With this medicines safety now in question, in the light of recent scientific evidence that it poses increased risk of heart attack, what are the natural medicine alternatives to Avandia

The world is currently in the grip of a diabetes epidemic due to spiralling obesity rates. But rather than encouraging people to exercise and eat well, the NHS have recently suggested increasing rates of gastric bypass surgery to save money, as the costs of treating diabetes with drugs reaches unsustainable levels. But in this current age of antibiotic resistance surgery has unnecessary risks.

The NHS spent more than half a billion pounds on just one drug for diabetes alone called Avandia in 2009. Besides moderate weight loss and regular exercise, are there also natural alternatives to help manage your diabetes? See Carahealth Blood Sugar Tonic

What is diabetes?

Diabetes is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin (Type 1 Diabetes) or because cells do not respond to the insulin (Type 2 Diabetes). Insulin essentially opens the doors of the cell to allow glucose to be used by the cell to make energy in the form of ATP. In diabetes, as insulin is not produced or not working, blood sugar remains high while the cells are starved of energy.

Over time, high blood glucose levels damage nerves and blood vessels, leading to complications such as heart disease and stroke, the leading causes of death among people with diabetes. Uncontrolled diabetes can eventually lead to other health problems as well, such as vision loss, kidney failure and amputations.

Another syndrome called polycystic ovary syndrome can occur with insulin resistance. PCOS is a syndrome in women where there is lack of ovulation and androgen excess production of androgens commonly displayed as male pattern hair growth or male pattern baldness in women.

Symptoms

High blood sugar results in the classical symptoms of diabetes known as the 3 P’s. These are

1. Polyuria (frequent urination)
2. Polydipsia (increased thirst)
3. Polyphagia (increased hunger)

There are three main types of diabetes:

1. Type 1 diabetes results from the body's failure to produce insulin, and presently requires the person to inject insulin (Also referred to as insulin-dependent diabetes mellitus, (IDDM) and juvenile diabetes).
2. Type 2 diabetes results from what is known as insulin resistance, a condition in which cells fail to use insulin properly.
3. Gestational diabetes is when pregnant women, who have never had diabetes before, have a high blood glucose level during pregnancy. It may precede development of type 2 Diabetes

Review : Physiological effects of insulin

The actions of insulin on cells include:

• Increased glycogen synthesis – insulin forces storage of glucose in liver (and muscle) cells in the form of glycogen; lowered levels of insulin cause liver cells to convert glycogen to glucose and excrete it into the blood. This is the clinical action of insulin, which is directly useful in reducing high blood glucose levels as in diabetes.
• Increased fatty acid synthesis – insulin forces fat cells to take in blood lipids, which are converted to triglycerides; lack of insulin causes the reverse. · Increased esterification of fatty acids – forces adipose tissue to make fats (i.e., triglycerides) from fatty acid esters; lack of insulin causes the reverse.
• Decreased proteolysis – decreasing the breakdown of protein.
• Decreased lipolysis – forces reduction in conversion of fat cell lipid stores into blood fatty acids; lack of insulin causes the reverse.
• Decreased gluconeogenesis– decreases production of glucose from non-sugar substrates, primarily in the liver (remember, the vast majority of endogenous insulin arriving at the liver never leaves the liver); lack of insulin causes glucose production from assorted substrates in the liver and elsewhere.
• Decreased autophagy - decreased level of degradation of damaged organelles. Postprandial levels inhibit autophagy completely.
• Increased amino acid uptake – forces cells to absorb circulating amino acids; lack of insulin inhibits absorption.
• Increased potassium uptake – forces cells to absorb serum potassium; lack of insulin inhibits absorption. Insulin's increase in cellular potassium uptake lowers potassium levels in blood.
• Arterial muscle tone – forces arterial wall muscle to relax, increasing blood flow, especially in micro arteries; lack of insulin reduces flow by allowing these muscles to contract.
• Increase in the secretion of hydrochloric acid by parietal cells in the stomach.

Natural Medicine Causes of Diabetes

From a naturopathic perspective late onset diabetes is caused by something know as insulin resistance. Very basically, insulin is not made out of thin air. Chromium, magnesium and B vitamins are just some nutrients involved in insulin production in the body. A lifetime of refined carbohydrates means that we produce far too much insulin, which can lead to nutritional deficiencies, resulting eventually in an inability to make insulin. Too much insulin can also lead to the cell receptors for insulin becoming unresponsive to insulin. This is a condition called insulin resistance.

Insulin resistance

Fat and muscle cells require insulin to absorb glucose. Insulin resistance (IR) is the condition in which normal amounts of insulin are inadequate to produce a normal insulin response from fat, muscle, and liver cells. Insulin resistance is also known as pre-diabetes. It results in blood glucose levels being higher than normal but not high enough for a diagnosis of diabetes. All these factors lead to elevated blood glucose levels known as hyperglycaemia, which is linked to metabolic syndrome and type 2 diabetes, a global pandemic.

When insulin resistance leads to Type 2 Diabetes

The most common type of insulin resistance is associated with a collection of symptoms known as metabolic syndrome. Insulin resistance can progress to full type 2 diabetes. This is often seen when hyperglycaemia develops after a meal, when pancreatic β-cells are unable to produce sufficient insulin to maintain normal blood sugar levels (euglycaemia). The inability of the β-cells to produce sufficient insulin in a condition of hyperglycaemia is what characterises the transition from insulin resistance to type 2 diabetes.

