Dysglycaemia (Metabolic Syndrome and Diabetes).
Keeping your blood sugar in check by Dr Carrie Decker ND.
In this article, learn more about diabetes, and natural ways to support blood sugar balance. Key Points:
- Relationship of diabetes with food economics
- Diabetes statistics and complications
- Metabolic syndrome as a risk factor for diabetes
- Holistic interventions for blood sugar management including dietary choices, exercise, and evidence based supplementation
Type-2 diabetes (T2DM), or insulin-resistant diabetes, is unfortunately a condition that is all too common in many modern cultures. With countless choices of foods at our disposal, and with occupations, or lifestyles that are far more sedentary than generations of our ancestors, it isn’t surprising. Cost of food also plays a role, as subsidised industries with products such as corn, soy, and wheat are able to produce products cheaply that are calorically dense and nutritionally deficient. Subclinical nutritional deficiencies are increasing, however, with this, waistlines and blood sugar levels are unfortunately increasing. Increases in cardiovascular disease, diabetes, and obesity all have been shown to be associated with consumption of cheaper, subsidised commodity based foods., 
Insulin-resistant diabetes is not a condition that develops overnight; for most people it is a long course of a decreasing response of the body to insulin due to excess consumption of foods that increase blood sugar and other potential predisposing factors. Medications such as prednisone can put the body at a much higher risk for the development of diabetes, and certain blood pressure medications that are commonly taken may do so as well, albeit to a much lower extent.
Learning more about diabetes and the related health complications can foster motivation to make changes, as there are many things one can do to improve blood sugar levels and recover from a condition such as T2 diabetes.
- Associated with the recent World Health Day in April 2016, the World Health Organization (WHO) published the first “Global Report on Diabetes.” The highlighted statistics on diabetes are alarming: diabetes has almost quadrupled since 1980 from 108 million to an estimated 422 million adults, and diabetes is the number one cause of death, with 1.5 million deaths directly associated with diabetes in 2012. More than 43% of these deaths occurred in individuals under the age of 70 years old. The increase in T2DM has been observed to mirror the increasing prevalence in individuals who are overweight and obese. These numbers are also concerningly high, with 1 in 3 adults over the age of 18 being overweight and 1 in 10 being obese.
- An overlapping syndrome of excess abdominal weight, elevated blood sugar, hypertension, elevated triglycerides and low HDL cholesterol is known as metabolic syndrome. Metabolic syndrome often precedes the development of diabetes and cardiovascular disease. In a 2001 population survey of 8841 adults from the United States, the overall prevalence of metabolic syndrome was found to be 22 percent, with an age-dependent increase. The relative risk (RR) of developing diabetes ranges from 3.53 to 5.17 in individuals with metabolic syndrome. The risk of cardiovascular disease all-cause mortality is also increased in individuals with metabolic syndrome, but not nearly to this extent.
- The risk of additional health complications associated with diabetes is high. Ongoing management is necessary to manage blood sugars and monitor for damage to the small blood vessels that affect the retina of the eye, kidneys, and peripheral nervous system (enables the body to feel sensations in the extremities such as the hands and feet). Changes to the larger vessels occur as well, with increased atherosclerosis and coronary artery disease. Lower limb amputation rates are 10 to 20 times higher among people with diabetes, and 7% of individuals with diabetes experience vision-threatening retinopathy. The estimate of end stage renal disease (which often leads to the need for dialysis) due to diabetes alone is 12 – 55%, about 10 times the risk of a population without diabetes. Finally, the rates of cardiovascular disease in individuals with diabetes is 2 to 3 times that of a population without diabetes.
- The gut flora also may be connected with the development of diabetes and obesity. An imbalance in the intestinal bacterial population could result in obesity, systemic inflammation, and the development of diabetes. Obesity has been shown to be associated with changes in the relative abundance of the two dominant bacteria that are present in the gut (the Bacteroidetes and the Firmicutes) as well as a lower diversity of gut flora than individuals having a healthy weight. Dietary choices affect the gut flora, and the mechanism by which some therapies improve blood sugar metabolism may be via changing the flora in the gut.,
Getting things back on track!
Core interventions for the management of diabetes and the related complications include lifestyle changes (healthy diet, exercise, smoking cessation), blood sugar management, regular exams for early detection of complications, and medications to control hyperglycemia and cardiovascular risk, if necessary. Nutritional supplements are also effective at reducing blood sugar and supporting healthy cholesterol levels, as dyslipidemia is common among metabolic syndrome and diabetics.
