November is American Diabetes Month! In this article, we’ll be discussing Type 2 Diabetes: what causes it, how to diagnose it, the medical complications of diabetes, and how to prevent and control it. There are several different ways to classify diabetes. The simple explanation is there is Type 1 (insulin lack) and Type 2 (insulin resistance). In recent years, a “Type 3 diabetes” has also been established. This latter type refers to the metabolic dysfunction crisis we are seeing more of in this country and is largely responsible for Alzheimer’s disease (coincidentally, November is also Alzheimer’s Awareness Month!). For the purpose of this article, we will not be discussing Type 1 Diabetes. Let us know if a post about how to prevent Alzheimer’s would be interesting or helpful too, and we’ll be happy to write one!
How Type 2 Diabetes Occurs
Type 2 Diabetes is increasingly common in America due to the SAD (Standard American Diet). Currently, more than 30 million adults in the U.S. have diabetes, and 90-95% of them have Type 2 Diabetes. Normally, the body processes sugar and simple carbohydrates from food via insulin secretion from the pancreas. Blood glucose is then brought into the muscle, and whatever is not used by the muscle is brought into the fat cells. However, with Type 2 diabetes, there is a relative lack of insulin, either because the pancreas doesn’t work anymore, or because of insulin resistance (where insulin is around in the blood, but not going where it needs to go). Too much insulin in the blood inhibits the breakdown of fat, which can produce other chemicals that cause inflammation. This can ultimately have an effect on your blood vessels that can lead to plaque build-up (atherosclerosis), or heart disease.
Diagnosis
The diagnosis of Type 2 Diabetes is established when a patient has: a fasting blood sugar of 126 or greater, a random blood sugar of 200 with symptoms of diabetes, or hemoglobin A1C (HbA1c) of 6.5 or greater. Traditionally, doctors are taught to act when a patient receives the diagnosis of diabetes. The problem is that the negative effects of increasing blood sugar on blood vessels and nerves have been occurring years before one is diagnosed. This is why lifestyle, integrative and functional doctors take a more preventive approach, by looking at your metabolic health long before you actually get the diagnosis of diabetes.
Complications
There are 3 macro-complications and 3 micro-complications caused by the effect of high blood sugar on the blood vessels in the case of Type 2 Diabetes.
The macro-complications are:
- stroke,
- heart disease, and
- peripheral vascular disease.
The micro-complications are:
- eye damage,
- kidney damage, and
- nerve damage due to the damaged blood vessels.
As noted before, high blood sugar over the years ultimately causes inflammation and plaque in the arteries. If we can diagnose and treat metabolic disease much earlier than a typical traditional medical approach, we can help prevent these complications from happening.
Preventing & Controlling Type 2 Diabetes
In terms of preventing and controlling type 2 diabetes, a lot of people are under the impression that they must completely cut their sugar intake. The fact is that it’s more about avoiding the foods that will be processed as simple sugars in your body, such as simple carbohydrates like white flour, white rice, white bread, etc. It doesn’t mean sugar can never be eaten; in fact, depriving yourself of sugar completely makes it more difficult to adhere to a way of eating. It simply means that the amount you eat needs to be a small and mindful treat, not a large daily consumption. The good news is, as you wean yourself from sugar, you will begin to notice that a lot of foods will actually taste too sweet!
The prevention and control of diabetes have a lot in common. The Standard American Diet (SAD) plays into the role of insulin resistance because it is a high carbohydrate, highly-processed diet. Because diet plays such a huge part in causing diabetes in the body, it stands to reason that diet and exercise are paramount to preventing and controlling Type 2 Diabetes as well. Lack of exercise due to our sedentary society and convenience (having things brought to us and done for us) also contributes to Type 2 Diabetes. Below are a few key ways to prevent and control Type 2 Diabetes:
- Diet: Eat whole foods, and limit processed foods (ideally NO processed foods :). Plant-based options are always good- unless they are processed! Limit alcohol intake because alcohol is a simple sugar. If you eat meat, choose organic, lean cuts of meat. Half of your plate should be vegetables. Vegetables provide fiber which lowers the glycemic load of your meal. The glycemic load is how your body “sees” the sugar. Think outside the box, such as having salad for breakfast. While low-carb diets, such as the ketogenic diet, will result in weight loss and better glucose control, these diets are often unsustainable. I recommend being under the consultation of a physician if you’re going to do one of those. In general, keeping your net carbs to under 100g/day is a healthy goal. Net carbs are the total grams of carbohydrate minus the fiber. Therefore, eating foods with high fiber will decrease your carbohydrate load for the day. And eating foods with high fiber will also promote a healthy gut microbiome, which can prevent weight gain.
- Exercise: Exercise is essential. Walking 15 minutes after a meal can decrease insulin levels in your blood by up to 50%! The ideal workout regimen would involve 30 minutes of exercise 5 days a week where you get your heart rate up. There are heart rate monitors available, but a simple way to tell you know you’re exercising to a maximal heart rate is if you are having trouble holding a conversation and speaking full sentences during your times of maximal effort. As always, check with your doctor before starting a program. (Or we can design one for you!)
- Supplements: There are several supplements on the market for diabetes and glucose control that include polyphenols from fruits such as amla (from India) and bergamot (from the Mediterranean coast). High polyphenol fruits are often seen and eaten in the blue zones, areas around the globe where people are routinely living as centenarians. Berberine, cinnamon, alpha-lipoic acid, and EGCG (from green tea) are other supplements that promote healthy glucose metabolism.
- Medications: While there are a number of classes of medications out there to treat type 2 diabetes, they are beyond the scope of this article. Make an appointment with me (or your doctor) to discuss your options for diabetes medication.
Lastly, as part of my health coaching services, I offer visits to the grocery store to help you pick out healthy foods, read labels and learn more about carbohydrates, all of which can help you prevent and control Type 2 Diabetes. Although it can be a frustrating diagnosis to receive, there are many ways you can control Type 2 Diabetes with simple changes in diet and exercise, and it can be thought of as an invitation to better your overall health in general. I am here to help; contact me today to schedule an appointment!