Symptoms of Insulin Resistance

1. 1. Fatigue. Many people with insulin resistance get sleepy immediately after eating a meal containing more than 20% or 30% carbohydrates
2. 2. Mental fatigue or brain fog.
3. 3. High blood sugar.
4. 4. Intestinal bloating. Most intestinal gas is produced from carbohydrates in the diet.
5. 5. Decreased synthesis of hydrochloric acid by the stomach (hypochlorydria).
6. 6. Weight gain, fat storage, and difficulty losing weight. Central obesity.
7. 7. Increased blood triglyceride levels.
8. 8. Increased blood pressure. Many people with hypertension are either diabetic or pre-diabetic. Hypertension results as insulin forces arterial wall muscle to relax (vasodilation) so in insulin resistance, the arterial wall muscles to contract (vasodilation)
9. 9. Depression. Because of the deranged metabolism resulting from insulin resistance, psychological effects are not uncommon with depression being the most prevalent.

Pathophysiology

In a person with normal metabolism, insulin is released from the beta (β) cells of the Islets of Langerhans located in the pancreas after eating ("postprandial"), which signals insulin-sensitive tissues in the body (e.g., muscle, adipose (fat cells)) to absorb glucose. This lowers blood glucose levels. The beta cells reduce their insulin output as blood glucose levels fall, with the result that blood glucose is maintained at approximately 5 mmol/L (mM) (90 mg/dL). In an insulin-resistant person, normal levels of insulin do not have the same effect on muscle and adipose cells, with the result that glucose levels stay higher than normal. To compensate for this, the pancreas in an insulin-resistant individual is stimulated to release more insulin.

• Insulin resistance in muscle and fat cells reduces glucose uptake and the storage of glucose as both glycogen and triglycerides. This results in high triglycerides in the blood known as hypertriglyceridaemia (High levels of triglycerides in the bloodstream are linked to atherosclerosis, heart disease and stroke).
• Insulin resistance in fat cells also results in elevated hydrolysis (breakdown) of stored triglycerides. This also results in hypertriglyceridaemia again resulting in increased risk of atherosclerosis, heart disease and stroke
• Insulin resistance in liver cells results in impaired glycogen synthesis also.

Causes of insulin resistance

There is clearly an inherited component, as sharply increased rates of insulin resistance and Type 2 diabetes are found in those with close relatives who have developed Type 2 diabetes. There are also grounds for suspecting that insulin resistance is related to a high-carbohydrate diet. Insulin resistance has also been linked to PCOS (polycystic ovary syndrome) as either causing it or being caused by it.

Insulin Resistance and Sugar

Insulin resistance has certainly risen in step with the increase in sugar consumption and the commercial usage of HFCS (high fructose corn syrup, currently the least expensive nutritive sweetener available). Studies have linked insulin resistance to increased amounts of fructose (i.e. HFCS). Fructose causes changes in blood lipid profiles due to its effects on liver function. High amounts of ordinary sucrose (i.e. table sugar) are also suspected of having some causative effect on the development of insulin resistance (sucrose is 1/2 fructose).

Hyperinsulinaemia and Insulin Resistance

Prolonged and repeated elevations of circulating insulin contribute to insulin resistance via down-regulation of insulin receptors. Elevated blood glucose levels are the primary stimulus for insulin secretion and production so excessive refined High GI carbohydrate intake is the main causes.

Inflammation and Insulin Resistance

Inflammation is also implicated in causing insulin resistance. Studies have shown that insulin resistance do not develop under dietary conditions that normally produce it in the absence of inflammatory mediators such as interleukin 6 (IL6) and tumour necrosis factor TNFalpha).

Vitamin D deficiency

Vitamin D deficiency is also associated with insulin resistance.

Other Contributing Factors

Various disease states make the body tissues more resistant to the actions of insulin. Examples include infection (mediated by the cytokine TNFα) and acidosis. Recent research is investigating the roles of adipokines (the cytokines produced by adipose tissue) in insulin resistance. Certain drugs may also be associated with insulin resistance (e.g., glucocorticoids). Insulin itself can lead to insulin resistance; every time a cell is exposed to insulin, the production of GLUT4 (type four glucose receptors) on the cell's membrane is decreased. This leads to a greater need for insulin, which again leads to fewer glucose receptors. Exercise reverses this process in muscle tissue, but if left unchecked, it can spiral into insulin resistance.

Insulin resistance is often found in people with central obesity, hypertension, hyperglycaemia and dyslipidaemia involving elevated triglycerides, small dense low-density lipoprotein (sdLDL) particles, and decreased HDL cholesterol levels.

Central obesity

Central obesity is related to fat cells called visceral adipose cells. These fat cells produce significant amounts of proinflammatory cytokines such as tumour necrosis factor-alpha (TNF-a), and Interleukins-1 and -6, etc. Proinflammatory cytokines profoundly disrupt normal insulin action in fat and muscle cells, and may be a major factor in insulin resistance Central obesity is also related to an accumulation of fat in the liver, a condition known as nonalcoholic fatty liver disease (NAFLD). The result of NAFLD is an excessive release of free fatty acids into the bloodstream and an increase in hepatic glucose production, both of which have the effect of exacerbating insulin resistance and increasing the likelihood of type-2 diabetes.

