Managing diabetes mellitus

DIABETES mellitus is a chronic disease characterised by abnormalities in the metabolism of carbohydrate, protein and fat. The National Diabetes Data Group of the US National Institutes of Health recommends the following criteria for diagnosing diabetes: 

Fasting (overnight): serum glucose (blood sugar) concentration greater than or equal to 140mg/dl on at least two separate occasions. 

Following ingestion of 75g of glucose: serum glucose concentration greater than or equal to 200mg/dl at two hours post-ingestion and at least one other sample during the two-hour test. 

People with diabetes cannot properly process glucose, a sugar used by the body for energy. As a result, glucose stays in the blood, causing blood glucose to rise. In the meantime, however, the cells of the body can be starved of glucose.  

Complications of diabetes include blindness, kidney failure, foot ulceration which may lead to gangrene and subsequent amputation, and appreciably increased risk of infections, coronary heart disease and stroke.  

The classic symptoms of diabetes are frequent urination, excessive thirst and excessive appetite. Because these symptoms are not significant, many people do not know that they suffer from diabetes or even consult a physician.  

Worldwide, the number of cases of diabetes is currently estimated to be around 150 million. This life-threatening disease contributed to 213,062 deaths in the United States in the year 2000.  

 

Types of diabetes 

Diabetes is divided into two major categories: Type 1 and Type 2. Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. 

In Type 1 diabetes, the pancreas cannot manufacture the hormone insulin that regulates blood glucose due to autoimmune destruction of the organ. Hence, the patients have to inject exogenous insulin regularly. It usually strikes children and young adults, occurs less frequently and may account for 5% to 10% of all diagnosed cases of diabetes. Genetic as well as environmental factors appear to be involved in triggering Type 1 diabetes. 

Type 2 diabetes, formerly known as non-insulin-dependent diabetes mellitus (NIDDM), accounts for most cases of diabetes worldwide. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly, although its production by the pancreas is often sufficient. As the need for insulin rises, the pancreas gradually loses its ability to make insulin. Obesity is a major contributing factor that causes the loss of insulin sensitivity.  

 

Dietary and lifestyle modifications 

To reduce the risk of developing the complications of diabetes, dietary and lifestyle modifications are fundamental to control against elevations in blood sugar.  

Increase the intake of foods that are rich in complex carbohydrates and fibre, such as oats, cereals, legumes, wholegrain products, dried beans, peas, lentils, fruits and vegetables. Fibre is capable of slowing down the digestion and absorption of carbohydrates and increasing the sensitivity of tissues to insulin, thereby preventing rapid rises in blood sugar. 

Alpha-lipoic acid is a vitamin-like antioxidant that enhances the glucose uptake and improves diabetic nerve damage in diabetic patients. Supplementation of alpha-lipoic acid can be considered due to limited food sources of this nutrient. 

Restrict the intake of refined and simple carbohydrates, such as white rice, white bread, table sugar, corn syrup, sweets and honey. 

Avoid high fat foods, but increase the intake of foods that are rich in omega-3 (such as cold-water fish like salmon, herring, mackerel and tuna) and omega-6 fatty acids (such as evening primrose oil, borage oil and blackcurrant oil). The omega-6 fatty acid could offer significant protection against the development of diabetic neuropathy, while the omega-3 oils could protect against the hardening of the arteries. 

Artificial sweeteners, such as aspartame and saccharin are recommended for diabetic patients. Avoid and limit the intake of alcohol. Avoid high sodium food, such as salty fish. Exercise regularly and reduce body weight. 

 

References:1. Smith LH & Gittleman AL. Diabetes. In: Encyclopedia of Natural Healing, 2nd ed. Canada: Alive Publishing Group Inc, 2002, p. 649-52.  

2. Lininger et al. Diabetes. In: The Natural Pharmacy, 2nd ed. United States of America: Healthnote Online, Inc, 1999, p. 53-8. 

3. Murray M & Pizzorno. Diabetes Mellitus. In: Encyclopedia of Natural Medicine, 2nd ed. California: Prima Publishing, 1998, p. 401-430. 

4. Reader's Digest Association. Alpha-lipoic acid. The Healing Power of Vitamins, Minerals and Herbs. Australia: Reader's Digest Pty Limited, 2000, p. 234-5. 

 

This article is courtesy of BioLife. For more information, e-mail [e-mail]. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.