Diet and diabetes
Dietary choices that are supportive to blood sugar balance include minimising foods with a high glycaemic index such as simple carbohydrates (white flour, pasta, breads, baked goods) and sugars and focusing the diet on a balance of foods that are higher in protein, fibre, healthy fats such as olive oil, coconut, and avocado, and are nutrient dense. Selecting quality proteins including grass-fed over corn-fed beef and free range eggs over caged also impacts the composition of the nutrients that you will obtain from these foods., Increasing fibre intake with vegetables, whole fruit (not juices), and whole grains, also positively impacts blood sugar and the prevention of diabetes., Blueberries are also a food with healthful benefits for diabetes, as well as cardiovascular disease., Work on filling your plate with foods that will support your blood sugar balance before finding room for simple carbohydrate sides, and select a fruit to fulfill your sweet tooth, rather than the pastry or ice cream. Holiday baked goods and treats are meant to be given away, so when you make holiday delights think of this as an opportunity to share, leaving only one or two for each individual in your household.
Exercise and diabetes
Exercise is an important part of a healthy lifestyle, and supports blood sugar balance, cardiovascular health, maintenance of an appropriate weight, and even supports your mood. Walking 11.3 miles (18.2 km) per week may be as effective as a combination of dietary modification, weight loss, and exercise at preventing progression of pre-diabetes into diabetes. One of the things that is important to making exercise an integral part of life is to find something you like; while some may enjoy the movement and time to think while running or cycling, others may be much happier in a group dance or fitness class setting. Find what is right for you, make a commitment to yourself and maybe a friend, and get moving!
Supplements that support blood sugar balance
There are a variety of nutritional supplements which have been studied for improving blood sugar balance and reducing insulin resistance. Lipoic acid is an antioxidant that improves insulin sensitivity, reduces the risk of diabetic neuropathy, and also may support weight loss goals if this is also an issue. The minerals chromium and vanadium, along with the B-vitamin biotin all play a role in blood sugar balance.,, A combination of chromium picolinate and biotin has been shown to improve glucose management and several lipid measurements in patients with poorly controlled diabetes.
Many botanical agents also have a long history of use in different cultures for improving blood sugar balance. Berberine, found in a variety of plants including Oregon Grape, Barberry, and Goldenseal, has been shown to improve insulin sensitisation and modify the gut microbiota which may contribute to the effects seen in individuals with diabetes.,, Supplementation with berberine hydrochloride has also been shown to improve cholesterol parameters, reducing total cholesterol, triglycerides, and LDL.
Other herbs such as gymnema (Gymnema sylvestre), an herb native to India and commonly used in Ayurvedic medicine, bitter melon (Momordica charantia), a fruit commonly used in Asian and Indian cuisine, Lagerstroemia speciosa and fenugreek (Trigonella foenum-graecum),, also common to India and the Middle East, and cinnamon, all have evidence and a long history of cultural use for the management of diabetes. Many of these herbs also have evidence for improving cholesterol balance as well. Although some of these herbs can be found and used for culinary purposes, for therapeutic use standardized supplements are often more effective as they concentrate the parts of these plants that are active.
In conclusion, diabetes does not have to be a life sentence, and there are many things that can be done to restore the body to a state of healthy blood sugar management and prevent the complications of diabetes. Being proactive and including a variety of these strategies, including dietary changes, exercise, and evidence based supplementation into your day-to-day protocol can go far to bring your body back to balance. Seeking the support of an integrative medical provider such as naturopathic doctor, integrative physician, or nutritional therapist, and personal trainer or other activity to get your body moving can help you to get on track with managing your health.
 Rehman A, Setter S, and Vue M. Drug-Induced Glucose Alterations Part 2: Drug-Induced Hyperglycemia. Diabetes Spectrum 2011 Nov; 24(4): 234-238.
 NIH. National Heart, Lung and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/ms/ Accessed August 2016.
 Emerging Risk Factors Collaboration, Sarwar N, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010 Jun 26;375(9733):2215-22. View Full Paper
 Esteve E, et al. Gut microbiota interactions with obesity, insulin resistance and type 2 diabetes: did gut microbiote co-evolve with insulin resistance? Curr Opin Clin Nutr Metab Care. 2011 Sep;14(5):483-90. View Abstract
 Slentz CA, et al. Effects of exercise training alone vs a combined exercise and nutritional lifestyle intervention on glucose homeostasis in prediabetic individuals: a randomised controlled trial. Diabetologia. 2016 Jul 15. [Epub ahead of print] View Abstract
 Singer GM, et al. The effect of chromium picolinate and biotin supplementation on glycemic control in poorly controlled patients with type 2 diabetes mellitus: a placebo-controlled, double-blinded, randomized trial. Diabetes Technol Ther. 2006 Dec;8(6):636-43. View Abstract
 Gupta A, et al. Effect of Trigonella foenum-graecum (fenugreek) seeds on glycaemic control and insulin resistance in type 2 diabetes mellitus: a double blind placebo controlled study. J Assoc Physicians India. 2001 Nov;49:1057-61. View Abstract
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