Magnesium Deficiency

Magnesium (Mg) is present in living cells and its plasma concentration is remarkably constant in healthy subjects. Magnesium levels are closely related to insulin. Poor intracellular Magnesium concentrations are found in noninsulin-dependent diabetes mellitus (NIDDM) and in hypertensive patients, By contrast, in NIDDM patient’s daily magnesium administration improves insulin sensitivity.

Bad fats

Some types of Monounsaturated fatty acids and saturated fats appear to promote insulin resistance, whereas some types of polyunsaturated fatty acids (omega-3 can increase insulin sensitivity.

Metabolic Syndrome

Insulin resistance may be part of what is known as metabolic syndrome. Metabolic syndrome is a grouping of traits and medical conditions that puts people at risk for both heart disease and type 2 diabetes. This prediabetic condition is characterised by a group of symptoms including elevated waist circumference, elevated levels of triglycerides, elevated blood pressure, low levels of HDL (good) cholesterol, elevated blood pressure and elevated fasting blood glucose levels.

Complications of diabetes

Excess circulating glucose and triglycerides leads to what is known as microvascular disease. This is a disease of the tiny blood vessels in the body, including the capillaries. Microvascular complications of diabetes include diabetic nephropathy, diabetic neuropathy and diabetic retinopathy.

Diabetic nephropathy

Diabetic nephropathy is a progressive kidney disease caused by disease of the small blood vessels in the kidney glomeruli. It is characterised by nephrotic syndrome and diffuse glomerulosclerosis. It is due to longstanding diabetes mellitus, and is a prime indication for dialysis and transplant in many Western countries.

Diabetic neuropathy

Diabetic neuropathy disorders affecting the nerves that are associated with diabetes mellitus. These conditions are thought to result from diabetic microvascular injury involving small blood vessels that supply nerves. The microvascular complications of diabetes such as neuropathy can lead to loss of sensation and the development of foot ulcers.

Diabetic retinopathy

Diabetic retinopathy is damage to the retina caused by complications of diabetes mellitus, which can eventually lead to blindness. It is an ocular manifestation of systemic disease, which affects up to 80% of all patients who have had diabetes for 10 years or more.

Risk factors for heart disease and stroke in people with diabetes

Family history of heart disease

If one or more members of your family had a heart attack at an early age (before age 55 for men or 65 for women), you may be at increased risk.

Central obesity

Central obesity means carrying extra weight around the waist, as opposed to the hips. A waist measurement of more than 40 inches for men and more than 35 inches for women means you have central obesity. Your risk of heart disease is higher because abdominal fat can increase the production of LDL (bad) cholesterol, the type of blood fat that can be deposited on the inside of blood vessel walls.

Having abnormal cholesterol or triglyceride levels

LDL cholesterol can build up inside your blood vessels, leading to narrowing and hardening of your arteries. High levels of LDL cholesterol raise your risk of getting heart disease. Triglycerides are a blood fat that raises your risk of heart disease when the levels are high.HDL (good) cholesterol removes deposits from inside your blood vessels and takes them to the liver for removal. Low levels of HDL cholesterol increase your risk for heart disease.

Hypertension

If you have high blood pressure, your heart must work harder to pump blood. High blood pressure causes strain on the heart, damages blood vessels and increases your risk of heart attack, stroke, eye problems, and kidney problems.

Smoking

Smoking doubles your risk of getting heart disease. Smoking and diabetes narrow blood vessels. Smoking also increases the risk of other long-term complications, such as eye problems. In addition, smoking can damage the blood vessels in your legs and increase the risk of amputation.

Diabetes in Ireland

The Diabetes Federation of Ireland says there could be as many as 200,000 people in Ireland unaware that they have the condition, in addition to 200,000 who are diagnosed with diabetes. The number of people with diabetes in Ireland is expected to double by 2010, fuelled mainly by our growing obesity rates caused by poor diet and sedentary lifestyles. The report points out that St James's Hospital in Dublin says it is seeing an increase of 20% each year in patients it diagnoses with type 2 diabetes. Most worryingly, it is estimated that up to 50% of people with diabetes are undiagnosed or are unaware of their condition.

Ireland has fallen behind other EU countries in tackling the growing diabetes epidemic, according to a major new report. Ireland is one of 14 EU member states that has no strategy in place for tackling what can be a killer disease, the report by the International Diabetes Federation (IDF) European Region and the Federation of European Nurses in Diabetes (FEND), has revealed.

Medical management

Treatment

Both metformin and the thiazolidinediones improve insulin resistance, but are only approved therapies for type 2 diabetes, not insulin resistance, per se. Metformin has become one of the more commonly prescribed medications for insulin resistance, and currently a newer drug, exenatide (marketed as Byetta), is being used. The Diabetes Prevention Program showed that exercise and diet were nearly twice as effective as metformin at reducing the risk of progressing to type 2 diabetes.

Avandia

Avandia also known as Rosiglitazone is an anti-diabetic drug. It is known as what is called an insulin sensitiser. This means that the drug binds to receptors in fat cells and muscle making the cells more responsive to insulin. It is marketed by the pharmaceutical company GlaxoSmithKline (GSK) as a stand-alone drug (Avandia) and in combination with metformin (Avandamet) or with glimepiride (Avandaryl). Annual sales peaked at approx $2.5bn in 2006, but declined after reports of adverse effects.

