are chromium deficient. Evidence show that supplementing with chromium improves blood glucose, lowers HbA1C, raises HDL cholesterol, and lowers triglycerides in type 2 diabetes.
Cinnamon has been shown to promote healthy glucose metabolism as well as improving insulin sensitivity. Studies on individuals with type 2 diabetes and healthy participants found that cinnamon extract lowers levels of fasting glucose, HbA1C and after-meal glucose and insulin concentrations, while improves in insulin sensitivity.
In addition, polyphenol compounds in cinnamon have shown to block free-radicals and able to delay AGEs formation.
Omega-3 fatty acids provide many benefits and of course essential to our health. Omega 3s promote weight loss, reduce inflammation, improve blood lipids, and enhance insulin sensitivity, Omega 3 fatty acids form the structure of the cell membrane helping cells to absorb nutrients and stay flexible. Sufficient amount of the omega 3 fatty acids improves cell membrane's ability to remove glucose from the bloodstream. A study on a large group of participants concluded that the higher blood omega-3 level is significantly associated with lower risk of diabetes .
Supplementation with the omega-3 EPA & DHA in overweight type 2 diabetic patients, significantly lowered their serum insulin, fasting glucose, HbA1C, insulin resistance, and inflammatory markers. Omega 3 fatty acids also reduced the serum triglycerides while raised HDL within 8 weeks.
Weight loss even at the moderate level is shown to improve insulin resistance, and cardiovascular health. Physical activity and exercise is great for overall health and it is found to reduce risk of developing diabetes. Type 2 diabetes can be substantially improved with diet, lifestyle changes, and nutritional supplements specially at the early stage, however depending on the advancement of the condition some medications are required to keep the glucose under control. Type 1 diabetes is treated with insulin. Meal planning, physical activity and nutritional support helps to improve overall health, reduce the adverse effects of diabetes, and keep blood sugar at the right levels.
Articles and products featured by Health Palace are collected from a variety of sources and are provided as a service by Health Palace. These newsletters, while of potential interest to readers, do not necessarily represent the opinions nor constitute the advice of Health Palace. Presented materials are only for information purposes and do not intent to treat, cure, or prevent any disease.
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