Diabetes

Diabetes mellitus (DM), commonly referred to as diabetes, is a metabolic disorder in which there are high blood sugar/glucose levels over an extended period.

 

Blood Sugar

 

Blood sugar, or serum glucose, is the main sugar found in your blood.  It comes from the food you eat, and is an energy source for your body. Blood sugar can be either low, normal or high. Many functional medicine clinics take the view that a fasting blood sugar level of 75-80 is optimal.

 

Low Blood sugar <70

 

Hypoglycemia (low blood sugar) can be mild, moderate, or severe.

 

 

Signs and Symptoms

Mild Hypoglycemia

Nausea, Trembling, Cold, Clammy, Wet Skin, Rapid Heartbeat,

Moderate Hypoglycemia

Irritability/Anxiety

Severe Hypoglycemia

Confusion, Disorientation, Convulsions, Seizures

 

 

The human brain requires ½ of all the normal circulating blood sugar (glucose) to function normally.  Because the brain requires a large amount of circulating sugar to function correctly and we don’t always have access to food 24 hours a day, we can maintain blood sugar levels through other pathways.

 

If blood sugar levels start to fall, the i releases glucagon which stimulates the liver to convert stored glycogen into serum glucose.  When glucose is released into the blood stream, the pancreas secretes insulin to drive the newly formed serum glucose into the blood cells to be used as energy. 

 

Another factor that influences blood sugar is cortisol.  If serum glucose falls to a low level, the adrenal glands secrete cortisol. Cortisol works by tapping into the protein stores via muscle breakdown. The protein broken down from the muscles undergoes gluconeogenesis, which in turns raises the blood sugar levels.

 

Blood Sugar >100

 

Blood sugar levels above 100 are toxic to many functions of the body.  As blood sugar levels increase, so do Advanced Glycation End Products (AGE).  AGE are proteins or lipids that become glycated because of exposure to sugars. They can be a factor in aging and in the development or worsening of many inflammatory and degenerative disease, such as diabetes, atherosclerosis, chronic kidney disease, and Alzheimer’s disease.

 

The Brain, Liver, Muscles, and Body Fat are the 4 main matters that utilize or store glucose.

 

Brain

Accounts for 2 percent of the overall body weight but requires 20 percent of our daily calories

Liver

The liver stores 50-120 grams of glycogen

Muscles

The muscles hold 350-400 grams of glycogen

Body Fat (Adipose Tissue)

Virtually unlimited supply of glycogen and calories stored in fat cells in the form of fatty acids.

 

 

Hyperinsulinemia

 

Insulin is a hormone made by the pancreas that allows your body to use sugar from carbohydrates you eat and store them in the form of glycogen.  Its primary purpose is to ensure your body’s blood sugar does not get too high or low.  However, insulin has many other functions that are vital to the body, including:

 

Increases liver, muscle uptake of glucose

Increases fat formation

Increases glycogen syntheses

Increases amino acid uptake by the cells

Increases potassium uptake

Decreases breakdown of protein

Decreases fat breakdown (lipolysis)

Carries fatty acids into fat cells

 

 

Effects of High Carbohydrate Diet on Obesity

 

 

 

Effects of High Carbohydrate Diet on Inflammation

 

 

 

 

 

Diabetes can be diagnosed in different ways

 

  • Fasting blood sugar > 126 mg/dl on 2 separate occasions
  • Blood sugar > 200 mg/dl with symptoms of hyperglycemia
  • 2 Hour blood sugar > 200 mg/dl during an Oral Glucose Tolerance Test (OGTT)
  • Hemoglobin A1c >6.5 – the is the most common way that we diagnose diabetes in our clinic

 

Treatment of Type II Diabetes

 

The goal of diabetes treatment is to decrease the amount of insulin or other medication needed.  Many clinicians think that perfect management of diabetes equals adding additional medications until laboratory numbers look better.  This does little to reverse or improve the underlying disease process.  The only way to improve diabetes is to decrease the need for insulin and medications.

 

This is accomplished by controlling carbohydrate intake, increasing the efficiency of insulin, increasing the efficiency of the pancreas, and optimizing the endocrine systems that help regulate blood sugar.  Our clinic often recommends a daily carbohydrate intake of less than 80 grams (Total Carbohydrates) per day along with a detailed exercise regimen.  Diabetes is a disease that can be reversed with the correct lifestyle. The TV series “Biggest Loser” were off all their medications within two weeks of starting the program. The entire write up on MEDPAGE TODAY can be viewed here https://www.medpagetoday.com/meetingcoverage/aace/32981