Side effects of Avandia

A study in 2007, found that Avandia may increase the risk of heart attack by as much as 43%. Avandia has also been linked to stroke. In some studies, it was found that the drug increases the risk of stroke by over 27%. GlaxoSmithKline reported a greater incidence of fractures of the upper arms, hands and feet in female diabetics given rosiglitazone compared with those given another anti-diabetic drug metformin. Avandia has also been suspected of causing macular oedema, which damages the retina of the eye and causes partial blindness. Avandia has also been shown to cause moderate to severe acute hepatitis in several adults who had been taking the drug at the recommended dose for 2–4 weeks.

The FDA began investigating the drug in 2007 after it was reported that it likely caused an increased risk in heart attacks, but following a 2007 study, an FDA advisory panel agreed that Avandia did not cause a statistically significant increase in heart attacks. The FDA voted to keep the drug on the market, however a few months later the agency added a black-box warning about potential heart risks of Avandia. The drug is currently the subject of many lawsuits against GSK. Over 13,000 have been brought against the company due to the drug. As of July 2010, GSK has agreed to settlements on more that 11,500 of these suits.

The drug is currently being investigated in the US and in Europe. The decisions by the European Medicines Agency (EMEA) and by the US FDA are both expected to come in September 2010. The EMEA and the FDA may vote to take the drug off the market, revise the warning labels and/or prescribing information, or leave it on the market with no changes.

Natural Medicine Treatment Principles in both Type 1 and Type 2 Diabetes

1. Lower blood sugar (hypoglycaemic herbs).
2. Improve insulin sensitivity (exercise, herbal medicine, supplements).
3. Protect against the risks of diabetes including cardiovascular disease, retinopathy, nephropathy and peripheral neuropathy.
4. Lower tirglycerides, total cholesterol, LDL, increase HDL.
5. Promote weight loss particularly central obesity.
6. Reduce inflammatory mediators including CRP, IL6, IL1, TNF alpha.
7. Replace nutritional deficiencies, Vitamin D, zinc, chromium, magnesium, B complex.

Natural Medicine Alternatives to Avandia

There are a number of safe and effective natural alternatives to Avandia and other anti-diabetic medication. Focus is to encourage weight loss, exercise and a Low GI diet combined with herbal medicine and nutritional supplements to improve insulin sensitivity and regulate blood sugar.

Herbal Medicine

Try Carahealth Blood Sugar Tonic

Cinnamon Cinnamonum zeylanicum, Gymnema Gmynema sylvestra, Globe artichoke Cynara scolymus, Nettle Urtica dioica, Fenugreek Trigonella foenum-graecum, Milk thistle Silybum marinarum and Bilberry Vaccinium myrtillus.

Carahealth Blood Sugar Support contains hypoglycaemic herbs specifically formulated to prevent sharp rises in blood sugar and to lower blood sugar levels. The tincture also reduces cravings for sugar by blocking sugar receptors in the tongue. It is indicated for reactive hypoglycaemia (This results from initial high blood sugar and resultant pancreatic dumping of insulin), and can alleviate symptoms including hunger, shakiness, nervousness, sweating, dizziness or light-headedness, confusion, difficulty speaking, anxiety, weakness.

The mix is specific to treat and prevent type 2 diabetes mellitus and is also useful to manage sugar levels in type 1 diabetes. The herbs potentiate the effect of prescribed insulin so that less insulin will be required under medical supervision. More broadly the tincture can treat Metabolic Syndrome, a condition associated with blood sugar imbalance, fasting hyperglycemia, diabetes mellitus type 2, insulin resistance, high blood pressure, central obesity, decreased HDL cholesterol and elevated triglycerides.

Cinnamon bark Cinnamonum zeylanicum

Though not yet evaluated by the Food and Drug Administration, at least two studies have shown that cinnamon can act significantly reducing some effects of diabetes. The study on people published in 2003 conducted in the Department of Human Nutrition, NWFP Agricultural University, Peshawar, Pakistan concluded:

The results of this study demonstrate that intake of 1, 3, or 6 g of cinnamon per day reduces serum glucose, triglyceride, LDL cholesterol, and total cholesterol in people with type 2 diabetes and suggest that the inclusion of cinnamon in the diet of people with type 2 diabetes will reduce risk factors associated with diabetes and cardiovascular diseases.

Cinnamon slows the rate at which the stomach empties after meals, reducing the rise in blood sugar after eating. Cinnamon may also significantly help people with type 2 diabetes improve their ability to respond to insulin, thus normalising their blood sugar levels. Cinnamon improves insulin activity.

Many people with insulin resistance and diabetes add cinnamon in therapeutic doses to their diet to help control blood sugar. This has the danger of increasing the risk of bleeding, since most commercial cinnamon preparations are actually from cassia, which also has anticoagulants, though true cinnamon cinnamomum sp. zeylonicum, or sp. verum, does not. It should be noted that the spice sold as cinnamon is often obtained from C. verum (true cinnamon), not C. aromaticum (cassia).

