Rarely is diabetes listed as the cause of death; however, it is linked to so many different degenerative diseases, such as heart disease, strokes, and even premature aging. Type II diabetes is a new epidemic among children. In the past, it was termed Adult onset diabetes to distinguish it from type I which occurred in children. Today, this term can not be used because of the growing numbers in children.
The epidemic is said to be driven by poor diet and the lack of exercise in kids. I believe that diet does play a role, and the lack of exercise to a lesser degree, however the hidden culprit is only now getting press. New research is linking toxins to the growing number of childhood cases of Type II Diabetes.
Type I Diabetes, which is an auto-immune condition where the body is attacking the beta cells in the pancreas, has been linked to genetics and toxins already. The toxic link to Type II is still not making its way into treatments even in the alternative world. This is unfortunate, because if you don’t eliminate the cause, you will never find a cure.
For any diabetic, you should be following the American Diabetes Associate standard of care, as well as supplement recommendations, and functional food recommendations to help control blood sugar.
American Diabetes Association Standard of Care
- Blood Pressure every office visit. (Goal <140/80)
- Foot Monofilament Test annually
- Eye Exam by ophthalmologist annually, but if 2 years in a row normal exam then exam every 2 years.
- Influenza vaccine: annually
- Pneumococcal vaccine: one time vaccination. However, revaccinate when >64 years old if initial vaccination was more than 5 years prior. Also repeat in patients with kidney disease or immune compromised.
- Hepatitis B vaccine: one time series of typically 3 shots in diabetics <60 years old.
- Weight loss of 7% of body weight will improve diabetes management.
- Exercise should include aerobic exercise and weight resistance exercise. (Goal 150 minutes/week)
- Alcohol Intake: Women: 1-2 drinks daily maximum. Men: 2 drinks daily maximum.
- Cardiovascular Risk Factors:
Men>50 and Women>60 with 1 or more should take baby aspirin daily
- Positive family history (father/brother with CVD<55 or mother/sister with CVD<65)
- High blood pressure
- Tobacco use
- Abnormal lipids
- Self-Exam of Feet: should examine and massage own feet 3-4 times per week to assess for any potential problems and to improve blood flow to your feet.
- Protein intake if have kidney problem:
- Early kidney problems such as albuminuria only: 1.0 gm protein/Kg of lean body weight daily.
- Definitive kidney disease: 8 gm protein/Kg of lean body weight daily.
Blood Sugar Related Labs:
- Blood sugar monitoring: Done by patient numerous times daily.
- Fasting: goal= 80-120 mg/dl
- One hour after meals: goal= 120-180 mg/dl
- Two hours after meals: goal= 100-140 mg/dl
- HgbA1c= glycosylated red blood cells. This is a percentage of red blood cells that have sugar (glucose) attached to them. The more sugar in the blood stream the higher the percentage of red blood cells that will have sugar attached (glycosylated). Red blood cells have a lifespan of 120 days, so this lab test is a good measurement every 4 months of sugar control.
Should be checked 2 times/year with good glucose control
Should be checked 4 times/year if poor sugar control or change in treatment.
- Normal range without diabetes: 4% to 6.0%
- (Goal with diabetes: <7.0%)
Kidney Related Labs:
- Creatinine: is a product of muscle contraction and should be excreted (expelled) by the kidneys. So the normal creatinine level should be low and steady: (0.5 to 1.2 mg/dl). If it is found to be high it is a sign that the kidneys, which act as a filter, are not working properly.
Should be checked annually. More frequently if have kidney damage.
- Glomerular Filtration Rate (GFR): is a test used to check how well the kidneys are working. Specifically, it estimates how much blood passes through the glomeruli each minute. Glomeruli are the tiny filters in the kidneys that filter waste from the blood. It is a mathematical calculation using the creatinine, which is supposed to flow through the kidneys and not be held onto, age and body weight. (Goal: >60)
Should be checked annually. More frequently if have kidney damage.
- 24 Hour Urine to measure Glomerular Filtration Rate: Instead of estimating the GFR this is a true measurement of a 24 hour period of a patient’s urine to measure the total creatinine in the urine and more accurately determine their GFR.
Typically only done in patients with kidney damage.
- Urine Albumin: Albumin is a protein and proteins are used by our body to build and maintain our structure; therefore, we do NOT want to lose albumin in our urine. A urine microalbumin test checks the urine to see if albumin is present? If it is, it is a sign that the kidneys are not filtering properly. (Goal: 0 to <15)
Should be checked annually.
Fasting Lipid Labs:
Should be done annually
- Triglycerides= Fat in the bloodstream. Fat is needed in the blood as a source of energy, but too much fat in the bloodstream gets deposited in the tissues.
(Goal < 150)
- Cholesterol= Fat in the bloodstream. Required to make cell membranes, bile acids, and steroids; but too much can get deposited in vessel walls as plaques. Cholesterol is also transported in the blood stream by lipoproteins.
(Goal < 200)
- Lipoproteins: Transport Cholesterol (fat) in blood.
- High Density Lipoprotein (HDL): Removes cholesterol from tissues and transports it to the liver for excretion/elimination. (“Protective”) Increased with exercise!
(Goal: Women >50, Men >40)
- Low Density Lipoprotein (LDL): Transport cholesterol (fat) to tissues for deposit. “Atherogenic” or plague builder!
(Goal: <100 patients with no cardiovascular disease
<70 patients with cardiovascular disease)
- Alpha Lipoic Acid: plays an important role in energy production, antioxidant activity, insulin signaling and cell signaling. Optimal levels of ALA may improve glucose utilization and protect against diabetic neuropathy, vascular disease and age-related cognitive decline.
Main food sources: organ meats, spinach and broccoli, Brussel sprouts and brewer’s yeast.
Recommended dose: 100-200mg daily.
- Essential Fatty Acids: Omega-3 and Omega-6 fatty acids are polyunsaturated fatty acids that cannot be synthesized by the human body. They are classifies as essential nutrients and must be obtained from dietary sources. The standard American diet is much higher in omega 6 than omega 3 fatty acids which can be pro-inflammatory. Poor omega 3 levels can by connected with dry skin/rash, poor wound healing, increased risk of infections, cardiovascular and inflammatory diseases.
Main food sources of omega 3: flaxseeds, walnuts, and Fish (mackerel, salmon, sardines)
Recommended dose: 1,000 mg to 2,000 mg daily
- Cholecalciferol or Vitamin D3: The body can synthesize vitamin D in the skin, from cholesterol, when sun exposure is adequate (hence its nickname, the “sunshine vitamin”). However, commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited and in many people conversion through sunlight is not optimal.
Main food sources: Fish, Dairy or Soy Milk fortified with vitamin D.
Recommended dose: 2,000 to 4,000 IU daily
12 Functional Foods
- Yogurt: probiotic
- Oats: boost immunity and decrease cholesterol
- Garlic: fights infection
- Shellfish: anti-viral and anti-inflammatory
- Chicken soup: anti-inflammatory
- Tea: anti-viral
- Beef: good source of zinc
- Sweet potatoes: good source of vitamin A
- Mushrooms: boost immune system
- Tumeric: anti-inflammatory and slight blood thinner
- Cinnamon: anti-inflammatory, blood thinner, and blood sugar stabilizing
- Ginger: digestive aid