Diabetes: An Integrative Approach

Diabetes has been around for ages. It used to be called “sugar diabetes,” but modern times have changed that to “diabetes mellitus.”  The “diabetes” part dates to ancient Greece, and indicates “one who straddles” or goes to the bathroom a lot. The “mellitus” part is kind of new—only about four hundred years old—and means “tastes like honey,” to indicate that the person’s urine tastes sweet. Tasting was the first lab test. In case you are wondering, healthy urine is generally non-toxic and is sterile until it hits the urethra, which is the tube running from the bladder to the outside, where it picks up some epithelial cells that might carry bacteria. Being a filtration product, urine does contain some junk eliminated from the body. We always thought that clear urine is a sign of ample hydration. Caffeine and alcohol can fool you.

If the body does not respond properly to insulin or if insulin production is inadequate, and if blood glucose is high, diabetes is diagnosed. People with diabetes often experience frequent urination and increasing thirst. In type 1 diabetes, the body does not produce insulin. This usually appears before age forty, but during the teen years is common. Insulin will be a lifelong companion. Most cases of diabetes are type 2, where insulin resistance is the issue. Weight loss, a healthy diet, exercise, and monitoring blood glucose may be all that’s needed to manage the disease initially, but because type 2 can be progressive, insulin may be in the future. Being overweight, inactive, and eating the wrong foods contribute to the risk of developing type 2. Recently, though, low testosterone has been linked to its onset (Corona, 2013). Gestational diabetes affects pregnant women. Exercise and diet often provide successful management, with about ten to twenty percent responding better to a drug. It’s important to take care of this because the fetus can suffer adverse consequences, including damage to the brain and heart, and fetal over-nutrition that increases birth size.

Healthy eating and physical activity are cornerstones of diabetes treatment, regardless of type. We’re looking for nutrient-dense, high-fiber diets that avoid refined and processed foods. If planning such a diet presents a daunting challenge, a dietitian, nutritionist or diabetes educator can help. In fact, that might be a good idea anyway. Exercise will increase your sensitivity to insulin, which means the body will require less insulin to carry sugar to the cells to be burned for energy. Glucose needs to get into a cell to make energy. If there’s no room for new glucose to enter a cell because the old glucose still hasn’t been burned, you now have glucose floating in the blood, looking for something to do. That, albeit simply, is diabetes. There’s more to managing this disease than there’s room to talk about here, but if you have it, you already know what to do—or should.

Recent investigations into complementary modalities for diabetes control have found vitamin D and cinnamon to be allies in the approach. Of late, there has been increased interest in the extraskeletal effects of vitamin D, notably in the development of type 2 diabetes, where it’s suspected that this hormone-vitamin affects glucose homeostasis in general, and gestational diabetes patients in particular. Contrasting the HbA1c levels of type 2 patients to those of normal controls found the former group to have lower values of 25(OH)D3, leading the researchers to view vitamin D supplementation as a means to improving glycemic control in type 2 (Kostoglou, 2013). Be aware that, just because this discovery is publicized, this is not a definitive reason to cast fate to the wind and jump onto a vitamin D bandwagon in lieu of conventional care. Nonetheless, the idea that patients with metabolic syndrome are vitamin D-shallow has enlisted more intense inspection. A two-year population-based cohort study in Spain, with biennial follow-up reviews, found that patients with persistent metabolic syndrome had lower levels of vitamin D than their counterparts, leading to the conclusion that a deficiency of vitamin D is associated with increased prevalence of the metabolic disorder (Gonzalez-Molero, 2013).

Vascular stiffness has plagued diabetes patients as a precursor to more serious cardiovascular matters. That vitamin D insufficiency is implicated in this instance is no surprise to American researchers who looked at the nutrient status of diabetes patients and saw the relationship. To compound the concern, low vitamin D values were also found to be related to increased inflammatory markers, including elevated HbA1c (Kabadi, 2013) (Lee, 2012) (Lieberman, 2013).  Contrary to part of this finding, a Middle-Eastern study found no association of low vitamin D levels to inflammation, but did find that supplementation had pronounced beneficial effects on glycemic control in pregnant women with gestational diabetes (Asemi, 2013). Although the complete mechanism has not been defined, vitamin D efficacy appears to be based on an increase of the first and second phases of insulin secretion and decreased insulin resistance (Borissova, 2003).

Cinnamon has been used as a spice for centuries by numerous cultures. Its healing properties were traditionally used to address gastrointestinal complaints, but its anti-inflammatory, antibacterial, antifungal and anti-oxidant properties have instilled a new interest in its use as a supportive treatment in several conditions, including diabetes. Cinnamon comes in two varieties—Ceylon and cassia, the latter being used by most Americans for baking and cooking. Ceylon cinnamon, however, has a more complex flavor.

Regardless of type, the bark of Cinnamonum trees contains phytochemicals that enhance insulin signaling and facilitate glucose uptake and storage by the body (Nahas, 2009) (Imparl-Radosevich, 1998) (Anderson, 2004). Supplemental cinnamon powder and extracts have been shown in numerous studies to reduce fasting blood sugar in persons with diabetes, and at the same time have positive effects on LDL, HDL, and triglycerides (Luo, 2013) (Davis, 2011) (Akilen, 2012).  Cinnamon’s ability to enhance glucose entrance into a cell is welcome news, but let’s not forget to add the exercise and dietary interventions that help to bring the point home.

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Lu T, Sheng H, Wu J, Cheng Y, Zhu J, Chen Y. Cinnamon extract improves fasting blood glucose and glycosylated hemoglobin level in Chinese patients with type 2 diabetes. Nutr Res. 2012 Jun;32(6):408-12.

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*These statements have not been evaluated by the FDA. These products are not intended to treat, diagnose, cure, or prevent any disease.