Gymnema / Gurmari Gmynema sylvestra

Gymnema is antidiabetic, antisweetener and anti-inflammatory. While it is still being studied, and the effects of the herb are not entirely known, the herb has been shown to reduce blood sugar levels when used for an extended period of time. Additionally, Gymnema reduces cravings for sugar by blocking sugar receptors in the tongue, thus some use it to fight sugar cravings. Extract of the leaves were isolated glycosides known as Gymnemic acids, which exhibit anti-sweet activity. The active ingredient is thought to be gurmenic acid, which has structure similar to saccharose. Extracts of Gymnema is not only claimed to curb a sweet tooth but also for treatment of as varied problems as hyperglycemia, obesity, high cholesterol levels, anaemia and digestion.

Globe artichoke Cynara scolymus

Globe artichoke is anticholesterolemic, antirheumatic, cholagogue, digestive, diuretic, hypoglycaemic and lithotropic. The globe artichoke has become important as a medicinal herb in recent years following the discovery of cynarin. This bitter-tasting compound, which is found in the leaves, improves liver and gall bladder function, stimulates the secretion of digestive juices, especially bile, and lowers blood cholesterol levels. Globe artichoke is used internally in the treatment of chronic liver and gall bladder diseases, jaundice, hepatitis, arteriosclerosis and the early stages of late-onset diabetes.

Nettle leaf Urtica dioica

Nettles are rich in vitamins A, C, D, iron, potassium, manganese, and calcium and chlorophyll making nettle an excellent blood tonic and remedy in anaemia and other debilitated states. They strengthen and support the whole body. Urtica has been shown experimentally to have both hypoglycaemic and hyperglycaemic properties, the hypoglycaemic component being ‘urticin’. Nettle leaf extract contains active compounds that reduce TNF-α and other inflammatory cytokines.

Fenugreek seeds Trigonella foenum-graecum

Fenugreek is much used in herbal medicine, especially in North Africa, the Middle East and India. Research has shown that the seeds can inhibit cancer of the liver, lower blood cholesterol levels and also have an antidiabetic effect. The seed yields a strong mucilage and is therefore useful in the treatment of inflammation and ulcers of the stomach and intestines. The seed is very nourishing and bodybuilding and is one of the most efficacious tonics in cases of physical debility caused by anaemia or by infectious diseases, especially where a nervous factor is involved. It is also used in the treatment of late-onset diabetes, poor digestion (especially in convalescence), insufficient lactation, painful menstruation, labour pains etc.

Milk thistle Silybum marinarum

Milk thistle is the trophorestorative of the liver. Milk thistle is used to increase the secretion and flow of bile from the liver and gall bladder and contains constituents, which protect liver cells from chemical damage. Silymarin, an extract from the seed, acts on the membranes of the liver cells preventing the entry of virus toxins and other toxic compounds and thus preventing damage to the cells from toxic chemicals and medications. It is used internally in the treatment of liver and gall bladder diseases, jaundice, cirrhosis, hepatitis and poisoning. It is indicated in skin complaints associated with a sluggish liver. As the liver breaks down glycogen into glucose between meals, taking a liver remedy is part of the naturopathic approach to balancing blood sugar.

Bilberry Vaccinium myrtillus

Bilberry is a remedy for diabetes if taken for a prolonged period. The leaves contain glucoquinones, which reduce the levels of sugar in the blood. Bilberry will help prevent retinopathy.

Nutritional Supplements for Diabetes

Vitamin E and diabetes

People with diabetes have a higher than usual need for vitamin E, which improves insulin activity and acts as an antioxidant and a blood oxygenator. Research has shown that people with low blood levels of vitamin E are more likely to develop Type 2 diabetes. Double-blind studies show that vitamin E improves glucose tolerance in people with Type 2 diabetes (NIDDM). Vitamin E was found to improve glucose tolerance in elderly non-diabetics.

A vitamin E deficiency results in increased free-radical-induced damage, particularly of the lining of the vascular system. Supplemental vitamin E may help prevent diabetic complications through its antioxidant activity, the inhibition of the platelet-releasing reaction and platelet aggregation, increasing HDL-cholesterol levels and its role in fatty acid metabolism. Vitamin E protects animals from diabetic cataracts. The most impressive study on vitamin E and diabetes used a total of 1,350 international units of d-alpha-tocopheryl acetate daily, divided into three doses. Begin by taking 400 international units each morning. After two weeks, add another dose of 400 international units in the evening. After two more weeks, add another 400 international units in the afternoon. The trace mineral selenium functions synergistically with vitamin E.

Note: If you have high blood pressure, limit your intake of supplemental vitamin E to a total of 400 international units daily. If you are taking an anticoagulant (blood thinner), consult your physician before taking supplemental vitamin E.

Vitamin C and insulin

People with Type 1 diabetes (IDDM) have low vitamin C levels. Vitamin C lowers sorbitol in diabetics. Sorbitol is a sugar that can accumulate and damage the eyes, nerves, and kidneys of diabetics. Vitamin C may improve glucose tolerance in Type 2 diabetes (NIDDM).

The transport of vitamin C into cells is facilitated by insulin. It has been postulated that, due to impaired transport or dietary insufficiency, a relative vitamin C deficiency exists in the diabetic and that this may be responsible for the increased capillary permeability and other vascular disturbances seen in diabetics. Dosage is 1-3 grams per day of vitamin C in the form of calcium ascorbate or magnesium ascorbate.

Vitamin B6 (Pyridoxine) and diabetics

Diabetics with neuropathy have been shown to be deficient in vitamin B6 and benefit from supplementation. Peripheral neuropathy is a known result of pyridoxine deficiency and is indistinguishable from diabetic neuropathy. Vitamin B6 supplements improve glucose tolerance in women with diabetes caused by pregnancy. Vitamin B6 is also effective for glucose intolerance induced by the birth control pill. 100 mg per day of vitamin B6-pyridoxine improves glucose tolerance dramatically. Pyridoxine is also important in preventing other diabetic complications because it is an important coenzyme in the cross-linking of collagen and inhibits platelet aggregation.

Vitamin B12 and peripheral neuropathy

Vitamin B12 supplementation has been used with some success in treating diabetic neuropathy. It is not clear if this is due to the correcting of a deficiency state or normalising vitamin B12 metabolism. Vitamin B12 is needed for normal functioning of nerve cells. Vitamin B12 taken orally, intravenously, or by injection reduces nerve damage caused by diabetes in most people. Oral supplementation may be sufficient, but intramuscular vitamin B12 may be necessary in many cases. Dosage is 500 mcg of Vitamin B12 three times per day.

Biotin and glucose metabolism

Biotin is a B vitamin needed to process glucose. It has been shown to work synergistically with insulin and independently in increasing the activity of glucokinase. This enzyme is responsible for the first step in glucose utilization. Glucokinase is present only in the liver, where, in diabetics, its concentration is very low. Supplementation with large quantities of biotin may significantly enhance glucokinase activity, thereby improving glucose metabolism in diabetics. When people with Type 1 diabetes (IDDM) were given 16 mg of biotin per day for just one week, their fasting glucose levels dropped by 50%. Similar results have been reported using 9 mg per day for two months in people with Type 2 diabetes (NIDDM). Biotin may also reduce pain from diabetic nerve damage. Take 16 mg of biotin for a few weeks to see if blood sugar levels will fall.

Cautions with niacin and glucose

High levels-several grams per day-of niacin, a form of vitamin B3, impair glucose tolerance, so, avoid it if you are diabetic. Smaller amounts (500-750 mg per day for one month followed by 250 mg per day) of niacin may help some people with Type 2 diabetes (NIDDM).

Chromium and Glucose Tolerance Factor GTF

Cholesterol and triglycerides are risk factors in heart disease and diabetes and studies show that chromium lowers levels of total cholesterol, LDL, cholesterol and triglycerides. Chromium supplements such as chromium picolinate have been shown to improve glucose tolerance in people with type 2 diabetes.

As a key constituent of the 'glucose tolerance factor,' chromium is a critical nutrient in diabetes. Supplementation in the form of chromium picolinate (200 mcg 2 x daily) has been demonstrated to decrease fasting glucose levels, improve glucose tolerance, lower insulin levels and decrease total cholesterol and triglyceride levels, while increasing HDL-cholesterol levels.

Double-blind research shows that chromium supplements improve glucose tolerance in people with both Type 1 and Type 2 diabetes, apparently by increasing sensitivity to insulin. Chromium improves the processing of glucose in people with pre-diabetic glucose intolerance and in women with diabetes associated with pregnancy. The typical amount of chromium used in research trials is 200 mcg per day. Some doctors recommend up to 1,000 mcg per day of Chromium for diabetics. Niacin administered at relatively low levels (100 mg) along with 200 mcg of chromium has been shown to be more effective than chromium alone. Exercise increases tissue chromium concentrations.

Manganese and glucose metabolism

Manganese is an important cofactor in the key enzymes of glucose metabolism. A deficiency of manganese was found to result in diabetes in guinea pigs. It also resulted in the frequent birth of offspring who develop pancreatic abnormalities or no pancreas at all. Diabetics have been shown to have only one-half the manganese of normal individuals.

Magnesium and diabetes

Magnesium levels are significantly lowered in diabetics, and lowest in those with severe retinopathy. Studies suggest that a deficiency in magnesium may worsen the blood sugar control in Type 2 diabetes. Scientists believe that a deficiency of magnesium interrupts insulin secretion in the pancreas and increases insulin resistance in the body's tissues.

Supplementation with magnesium leads to improved insulin production in elderly people with Type 2 diabetes. Elders without diabetes may also produce more insulin as a result of magnesium supplements. Insulin requirements are lower in people with Type 1 diabetes who supplement with magnesium.

Diabetes-induced damage to the eyes is more likely to occur to magnesium-deficient people with Type 1 diabetes (IDDM). In pregnant women with IDDM who are magnesium deficient, the lack of magnesium may even account for the high rate of spontaneous abortion and birth defects associated with IDDM. Low magnesium levels appears to be a significant risk factor in the development of cardiovascular disease, particularly coronary artery spasm. The therapeutic dose in diabetics with normal kidney function is 300-400 mg of magnesium per day.

Vanadium an diabetes

A form of vanadium, vanadyl sulfate, seems to improve glucose control in people with type 2 diabetes. Vanadium is a compound found in tiny amounts in plants and animals. Early studies showed that vanadium normalized blood glucose levels in animals with Type 1 and Type 2 diabetes. A recent study found that when people with diabetes were given vanadium, they developed a modest increase in insulin sensitivity and were able to decrease their insulin requirements.

Benfotiamine, a pro-vitamin of vitamin B1 and diabetes

Benfotiamine has been in use in Europe as an over-the-counter medicine for alcoholic neuropathy for the past half century with no significant side-effects or toxicity, has recently been found to block the major metabolic pathways by which excess blood glucose in the body is transformed into the advanced glycation endproducts (AGEs) which cause diabetic complications.

Studies have shown that taking oral benfotiamine can prevent diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy independently of any affect on the blood sugar levels of the patient. In theory, taking benfotiamine might allow patients to be less scrupulous in trying to normalize blood sugar levels and thus free them from the danger of hypoglycemia and the stress of stringent blood sugar monitoring, while still protecting them against the negative effects of hyperglycemia. Research is ongoing to establish the full significance of benfotiamine in the treatment of diabetes.

Zinc and diabetes

Zinc deficiency has been suggested to play a role in the development of diabetes in humans. Zinc is involved in virtually all aspects of insulin metabolism including synthesis, secretion and utilisation. Zinc also has a protective effect against beta cell destruction, and has well-known anti-viral effects. People with Type 2 diabetes (NIDDM) also have low zinc levels, caused by excess loss of zinc in their urine, which may impair immune function.

Zinc supplements have lowered blood sugar levels in people with IDDM. People with NIDDM are recommended to supplement their diet with moderate amounts of zinc (15-50 mg per day) as a way to correct for the deficit. Note: Take zinc with food to prevent stomach upset. If you take over 30 milligrams of zinc on a daily basis for more than one or two months, you should also take 1 to 2 milligrams of copper each day to maintain a proper mineral balance.

Coenzyme Q10 and diabetes

People with diabetes cannot adequately process carbohydrates. Coenzyme Q10, or CoQ10, is needed for normal carbohydrate metabolism. Coenzyme Q10 is an antioxidant that fights free-radical damage and is a blood oxygenator. Animals with diabetes are CoQ10 deficient. In one trial, blood sugar levels fell substantially in 31% of people with diabetes after they supplemented with 120 mg of CoQ10 per day. Because the eye is so richly supplied with tiny blood vessels, this is another nutrient that can help in cases of retinopathy. Take 50 milligrams of coenzyme Q10 twice daily for up to three months, then reduce the dosage to 30 milligrams daily.

Inositol and diabetes

Inositol is needed for normal nerve function. Diabetes can cause nerve damage, or diabetic neuropathy. Some of these abnormalities have been reversed by inositol supplementation (500 mg taken twice per day).

ALA and GLA and diabetes

Alpha-lipoic acid (ALA) is a powerful natural antioxidant. It has been used to improve diabetic neuropathies (at an intake of 600 mg per day) and has reduced pain in several studies. Gamma-linolenic acid (GLA), found in black currant seed oil, borage oil, and evening primrose oil, has been shown to be helpful for improving damaged nerve function, which is common in diabetes. Supplementing with 4 grams of evening primrose oil per day for six months has been found to reverse the cause of diabetic nerve damage and improve this painful condition. In double-blind research, 6 grams per day helps reduce nerve damage in people with both Type 1 and Type 2 diabetes (IDDM and NIDDM). Take 500 to 1,000 milligrams of any of these oils twice daily.

Carnitine and diabetes

Carnitine is a substance needed for the body to properly use fat for energy. When diabetics are given carnitine (1 mg per 2.2 pounds of body weight), high blood levels of fats-both cholesterol and triglycerides-dropped 25-39% in just ten days. In addition, carnitine improves the breakdown of fatty acids, possibly playing a role in preventing diabetic ketoacidosis.

Taurine and diabetes

Taurine is an amino acid found in protein-rich food. People with Type 1 diabetes (IDDM) have low taurine levels, that lead to "thickened" blood-a condition which increases the risk of heart disease. Supplementing taurine (1.5 grams per day) restores taurine levels to normal and corrects the problem of blood viscosity within three months.

Mushrooms and diabetes

Research has shown the Maitake mushroom Grifola frondosa has a hypoglycemic effect, and may be beneficial for the management of diabetes. The reason Maitake lowers blood sugar is due to the fact the mushroom naturally acts as an alpha glucosidase inhibitor. Other mushrooms like Reishi, Agaricus blazei, Agrocybe cylindracea and Cordyceps have been noted to lower blood sugar levels to a certain extent, although the mechanism is currently unknown.

Dietary Advice for Diabetes

Adopt a general anti-inflammatory diet to reduce IL6, IL1, TNF alpha & CRP

Mediterranean diet lower CRP, IL1 & IL6

Levels of C-reactive protein can be decreased by increasing consumption of fruits and vegetables. Sticking to a Mediterranean diet, high in fruits and vegetables and low in saturated fats, lowers levels of inflammation as reflected by lower levels of C-reactive protein, IL1 and IL6.

Foods high in fibre lower CRP, IL1 & IL6

In a study of 524 healthy adults, investigators found that those with the highest fibre intake had lower blood levels of C-reactive protein CRP than those who ate the least fibre. The findings support the general recommendation that adults get 20 to 35 grams of fibre per day in the form of fruits, vegetables, beans and whole grains. Both of the main forms of fibre, soluble and insoluble, were related to lower CRP levels. Soluble fibre is found in oatmeal, beans, berries and apples, while whole grains and many vegetables are good sources of insoluble fibre. American Journal of Clinical Nutrition, April 2006.

Flavonoids lower C-reactive protein

Intake of dietary flavonoids is inversely associated with serum CRP concentrations in U.S. adults. Intake of flavonoid-rich foods reduces inflammation-mediated chronic diseases. Food sources of flavonoids include, tea, green tea, apples, apricots, blueberries, pears, raspberries, strawberries, black beans, cabbage, onions, parsley, pinto beans and tomatoes.

Vitamin C lowers C-reactive protein

Vitamin C treatment significantly reduces C-reactive protein.

Omega-3 fatty acids lower CRP, IL1 & IL6

Higher intake of n–3 polyunsaturated fatty acids from marine or fish is inversely associated with serum C-reactive protein (CRP) concentrations. Therefore, eating more fish or taking fish oil capsules can reduce C reactive protein levels.

Dark chocolate lowers C-reactive protein

Consuming dark chocolate can reduce C-reactive protein levels.

General Anti-inflammatory Diet

Certain foods contain compounds which are naturally anti-inflammatory. Examples of such compounds are omega 3, curcumin, resveratrol and flavonoids. Eat plenty of berries and cherries and fruits and vegetables.

• Minimise saturated and trans fats.
• Eat a good source of omega-3 fatty acids, such as fish or fish oil supplements, walnuts and flax.
• Reduce intake of refined carbohydrates such as pasta and white rice.
• Eat plenty of whole grains such as oats, brown rice and bulgur wheat.
• Cut back on red meat and full-fat dairy foods.
• Eat lean protein sources such as chicken.
• Avoid refined foods and processed foods.
• Ginger, curry, and turmeric have an anti-inflammatory effect.
• Green tea and tea are rich in flavonoids.

Eat Bitter Melon

Actions of bitter melon

Abortive, contraceptive, antimicrobial,antifungal, bitter, cardiotonic (tones, balances, strengthens the heart), digestive stimulant, emetic (causes vomiting), hypocholesterolemic (lowers cholesterol), hypoglycemic, menstrual stimulator, purgative (strong laxative), vermifuge (expels worms)

Indications

• Diabetes
• High cholesterol and triglyceride levels
• H. pylori ulcers
• Bitter digestive aid for intestinal gas, bloating, stomach ache, and sluggish digestion
• Intestinal parasites

The traditional South American remedy for diabetes is to juice 1-2 fresh bitter melon fruits and drink twice daily.

Eat foods high in fibre

Foods high in fibre help lower blood cholesterol. Oat bran, oatmeal, whole-grain breads and cereals, dried beans and peas (such as kidney beans, pinto beans, and black-eyed peas), fruits, and vegetables are all good sources of fibre.

Reduce saturated fat

Saturated fat raises your blood cholesterol level. Saturated fat is found in meats, poultry skin, butter, dairy products with fat, shortening, lard, and tropical oils such as palm oil.

Coconut oil  (the new olive oil)

Coconut oil, as a virgin coconut oil, is cholesterol free. Coconut oil contains medium-chain triglycerides, when these are digested they go straight to the liver and are transformed into energy, not fat. Coconut oil contains fewer calories than many other oils and fats. Coconut oil is high in lauric acid, which is a key constituent of breast milk. Lauric acid is believed to have both anti–viral and anti–fungal properties, helping to prevent and treat health problems such as yeast infections and candida. Coconut oil oil has been used for centuries in Eastern Ayurvedic Medicine to prevent and treat conditions including diabetes, viral infections and cardiovascular problems. Coconut oil is thermogenic, which means it helps to increase the body’s metabolism, contributing to increased energy levels and weight loss.

Minimise cholesterol

Keep the cholesterol in your diet to less than 300 milligrams a day. Cholesterol is found in meat, dairy products, chocolate and eggs.

Avoid trans/ hydrogenated fats

Trans fats raises blood cholesterol. They are often in crackers, biscuits, snack foods, commercially prepared baked goods, cake mixes, microwave popcorn, fried foods and even salad dressings. Some margarines have trans fat. Check the label for trans fat. Some big chains are now cottoning on that we want these removed.

Quit smoking

Lifestyle Advice

Tai Chi and Qi Gong

A pilot study has also found evidence that Tai Chi and Qi Gong reduce the severity of Type 2 diabetes.

Increase physical activity

Aim for at least 30 minutes of exercise most days of the week. Think of ways to increase physical activity, such as taking the stairs instead of the elevator. Reach and maintain a healthy body weight. Being a healthy weight range can lower your risk of diabetes, heart disease and stroke but even many types of cancer including colon, breast and prostate.

Exercise reverses insulin resistance by increasing GLUT4 receptors on the cell to improve insulin sensitivity. Beware of exercise studies shown to improve insulin sensitivity. Recommended exercise should improve cardiovascular health and insulin sensitivity too.

For further details on this topic, to lecture for your group or institution on this subject. or to arrange an online appointment contact Carina This email address is being protected from spambots. You need JavaScript enabled to view it..

Carina Harkin BHSc.Nat.BHSc.Hom.BHSc.Acu.

Cert IV TAE. ARCHTI mem.